Drug interactions
Cimetidine + Tramadol
Severity: Moderate
Cimetidine 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
Cimetidine may reduce conversion of tramadol to its active opioid metabolite, potentially lowering analgesia. Parent tramadol levels may rise, with a possible slight increase in serotonergic or seizure risk.
What this interaction means in plain words
Cimetidine 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.
Cimetidine belongs to Gastrointestinal Tract; Tramadol belongs to Musculoskeletal.
Why it happens
Cimetidine inhibits CYP2D6, which converts tramadol to O-desmethyltramadol.
What to do
Monitor pain control and adverse effects, and consider an alternative analgesic or acid suppressant if efficacy is inadequate.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
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 Cimetidine with Tramadol?
MediHelp rates the interaction as moderate. Cimetidine 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. Cimetidine may reduce conversion of tramadol to its active opioid metabolite, potentially lowering analgesia. Parent tramadol levels may rise, with a possible slight increase in serotonergic or seizure risk.
How serious is the interaction between Cimetidine 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 pain control and adverse effects, and consider an alternative analgesic or acid suppressant if efficacy is inadequate.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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