Drug interactions
Methylenedioxymethamphetamine + Tramadol
Severity: Major
Methylenedioxymethamphetamine 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
MDMA releases serotonin and inhibits its reuptake, and tramadol has serotonergic activity and lowers seizure threshold, so serotonin syndrome and seizures are possible. CYP2D6 inhibition by MDMA may also alter tramadol activation.
What this interaction means in plain words
Methylenedioxymethamphetamine 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 effects and possible CYP2D6 inhibition.
What to do
Avoid the combination; if exposure occurs, monitor for hyperthermia, clonus, agitation and seizures and provide supportive care.
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 Methylenedioxymethamphetamine with Tramadol?
MediHelp rates the interaction as major. Methylenedioxymethamphetamine 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. MDMA releases serotonin and inhibits its reuptake, and tramadol has serotonergic activity and lowers seizure threshold, so serotonin syndrome and seizures are possible. CYP2D6 inhibition by MDMA may also alter tramadol activation.
How serious is the interaction between Methylenedioxymethamphetamine 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 the combination; if exposure occurs, monitor for hyperthermia, clonus, agitation and seizures and provide supportive care.
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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