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| Interactions: | Amitriptyline
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant Amitriptyline . If possible, avoid this combination.
Amoxapine
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant Amoxapine . If possible, avoid this combination.
Bupivacaine Comb.
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving phenothiazine therapy. If possible, avoid this combination.
Carbamazepine
Adverse Effect: Decreased tramadol efficacy Clinical Management: Monitor patients for tramadol efficacy. Doses may need to be increased, even doubled, in patients who are receiving chronic carbamazepine therapy.
Clomipramine
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant Tricyclic antidepressant therapy. If possible, avoid this combination.
Clozapine
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving neuroleptic therapy. If possible, avoid this combination
Digoxin
Adverse Effect: An increased risk of digoxin toxicity (nausea, vomiting, cardiac arrhythmias) Clinical Management: Closely monitor digoxin serum concentrations and adjust doses accordingly.
Diphenhydramine
Adverse Effect: CNS depression (sedation, lethargy, speech difficulties) Clinical Management: Use caution if tramadol is to be used concomitantly in patients receiving diphenhydramine therapy. Monitor patients for signs of CNS depression (sedation, lethargy, speech difficulties) and adjust doses accordingly.
Dothiepin
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant Dothiepin . If possible, avoid this combination.
Doxepin
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant Doxepin. If possible, avoid this combination.
Fentanyl
Adverse Effect: CNS depression (sedation, lethargy, speech difficulties) Clinical Management: Use caution if tramadol is to be used concomitantly in patients receiving Fentanyl . Monitor patients for signs of CNS depression (sedation, lethargy, speech difficulties) and adjust doses accordingly. The manufacturer recommends that reduced dosages of tramadol be used when it is coadministered with other CNS depressants.
Fluoxetine
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant fluoxetine therapy. If possible, avoid this combination.
Flupenthixol Decanoate
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving Flupenthixol Decanoate therapy. If possible, avoid this combination
Fluphenazine
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving phenothiazine therapy. If possible, avoid this combination.
Haloperidol
Adverse Effect: an increased risk of seizures
Imipramine
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant TCA therapy.If possible, avoid this combination.
Ketamine
Adverse Effect: an increased risk of respiratory depression and excessive CNS depression Clinical Management: Caution should be used when anesthetic medications are administered to tramadol-treated patients.
Loxapine
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving neuroleptic therapy. If possible, avoid this combination
Morphine
Adverse Effect: CNS depression (sedation, lethargy, speech difficulties) Clinical Management: Use caution if tramadol is to be used concomitantly in patients receiving morphine therapy. Monitor patients for signs of CNS depression (sedation, lethargy, speech difficulties) and adjust doses accordingly. The manufacturer recommends that reduced dosages of tramadol be used when it is coadministered with other CNS depressants.
Nortriptyline
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant TCA therapy. If possible, avoid this combination, especially in patients with underlying conditions that might predispose to seizures.
Penfluridol
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving neuroleptic therapy. If possible, avoid this combination.
Pethidine
Adverse Effect: CNS depression (sedation, lethargy, speech difficulties) Clinical Management: Use caution if tramadol is to be used concomitantly in patients receiving meperidine therapy. Monitor patients for signs of CNS depression (sedation, lethargy, speech difficulties) and adjust doses accordingly. The manufacturer recommends that reduced dosages of tramadol be used when it is coadministered with other CNS depressants.
Pimozide
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving neuroleptic therapy. If possible, avoid this combination.
Quinidine
Adverse Effect: The possibility of altered tramadol concentrations and efficacy Clinical Management: Closely monitor patient response and adjust doses accordingly.
Risperidone
Adverse Effect: an increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving neuroleptic therapy. If possible, avoid this combination
Selegiline
Adverse Effect: nausea, vomiting, cardiovascular collapse, respiratory depression, seizures Clinical Management: Coadministration of tramadol and Selegiline should be undertaken with great caution. Blood pressure and ventilation should be closely monitored .
Sertraline
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant sertraline therapy. If possible, avoid this combination.
Thioridazine
Adverse Effect: An increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving phenothiazine therapy. If possible, avoid this combination, especially in patients with underlying conditions that might predispose to seizures.
Trazadone
Adverse Effect: CNS depression (sedation, lethargy, speech difficulties) Clinical Management: Use caution if tramadol is to be used concomitantly in patients receiving trazodone therapy. Monitor patients for signs of CNS depression (sedation, lethargy, speech difficulties) and adjust doses accordingly. The manufacturer recommends that reduced dosages of tramadol be used when it is coadministered with other CNS depressants.
Trifluoperazine
Adverse Effect: Increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving Trifluoperazine therapy. If possible, avoid this combination
Trimipramine
Adverse Effect: An increased risk of seizures Clinical Management: Caution should be used if tramadol is to be administered to patients receiving concomitant Tricyclic antidepressant therapy. If possible, avoid this combination, especially in patients with underlying conditions that might predispose to seizures.
Warfarin
Adverse Effect: An increased risk of bleeding Clinical Management: Closely monitor international normalized ratio (INR) and adjust warfarin doses accordingly. Also monitor signs and symptoms of bleeding and bruising |
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