Drug interactions
Darunavir + Tramadol
Severity: Moderate
Darunavir 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
Darunavir, usually boosted with ritonavir or cobicistat, inhibits CYP3A4 and may raise tramadol concentrations. Boosting agents also inhibit CYP2D6, so exposure to tramadol and its active metabolite may change, with a risk of toxicity including seizures and serotonin syndrome.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Tramadol belongs to Musculoskeletal.
Why it happens
CYP3A4 inhibition (and CYP2D6 inhibition by the booster) reduces tramadol clearance.
What to do
Consider a lower tramadol dose and monitor for sedation, respiratory depression and seizures. Switch to a different analgesic if toxicity or inadequate analgesia develops.
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 Tramadol
- Isocarboxazid + Tramadol Contraindicated
- Olanzapine / samidorphan + Tramadol Contraindicated
- Phenelzine + Tramadol Contraindicated
- Procarbazine + Tramadol Contraindicated
- Rasagiline + Tramadol Contraindicated
- Safinamide + Tramadol Contraindicated
Other interactions of Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Tramadol?
MediHelp rates the interaction as moderate. Darunavir 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. Darunavir, usually boosted with ritonavir or cobicistat, inhibits CYP3A4 and may raise tramadol concentrations. Boosting agents also inhibit CYP2D6, so exposure to tramadol and its active metabolite may change, with a risk of toxicity including seizures and serotonin syndrome.
How serious is the interaction between Darunavir 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: Consider a lower tramadol dose and monitor for sedation, respiratory depression and seizures. Switch to a different analgesic if toxicity or inadequate analgesia develops.
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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