Drug interactions
Lopinavir + Tramadol
Severity: Moderate
Lopinavir 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
Lopinavir, boosted with ritonavir, inhibits CYP3A4 and may raise tramadol levels, increasing the chance of adverse effects. Ritonavir also affects CYP2D6, so the active metabolite may vary.
What this interaction means in plain words
Lopinavir 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.
Lopinavir belongs to Anti Virals; Tramadol belongs to Musculoskeletal.
Why it happens
CYP3A4 inhibition (mainly by ritonavir) reducing tramadol clearance.
What to do
Monitor for sedation, respiratory depression, seizures and serotonin toxicity, and adjust the tramadol dose as needed.
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 Lopinavir 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 Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Lopinavir with Tramadol?
MediHelp rates the interaction as moderate. Lopinavir 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. Lopinavir, boosted with ritonavir, inhibits CYP3A4 and may raise tramadol levels, increasing the chance of adverse effects. Ritonavir also affects CYP2D6, so the active metabolite may vary.
How serious is the interaction between Lopinavir 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 serotonin toxicity, and adjust the tramadol dose as needed.
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.
