Drug interactions
Lenacapavir + Tramadol
Severity: Moderate
Lenacapavir 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
Lenacapavir is a moderate CYP3A4 inhibitor and may raise tramadol exposure by reducing its N-demethylation. Higher parent drug levels may increase the risk of opioid adverse effects, seizures and serotonin toxicity. The clinical effect is uncertain because CYP2D6 also contributes to tramadol's activation.
What this interaction means in plain words
Lenacapavir 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.
Lenacapavir belongs to Anti Virals; Tramadol belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated tramadol metabolism by lenacapavir, increasing tramadol concentrations.
What to do
Monitor for sedation, respiratory depression, seizures and serotonergic symptoms when starting or stopping lenacapavir. Reduce the tramadol dose if adverse effects 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 Lenacapavir
- Apalutamide + Lenacapavir Contraindicated
- Carbamazepine + Lenacapavir Contraindicated
- Enzalutamide + Lenacapavir Contraindicated
- Flibanserin + Lenacapavir Contraindicated
- Lenacapavir + Phenytoin Contraindicated
- Lenacapavir + Rifampicin Contraindicated
Frequently asked questions
Can I take Lenacapavir with Tramadol?
MediHelp rates the interaction as moderate. Lenacapavir 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. Lenacapavir is a moderate CYP3A4 inhibitor and may raise tramadol exposure by reducing its N-demethylation. Higher parent drug levels may increase the risk of opioid adverse effects, seizures and serotonin toxicity. The clinical effect is uncertain because CYP2D6 also contributes to tramadol's activation.
How serious is the interaction between Lenacapavir 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, respiratory depression, seizures and serotonergic symptoms when starting or stopping lenacapavir. Reduce the tramadol dose if adverse effects 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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