Drug interactions
Diphenoxylate-atropine + Tramadol
Severity: Moderate
Diphenoxylate-atropine 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
Both drugs are opioid agonists, so combined use adds CNS and respiratory depression, sedation and constipation. Tramadol also lowers the seizure threshold and has serotonergic activity, and atropine adds anticholinergic effects.
What this interaction means in plain words
Diphenoxylate-atropine 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.
Diphenoxylate-atropine belongs to Gastrointestinal Tract; Tramadol belongs to Musculoskeletal.
Why it happens
Additive opioid receptor-mediated CNS and respiratory depression, with tramadol adding seizure-threshold lowering and serotonergic effects.
What to do
Avoid unnecessary concurrent use and prefer a non-opioid antidiarrheal. If both are needed, use the lowest effective doses and monitor for sedation, respiratory depression and seizures.
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 Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine 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 Diphenoxylate-atropine with Tramadol?
MediHelp rates the interaction as moderate. Diphenoxylate-atropine 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. Both drugs are opioid agonists, so combined use adds CNS and respiratory depression, sedation and constipation. Tramadol also lowers the seizure threshold and has serotonergic activity, and atropine adds anticholinergic effects.
How serious is the interaction between Diphenoxylate-atropine 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: Avoid unnecessary concurrent use and prefer a non-opioid antidiarrheal. If both are needed, use the lowest effective doses and monitor for sedation, respiratory depression and seizures.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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