You may use ARTHRO-IONX along with other medications or supplements. It is homeopathic in nature and so it will not negatively interact with other physical substances. You can use Tramadol along with ARTHRO-IONX to provide comfort while healing is occurring. Healing takes more time than just suppressing symptoms. ARTHRO-IONX helps to stimulate healing. In addition I find it helpful to follow a holistic approach by giving some nutritional supplements to accompany ARTHRO-IONX. The supplements I recommend are Canine Probiotics, Vitamin C, and Omega 3,6,9. ARTHRO-IONX will help the body to better utilize the nutrition for a synergistic response. Please let us know how you progress or if you have any other questions.