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Tramadol Interactions: 3 Facts You Need to Know

By Manjari Bansal
Tramadol can cause detrimental effects when other medications are also present. Learn three important facts about the ways tramadol can interact with other drugs.

Your doctor may prescribe tramadol to treat moderate to severe pain. Since tramadol is an opioid, it may interact with other medications and cause serious side effects. Learn three important facts about tramadol drug interactions before you use it.

1. Tramadol may cause serious side effects if used with alcohol or opioid medicines.

“Using tramadol, or any narcotic pain medication, with other drugs that also cause central nervous system depression such as alprazolam (Xanax) or ETOH (alcohol) can lead to serious side effects including impaired judgment, depressed respiration, coma, and death,” Alan Thomalla, PhD, a licensed psychologist at ABC Resources, tells WebMD Connect to Care.

“If a person combined tramadol with a similar analgesic opioid agonist such as fentanyl, this effect and subsequent risk would be magnified tenfold,” Thomalla adds.

2. Tramadol may interact with other medications and cause negative effects.

Since tramadol is a synthetic opioid, it can negatively interact with other medications, Mayo Clinic notes. For example, if you take certain cold or allergy medications along with tramadol, sedative effects may increase, which can be dangerous.

“Tramadol can cause dizziness or drowsiness, and should not be mixed with other medications that can produce a similar effect,” Aaron Sternlicht, LMHC, CASAC, a therapist and co-founder of Family Addiction Specialist in New York, tells WebMD Connect to Care.

The University of Michigan Health notes that, before starting tramadol, you should inform your doctor if you are using any of the following medications:

  • Cold or allergy medicines
  • Asthma medicines
  • Antibiotics and antifungal medicines
  • Medications for heart problems and seizures
  • Medicines for motion sickness, overactive bladder, or irritable bowel syndrome.
  • Sedative medications
  • Other medicines that cause drowsiness like sleeping pills or muscle relaxants

3. Tramadol can cause serotonin syndrome if taken with some antidepressants.

Selective serotonin reuptake inhibitors (SSRIs) are medicines commonly prescribed for treating depression. They work by increasing the level of serotonin in the brain, according to Mayo Clinic.

“If tramadol is taken together with fluoxetine (Prozac), sertraline (Zoloft), or any of the SSRI medications, the combination can increase the risk of a serious condition called serotonin syndrome. This condition can lead to increased heart rate and blood pressure, blurred vision, excessive sweating, shaking, muscle spasms or stiffness, confusion, hallucinations, seizures, and can result in coma or death,” Thomalla explains.

According to a 2017 study published in the European Journal of Hospital Pharmacy, serotonin syndrome due to the combination of tramadol and SSRIs is usually mild to moderate, but it can be life-threatening. So, it is safer for people to prevent this condition altogether.

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