Drug interactions
Indinavir + Tramadol
Severity: Moderate
Indinavir 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
Indinavir inhibits CYP3A4 and can increase tramadol plasma concentrations. This may raise the risk of tramadol toxicity, including seizures, serotonin syndrome and respiratory depression, although CYP2D6 activation to the active metabolite may shift.
What this interaction means in plain words
Indinavir 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.
Why it happens
Inhibition of CYP3A4-mediated tramadol metabolism by indinavir.
What to do
Monitor for opioid toxicity, sedation and serotonergic or seizure activity when starting or stopping indinavir. Lower the tramadol dose if needed.
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
Frequently asked questions
Can I take Indinavir with Tramadol?
MediHelp rates the interaction as moderate. Indinavir 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. Indinavir inhibits CYP3A4 and can increase tramadol plasma concentrations. This may raise the risk of tramadol toxicity, including seizures, serotonin syndrome and respiratory depression, although CYP2D6 activation to the active metabolite may shift.
How serious is the interaction between Indinavir 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 opioid toxicity, sedation and serotonergic or seizure activity when starting or stopping indinavir. Lower the tramadol dose if needed.
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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