Drug interactions
Lithium + Tramadol
Severity: Moderate
Lithium 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
Lithium can enhance serotonergic neurotransmission, and with tramadol this may lead to serotonin syndrome. Cases are uncommon but potentially serious. Tramadol may also lower the seizure threshold.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects of lithium and tramadol's serotonin reuptake inhibition.
What to do
Monitor for neuromuscular excitability, agitation, tremor, diarrhea and hyperthermia, particularly after dose changes. Consider a non-serotonergic analgesic where practical.
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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium Major
Frequently asked questions
Can I take Lithium with Tramadol?
MediHelp rates the interaction as moderate. Lithium 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. Lithium can enhance serotonergic neurotransmission, and with tramadol this may lead to serotonin syndrome. Cases are uncommon but potentially serious. Tramadol may also lower the seizure threshold.
How serious is the interaction between Lithium 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 neuromuscular excitability, agitation, tremor, diarrhea and hyperthermia, particularly after dose changes. Consider a non-serotonergic analgesic where practical.
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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