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. Arthro-IonX helps to decrease pain and inflammation and 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 digestive enzymes with meals, MSM, probiotics, and fish oil. Arthro-IonX will help the body to better utilize the nutrition for a synergistic response. Once your dog is feeling better you could try to reduce the amount of Rimadyl or Tramadol as long as you are still achieving a level of comfort. If you overwork the liver and kidneys metabolizing the drugs it will make the arthritis symptoms worse in the long run. Please let us know how you do or if you have any other questions.