Drug interactions
Nevirapine + Tramadol
Severity: Moderate
Nevirapine 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
Nevirapine induces CYP3A4 and CYP2B6, which can lower tramadol exposure and weaken analgesia. Induction also changes the balance between tramadol and its active metabolite.
What this interaction means in plain words
Nevirapine 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.
Nevirapine belongs to Anti Virals; Tramadol belongs to Musculoskeletal.
Why it happens
Nevirapine induction of CYP3A4 and CYP2B6 increases the metabolism of tramadol.
What to do
Monitor pain control and titrate the tramadol dose to effect. If nevirapine is stopped, reassess for increased tramadol effects and adverse reactions.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Nevirapine with Tramadol?
MediHelp rates the interaction as moderate. Nevirapine 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. Nevirapine induces CYP3A4 and CYP2B6, which can lower tramadol exposure and weaken analgesia. Induction also changes the balance between tramadol and its active metabolite.
How serious is the interaction between Nevirapine 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 pain control and titrate the tramadol dose to effect. If nevirapine is stopped, reassess for increased tramadol effects and adverse reactions.
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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