Drug interactions
Erythromycin lactobionate + Tramadol
Severity: Moderate
Erythromycin lactobionate 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
Erythromycin inhibits CYP3A4, reducing N-demethylation of tramadol and raising parent drug concentrations. This may increase the risk of seizures and serotonin syndrome, and may also alter opioid effects.
What this interaction means in plain words
Erythromycin lactobionate 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.
Erythromycin lactobionate belongs to Anti Bacterial; Tramadol belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated tramadol metabolism by erythromycin.
What to do
Monitor for sedation, seizures and serotonergic symptoms, and reduce the tramadol dose if needed. Reassess when erythromycin is stopped, as tramadol exposure will fall.
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 Erythromycin lactobionate 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 7 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 Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Erythromycin lactobionate with Tramadol?
MediHelp rates the interaction as moderate. Erythromycin lactobionate 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. Erythromycin inhibits CYP3A4, reducing N-demethylation of tramadol and raising parent drug concentrations. This may increase the risk of seizures and serotonin syndrome, and may also alter opioid effects.
How serious is the interaction between Erythromycin lactobionate 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, seizures and serotonergic symptoms, and reduce the tramadol dose if needed. Reassess when erythromycin is stopped, as tramadol exposure will fall.
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.
