Can you take tramadol with extra strength Tylenol?

Absolutely! When I had my knee replacement done, I was prescribed Tramadol (or Ultram) and paracetamol (or Tylenol/acetaminophen) in combo. The doses were 50 to 150 mgs of Tramadol (NOT extended release!) with 1,000mg of paracetamol every 4-6 hrs minimum. It worked wonderfully well for me.