Clover tells me that he has mixed tramadol
before. The result wasn't necessarily bad, but he says that alcohol tends to make the tramadol less effective for him.
Pharmacologically it's never a good idea to mix alcohol with any drug
. Alcohol combined with other drugs
tends to increase the risk of liver and kidney damage. This is not something that is specific to tramadol, but it is specific to alcohol. Alcohol is a very 'dirty' drug pharmacologically speaking. Alcohol affects a wide array of different biochemical processes in the body, it permeates nearly all cellular compartments, and so it's toxic effects can damage cells throughout the body.
For most healthy people though it does take a lot to do permanent damage. Binge drinking is worse than chronic drinking and things like milk thistle and abstinence can allow the body to repair most damage done.
Sorry I don't have any specific information regarding the toxicity of tramadol and alcohol combined.