Drug interactions
Levorphanol + Tramadol
Severity: Major
Levorphanol and Tramadol: major 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
Tramadol with levorphanol, a potent opioid, adds respiratory and CNS depression and may interfere with analgesia or provoke withdrawal in opioid-dependent patients. Tramadol also lowers the seizure threshold.
What this interaction means in plain words
Levorphanol and Tramadol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive opioid effects and mu-receptor competition, with tramadol's added monoamine reuptake inhibition.
What to do
Avoid combining; use a single opioid. If both are needed, monitor for sedation, respiratory depression and withdrawal.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Levorphanol with Tramadol?
MediHelp rates the interaction as major. Levorphanol and Tramadol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Tramadol with levorphanol, a potent opioid, adds respiratory and CNS depression and may interfere with analgesia or provoke withdrawal in opioid-dependent patients. Tramadol also lowers the seizure threshold.
How serious is the interaction between Levorphanol and Tramadol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining; use a single opioid. If both are needed, monitor for sedation, respiratory depression and withdrawal.
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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