Drug interactions
Asenapine + Tramadol
Severity: Moderate
Asenapine 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
Both drugs cause sedation and dizziness, so together they may impair alertness and coordination more than either alone. Asenapine can cause orthostatic hypotension, and tramadol may lower the seizure threshold.
What this interaction means in plain words
Asenapine 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.
Asenapine belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.
Why it happens
Additive CNS depressant and hypotensive effects.
What to do
Monitor for sedation, orthostatic hypotension and seizures, especially at initiation and after dose increases. Advise patients to avoid driving or operating machinery until tolerance is established.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Asenapine and Tramadol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Tramadol?
MediHelp rates the interaction as moderate. Asenapine 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. Both drugs cause sedation and dizziness, so together they may impair alertness and coordination more than either alone. Asenapine can cause orthostatic hypotension, and tramadol may lower the seizure threshold.
How serious is the interaction between Asenapine 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 sedation, orthostatic hypotension and seizures, especially at initiation and after dose increases. Advise patients to avoid driving or operating machinery until tolerance is established.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
