Drank one glass of wine with dinner at 9pm. is it safe to take prescribed tramadol 50mg for back pain at 11pm before bed?

No: Some potentially dangerous effects of mixing Tramadol with alcohol include: dizziness. drowsiness. impaired coordination. loss of consciousness. nausea. overdose. shallow breathing. slowed heart rate. Vomiting Please do not combine alcohol with transform, it is not safe

Yes: Tramadol is sedating and wine is sedating so combining alcohol with Tramadol can increase side effects like drowsiness and dizziness, but since one glass is not too much, since most of that glass will be out of your system by 11 PM and since you are going to bed it should be OK. But it would not be wise to take Tramadol and alcohol together during the day when you need to be alert and functional.

Acetaminophen first: Not knowing the nature & origin of your back pain, I would say it's ok. But try 2 tablets acetaminophen 500 mg first. Hope that helps.