When is it safe to take Xanax ER after taking tramadol?

That’s a good question. I’d seriously ask your pharmacist. Last year I injured my back and my doc prescribed tramadol 50mgs for the back and He gave me 10 .50mgs Xanax because I was having some serious anxiety related to the back injury. When I went to pick them up, the guy at the counter told me the pharmacist wanted to consult with me, I said ok, (they never need to talk to me.) The pharmacist told me I could absolutely not take the Xanax and the tramadol together. That surprised me because both were low doses, then I asked your question, how far apart can I take them, and she said she wouldn’t take them together at all. She said with both of those drugs in my system I could have serious breathing issues, and honestly, it scared me enough that I didn’t take the tramadol (and I was in a lot of pain). Doing internet research, Benzos and opioids do not mix. I would recommend having a conversation with your pharmacist or doctor regarding that question. Probably not what you wanted to hear, but truthful. Dealing with pain on top of anxiety is miserable. Hang in there.