Drug interactions
Dextromoramide + Tramadol
Severity: Major
Dextromoramide 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
Tramadol is a weak opioid agonist with monoaminergic activity and may provoke withdrawal or interfere with analgesia in patients dependent on potent opioids. Combined use also adds respiratory and CNS depression and raises seizure risk.
What this interaction means in plain words
Dextromoramide 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.
Why it happens
Additive opioid effects and mu-receptor competition, with tramadol's added monoamine reuptake inhibition.
What to do
Avoid combining; choose a single opioid regimen. If both are given, monitor for sedation, respiratory depression and withdrawal.
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
Frequently asked questions
Can I take Dextromoramide with Tramadol?
MediHelp rates the interaction as major. Dextromoramide 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. Tramadol is a weak opioid agonist with monoaminergic activity and may provoke withdrawal or interfere with analgesia in patients dependent on potent opioids. Combined use also adds respiratory and CNS depression and raises seizure risk.
How serious is the interaction between Dextromoramide 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 combining; choose a single opioid regimen. If both are given, monitor for sedation, respiratory depression and withdrawal.
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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