Drug interactions
Isoniazid + Tramadol
Severity: Moderate
Isoniazid 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
Isoniazid has weak monoamine oxidase inhibiting activity, and tramadol inhibits serotonin and norepinephrine reuptake. The combination could theoretically raise the risk of serotonin toxicity, though clinical reports are scarce.
What this interaction means in plain words
Isoniazid 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.
Isoniazid belongs to Anti Bacterial; Tramadol belongs to Musculoskeletal.
Why it happens
Weak MAO inhibition by isoniazid combined with tramadol's serotonin reuptake inhibition.
What to do
Monitor for signs of serotonin syndrome such as agitation, tremor, diaphoresis and hyperreflexia, especially when starting or increasing doses. Consider an alternative analgesic if symptoms appear.
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
Other interactions of Isoniazid
Frequently asked questions
Can I take Isoniazid with Tramadol?
MediHelp rates the interaction as moderate. Isoniazid 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. Isoniazid has weak monoamine oxidase inhibiting activity, and tramadol inhibits serotonin and norepinephrine reuptake. The combination could theoretically raise the risk of serotonin toxicity, though clinical reports are scarce.
How serious is the interaction between Isoniazid 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 signs of serotonin syndrome such as agitation, tremor, diaphoresis and hyperreflexia, especially when starting or increasing doses. Consider an alternative analgesic if symptoms appear.
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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