Drug interactions
Artemether / lumefantrine + Tramadol
Severity: Moderate
Artemether / lumefantrine 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
Lumefantrine inhibits CYP2D6, the enzyme that converts tramadol to its active opioid metabolite O-desmethyltramadol. This can reduce analgesic effect while leaving parent tramadol, which carries serotonergic and seizure risk, relatively higher. The effect is usually short-lived given the brief antimalarial course.
What this interaction means in plain words
Artemether / lumefantrine 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.
Why it happens
Inhibition of CYP2D6-mediated activation of tramadol to O-desmethyltramadol.
What to do
Monitor for reduced analgesia and for adverse effects from parent tramadol during the antimalarial course. Consider a non-CYP2D6-dependent analgesic if pain control is inadequate.
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
Frequently asked questions
Can I take Artemether / lumefantrine with Tramadol?
MediHelp rates the interaction as moderate. Artemether / lumefantrine 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. Lumefantrine inhibits CYP2D6, the enzyme that converts tramadol to its active opioid metabolite O-desmethyltramadol. This can reduce analgesic effect while leaving parent tramadol, which carries serotonergic and seizure risk, relatively higher. The effect is usually short-lived given the brief antimalarial course.
How serious is the interaction between Artemether / lumefantrine 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 for reduced analgesia and for adverse effects from parent tramadol during the antimalarial course. Consider a non-CYP2D6-dependent analgesic if pain control is inadequate.
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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