Drug interactions
Cyproheptadine + Tramadol
Severity: Moderate
Cyproheptadine 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
Tramadol is an opioid and cyproheptadine is a sedating antihistamine, so the combination can cause additive drowsiness and respiratory depression. Cyproheptadine's serotonin blockade may also partly reduce tramadol's serotonergic effects.
What this interaction means in plain words
Cyproheptadine 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.
Cyproheptadine belongs to Respiratory; Tramadol belongs to Musculoskeletal.
Why it happens
Additive CNS depression from H1 antagonism and opioid activity, with 5-HT2 antagonism by cyproheptadine.
What to do
Monitor for sedation and respiratory depression, and use the lowest effective doses. Advise patients to avoid alcohol and driving.
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 Cyproheptadine
- Cyproheptadine + Isocarboxazid Contraindicated
- Cyproheptadine + Phenelzine Contraindicated
- Cyproheptadine + Tranylcypromine Contraindicated
- Alfentanil + Cyproheptadine Major
- Belladonna and opium + Cyproheptadine Major
- Benzhydrocodone / acetaminophen + Cyproheptadine 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 Cyproheptadine with Tramadol?
MediHelp rates the interaction as moderate. Cyproheptadine 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. Tramadol is an opioid and cyproheptadine is a sedating antihistamine, so the combination can cause additive drowsiness and respiratory depression. Cyproheptadine's serotonin blockade may also partly reduce tramadol's serotonergic effects.
How serious is the interaction between Cyproheptadine 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 for sedation and respiratory depression, and use the lowest effective doses. Advise patients to avoid alcohol and driving.
What other medicines interact with Cyproheptadine?
MediHelp also lists interactions of Cyproheptadine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Cyproheptadine page.
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