Drug interactions
Lofepramine + Tramadol
Severity: Major
Lofepramine and Tramadol: major interaction.
Last updated Sources: US FDA label
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
Lofepramine is a tricyclic antidepressant and, like tramadol, affects serotonergic and noradrenergic transmission, increasing the risk of serotonin syndrome and seizures. Both also cause sedation.
What this interaction means in plain words
Lofepramine 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 serotonergic activity and lowered seizure threshold, with additive CNS depression.
What to do
Avoid if possible or use the lowest tramadol dose with close monitoring for serotonin toxicity, seizures and sedation. Consider a non-serotonergic analgesic.
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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References
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 Lofepramine with Tramadol?
MediHelp rates the interaction as major. Lofepramine 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. Lofepramine is a tricyclic antidepressant and, like tramadol, affects serotonergic and noradrenergic transmission, increasing the risk of serotonin syndrome and seizures. Both also cause sedation.
How serious is the interaction between Lofepramine 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 if possible or use the lowest tramadol dose with close monitoring for serotonin toxicity, seizures and sedation. Consider a non-serotonergic analgesic.
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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