Drug interactions
Nelfinavir + Tramadol
Severity: Moderate
Nelfinavir 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
Nelfinavir inhibits CYP3A4 and may increase tramadol concentrations, raising the risk of adverse effects including sedation, seizures and serotonin toxicity.
What this interaction means in plain words
Nelfinavir 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.
Nelfinavir belongs to Anti Virals; Tramadol belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated tramadol metabolism.
What to do
Monitor for opioid and serotonergic toxicity and lower the tramadol dose if adverse effects occur.
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 Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Nelfinavir with Tramadol?
MediHelp rates the interaction as moderate. Nelfinavir 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. Nelfinavir inhibits CYP3A4 and may increase tramadol concentrations, raising the risk of adverse effects including sedation, seizures and serotonin toxicity.
How serious is the interaction between Nelfinavir 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 opioid and serotonergic toxicity and lower the tramadol dose if adverse effects occur.
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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