Drug interactions
Oxymorphone + Tramadol
Severity: Major
Oxymorphone 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
Combining tramadol with a full opioid agonist adds to CNS and respiratory depression and offers little analgesic advantage. Tramadol also lowers seizure threshold and has serotonergic activity, and in opioid-dependent patients its partial opioid effects may complicate dependence or withdrawal.
What this interaction means in plain words
Oxymorphone 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.
Oxymorphone belongs to Musculoskeletal; Tramadol belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor effects and CNS depression, with added seizure and serotonergic risk from tramadol.
What to do
Avoid concurrent use and consolidate to one opioid. If both are used, limit doses and monitor for sedation, respiratory depression and seizures.
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 Oxymorphone
- Alvimopan + Oxymorphone Contraindicated
- Ethanol + Oxymorphone Contraindicated
- Isocarboxazid + Oxymorphone Contraindicated
- Olanzapine / samidorphan + Oxymorphone Contraindicated
- Oxymorphone + Phenelzine Contraindicated
- Oxymorphone + Selegiline transdermal 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 Oxymorphone with Tramadol?
MediHelp rates the interaction as major. Oxymorphone 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. Combining tramadol with a full opioid agonist adds to CNS and respiratory depression and offers little analgesic advantage. Tramadol also lowers seizure threshold and has serotonergic activity, and in opioid-dependent patients its partial opioid effects may complicate dependence or withdrawal.
How serious is the interaction between Oxymorphone 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 concurrent use and consolidate to one opioid. If both are used, limit doses and monitor for sedation, respiratory depression and seizures.
What other medicines interact with Oxymorphone?
MediHelp also lists interactions of Oxymorphone with, for example, Alvimopan, Ethanol, Isocarboxazid. The full list is on the Oxymorphone page.
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