Drug interactions
Meperidine + Tramadol
Severity: Major
Meperidine 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
Both are opioid analgesics with serotonergic activity, and both lower seizure threshold. Together they increase risk of serotonin syndrome, seizures, and additive respiratory and CNS depression. Duplicate opioid therapy offers little benefit.
What this interaction means in plain words
Meperidine 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.
Meperidine belongs to Musculoskeletal; Tramadol belongs to Musculoskeletal.
Why it happens
Additive opioid receptor effects, serotonin and norepinephrine reuptake inhibition, and seizure threshold lowering.
What to do
Avoid using the two together and use a single opioid. If a switch is made, monitor for sedation, respiratory depression and serotonin toxicity.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Meperidine with Tramadol?
MediHelp rates the interaction as major. Meperidine 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. Both are opioid analgesics with serotonergic activity, and both lower seizure threshold. Together they increase risk of serotonin syndrome, seizures, and additive respiratory and CNS depression. Duplicate opioid therapy offers little benefit.
How serious is the interaction between Meperidine 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 using the two together and use a single opioid. If a switch is made, monitor for sedation, respiratory depression and serotonin toxicity.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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