Drug interactions
Amiodarone + Tramadol
Severity: Moderate
Amiodarone and Tramadol: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amiodarone inhibits CYP2D6, reducing conversion of tramadol to its active metabolite O-desmethyltramadol and potentially weakening analgesia. Higher parent tramadol levels may increase serotonergic and seizure risk.
What this interaction means in plain words
Amiodarone and Tramadol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amiodarone belongs to Cardiovascular; Tramadol belongs to Musculoskeletal.
Why it happens
Amiodarone inhibits CYP2D6, reducing tramadol activation, and may also inhibit CYP3A4.
What to do
Monitor analgesic response and consider an alternative analgesic if pain control is inadequate. Watch for serotonergic or seizure effects; amiodarone's long half-life means the inhibition persists after discontinuation.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Tramadol
- Isocarboxazid + Tramadol Contraindicated
- Olanzapine / samidorphan + Tramadol Contraindicated
- Phenelzine + Tramadol Contraindicated
- Procarbazine + Tramadol Contraindicated
- Rasagiline + Tramadol Contraindicated
- Safinamide + Tramadol Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Tramadol?
MediHelp rates the interaction as moderate. Amiodarone and Tramadol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Amiodarone inhibits CYP2D6, reducing conversion of tramadol to its active metabolite O-desmethyltramadol and potentially weakening analgesia. Higher parent tramadol levels may increase serotonergic and seizure risk.
How serious is the interaction between Amiodarone and Tramadol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor analgesic response and consider an alternative analgesic if pain control is inadequate. Watch for serotonergic or seizure effects; amiodarone's long half-life means the inhibition persists after discontinuation.
What other medicines interact with Tramadol?
MediHelp also lists interactions of Tramadol with, for example, Isocarboxazid, Olanzapine / samidorphan, Phenelzine. The full list is on the Tramadol page.
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