Drug interactions
Clobazam + Tramadol
Severity: Major
Clobazam 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
Benzodiazepines and opioids together can cause profound sedation, respiratory depression, coma and death. Clobazam is also a weak CYP2D6 inhibitor and may modestly reduce activation of tramadol. Tramadol lowers seizure threshold, which is relevant in patients taking clobazam for epilepsy.
What this interaction means in plain words
Clobazam 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.
Clobazam belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression, with weak CYP2D6 inhibition by clobazam.
What to do
Avoid unless alternatives are inadequate; if used, give the lowest doses for the shortest time and monitor respiratory status and sedation. Counsel patients to avoid alcohol.
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
Other interactions of Clobazam
- Amobarbital + Clobazam Major
- Buprenorphine + Clobazam Major
- Butorphanol + Clobazam Major
- Carisoprodol + Clobazam Major
- Chloral hydrate + Clobazam Major
- Clobazam + Clozapine Major
Frequently asked questions
Can I take Clobazam with Tramadol?
MediHelp rates the interaction as major. Clobazam 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. Benzodiazepines and opioids together can cause profound sedation, respiratory depression, coma and death. Clobazam is also a weak CYP2D6 inhibitor and may modestly reduce activation of tramadol. Tramadol lowers seizure threshold, which is relevant in patients taking clobazam for epilepsy.
How serious is the interaction between Clobazam 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 unless alternatives are inadequate; if used, give the lowest doses for the shortest time and monitor respiratory status and sedation. Counsel patients to avoid alcohol.
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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