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Drug interactions

Brexanolone + Tramadol

Severity: Major

Brexanolone and Tramadol: major interaction.

Last updated Sources: US FDA label

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

Brexanolone causes excessive sedation and sudden loss of consciousness in some patients. Opioids such as tramadol add CNS depression, increasing the risk of profound sedation and respiratory depression.

What this interaction means in plain words

Brexanolone and Tramadol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Evidence level: Moderate

Why it happens

Additive CNS depression via GABA-A modulation and opioid receptor agonism.

What to do

Monitor continuously for sedation and hypoxia during brexanolone infusion. Consider holding or reducing the tramadol dose while the infusion is running.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Brexanolone with Tramadol?

MediHelp rates the interaction as major. Brexanolone and Tramadol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Brexanolone causes excessive sedation and sudden loss of consciousness in some patients. Opioids such as tramadol add CNS depression, increasing the risk of profound sedation and respiratory depression.

How serious is the interaction between Brexanolone and Tramadol?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor continuously for sedation and hypoxia during brexanolone infusion. Consider holding or reducing the tramadol dose while the infusion is running.

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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