For the love of God do not mix tramadol and MDMA. Tramadol is a weird and wicked opioid that is also an snri. You are risking a serious condition called serotonin syndrome/storm. Which is extremely life threatening. Without getting to deep into the weeds here MDMA causes the body to realize a massive flood of serotonin. While tramadol work to slow the reuptake of serotonin. Meaning you have one drug flooding your body with serotonin and another that won't allow your body to eliminate serotonin. Basically it can cause a severe overdose of serotonin that can easily result in death. Not trying to scare anyone those are just facts.I don’t know if there are safety concerns, but at least with tramadol and MDMA, this gave me pause: