Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Bupropion, cinacalcet, quinidine, or oral terbinafine may decrease the pain relieving effects of tramadol by interfering with how the body activates tramadol. These medications may also increase your risk for seizures or serotonin side effects due to tramadol.
What might happen:
Tramadol may not work as well for pain after starting bupropion, cinacalcet, quinidine, or oral terbinafine.High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.Do not take more than the prescribed dose of tramadol.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.If you experience muscle twitching, tremors, shivering and stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, severe diarrhea, or think you may have had a seizure, contact your doctor right away.
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