Drug interactions
Buprenorphine long-acting + Tramadol
Severity: Major
Buprenorphine long-acting 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
Tramadol is an opioid analgesic and long-acting injectable buprenorphine provides sustained partial opioid agonism, so together they add to sedation and respiratory depression. Buprenorphine's high receptor affinity may also blunt tramadol analgesia or precipitate withdrawal. The long duration means the effect cannot be quickly reversed.
What this interaction means in plain words
Buprenorphine long-acting 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.
Why it happens
Additive opioid and CNS depressant effects, with competition at mu-opioid receptors between tramadol and a high-affinity partial agonist.
What to do
Avoid routine combination; use non-opioid analgesics for pain in patients on buprenorphine depot. If tramadol is unavoidable, monitor for sedation, respiratory depression and poor analgesia.
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?
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References
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 Buprenorphine long-acting with Tramadol?
MediHelp rates the interaction as major. Buprenorphine long-acting 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. Tramadol is an opioid analgesic and long-acting injectable buprenorphine provides sustained partial opioid agonism, so together they add to sedation and respiratory depression. Buprenorphine's high receptor affinity may also blunt tramadol analgesia or precipitate withdrawal. The long duration means the effect cannot be quickly reversed.
How serious is the interaction between Buprenorphine long-acting 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: Avoid routine combination; use non-opioid analgesics for pain in patients on buprenorphine depot. If tramadol is unavoidable, monitor for sedation, respiratory depression and poor analgesia.
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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