Drug interactions
Istradefylline + Tramadol
Severity: Moderate
Istradefylline 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
At 40 mg/day, istradefylline raises exposure to CYP3A4 substrates, which may increase tramadol levels and the risk of adverse effects such as seizures and serotonin toxicity. This effect was not seen at 20 mg/day.
What this interaction means in plain words
Istradefylline 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.
Istradefylline belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.
Why it happens
Weak CYP3A4 inhibition by istradefylline at higher doses, reducing tramadol clearance.
What to do
Monitor for tramadol adverse effects if istradefylline 40 mg/day is used, and consider reducing the tramadol dose. Keep istradefylline at 20 mg/day where clinically suitable.
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 Istradefylline 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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Tramadol?
MediHelp rates the interaction as moderate. Istradefylline 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. At 40 mg/day, istradefylline raises exposure to CYP3A4 substrates, which may increase tramadol levels and the risk of adverse effects such as seizures and serotonin toxicity. This effect was not seen at 20 mg/day.
How serious is the interaction between Istradefylline 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 tramadol adverse effects if istradefylline 40 mg/day is used, and consider reducing the tramadol dose. Keep istradefylline at 20 mg/day where clinically suitable.
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.
