Mixing Tianeptine (gas station heroin) and Tramadol
Dangerous
Both can cause seizures, and together they stack two opioids.
Do this
Do not combine. Keep naloxone nearby.
Where the risk isTap for why
What to do
- Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
- Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
- Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
- Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
- Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
- Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.
What “Dangerous” means
High risk of death or life-changing injury. Do not combine.
How the ratings workThe longer explanation
Seizures are among the serious effects reported to the FDA from tianeptine products, and tramadol lowers the seizure threshold on top of adding a second opioid.
Sources (3)
- FDA warns consumers not to purchase or use any tianeptine product due to serious risks. 2025fda.gov
- Gassaway MM et al. The atypical antidepressant and neurorestorative agent tianeptine is a μ-opioid receptor agonist. Transl Psychiatry. 2014nature.com
- El Zahran T et al. Characteristics of Tianeptine Exposures Reported to the National Poison Data System — United States, 2000–2017. MMWR. 2018pmc.ncbi.nlm.nih.gov
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Other names
- Tianeptine
- gas station heroin, tianaa, zaza red, neptune's fix, pegasus, td red
- Sold as a supplement — at the doses people take, a full opioid
Also searched asgas station heroin and tramadol, tianaa and tramadol
Related combinations
Tianeptine withWhat not to mix with Tianeptine →
Tramadol withWhat not to mix with Tramadol →
All combinations →Can you mix Tianeptine (gas station heroin) and Tramadol?
MixSafe rates mixing Tianeptine and Tramadol as "Dangerous" — high risk of death or life-changing injury. Do not combine. Source: MixSafe research. Educational information, not medical advice.