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Drug interactions

Chlorpromazine + Tramadol

Severity: Major

Chlorpromazine 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

Both drugs cause sedation, and chlorpromazine can also cause hypotension and lower seizure threshold, as can tramadol. Chlorpromazine inhibits CYP2D6, which may reduce tramadol activation and analgesia while increasing the risk of seizures.

What this interaction means in plain words

Chlorpromazine 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.

Chlorpromazine belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.

Evidence level: Moderate

Why it happens

Additive CNS depression and seizure threshold lowering, plus CYP2D6 inhibition by chlorpromazine.

What to do

Use the lowest effective doses and monitor sedation, blood pressure and seizure activity. Consider a different analgesic in patients with seizure risk.

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 Chlorpromazine with Tramadol?

MediHelp rates the interaction as major. Chlorpromazine 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. Both drugs cause sedation, and chlorpromazine can also cause hypotension and lower seizure threshold, as can tramadol. Chlorpromazine inhibits CYP2D6, which may reduce tramadol activation and analgesia while increasing the risk of seizures.

How serious is the interaction between Chlorpromazine 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: Use the lowest effective doses and monitor sedation, blood pressure and seizure activity. Consider a different analgesic in patients with seizure risk.

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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