Drug interactions
Perphenazine + Tramadol
Severity: Moderate
Perphenazine 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
Perphenazine adds to the sedative effect of tramadol and can cause hypotension. Perphenazine is also a CYP2D6 inhibitor and substrate, which may reduce formation of tramadol's active metabolite, and both drugs can lower the seizure threshold.
What this interaction means in plain words
Perphenazine 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.
Perphenazine belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.
Why it happens
Additive CNS depression and seizure threshold lowering, with CYP2D6 inhibition by perphenazine.
What to do
Start tramadol at a low dose, and monitor sedation, seizure activity and analgesic effect.
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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Perphenazine with Tramadol?
MediHelp rates the interaction as moderate. Perphenazine 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. Perphenazine adds to the sedative effect of tramadol and can cause hypotension. Perphenazine is also a CYP2D6 inhibitor and substrate, which may reduce formation of tramadol's active metabolite, and both drugs can lower the seizure threshold.
How serious is the interaction between Perphenazine 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: Start tramadol at a low dose, and monitor sedation, seizure activity and analgesic effect.
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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