Drug interactions
Azelastine + Tramadol
Severity: Moderate
Azelastine 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
Tramadol can cause sedation and dizziness, and with azelastine these effects may be additive. Respiratory depression is possible at higher doses, and tramadol also lowers the seizure threshold.
What this interaction means in plain words
Azelastine 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.
Azelastine belongs to Respiratory; Tramadol belongs to Musculoskeletal.
Why it happens
Additive CNS depression from opioid and monoaminergic effects of tramadol with H1 antagonism of azelastine.
What to do
Monitor sedation and respiratory status and use the lowest effective doses. Advise patients to avoid alcohol and driving until response is known.
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 Azelastine
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 Azelastine with Tramadol?
MediHelp rates the interaction as moderate. Azelastine 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. Tramadol can cause sedation and dizziness, and with azelastine these effects may be additive. Respiratory depression is possible at higher doses, and tramadol also lowers the seizure threshold.
How serious is the interaction between Azelastine 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 sedation and respiratory status and use the lowest effective doses. Advise patients to avoid alcohol and driving until response is known.
What other medicines interact with Azelastine?
MediHelp also lists interactions of Azelastine with, for example, Calcium / magnesium / potassium / sodium oxybates, Methadone, Sodium oxybate. The full list is on the Azelastine page.
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