Drug interactions
Efavirenz + Tramadol
Severity: Moderate
Efavirenz 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
Efavirenz induces CYP3A4 and CYP2B6 and can lower tramadol exposure, possibly reducing analgesic effect. The magnitude is variable and the clinical impact is generally modest.
What this interaction means in plain words
Efavirenz 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.
Efavirenz belongs to Anti Virals; Tramadol belongs to Musculoskeletal.
Why it happens
Efavirenz-mediated induction of CYP3A4 and CYP2B6 increases tramadol metabolism.
What to do
Monitor pain control and titrate tramadol upward if needed, and reassess dosing if efavirenz is stopped.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Efavirenz and Tramadol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Efavirenz with Tramadol?
MediHelp rates the interaction as moderate. Efavirenz 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. Efavirenz induces CYP3A4 and CYP2B6 and can lower tramadol exposure, possibly reducing analgesic effect. The magnitude is variable and the clinical impact is generally modest.
How serious is the interaction between Efavirenz 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 pain control and titrate tramadol upward if needed, and reassess dosing if efavirenz is stopped.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
