Drug interactions
Mitotane + Tramadol
Severity: Moderate
Mitotane 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
Mitotane is a strong CYP3A4 inducer and can lower tramadol and O-desmethyltramadol concentrations, reducing analgesic effect. Induction persists for weeks after mitotane is stopped.
What this interaction means in plain words
Mitotane 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.
Mitotane belongs to Oncology; Tramadol belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 (and CYP2B6) increasing tramadol metabolism.
What to do
Monitor for reduced analgesia and consider a different analgesic or dose titration. If mitotane is stopped, watch for tramadol toxicity as induction wanes.
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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Mitotane with Tramadol?
MediHelp rates the interaction as moderate. Mitotane 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. Mitotane is a strong CYP3A4 inducer and can lower tramadol and O-desmethyltramadol concentrations, reducing analgesic effect. Induction persists for weeks after mitotane is stopped.
How serious is the interaction between Mitotane 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 reduced analgesia and consider a different analgesic or dose titration. If mitotane is stopped, watch for tramadol toxicity as induction wanes.
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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