Drug interactions
Posaconazole + Tramadol
Severity: Moderate
Posaconazole 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
Posaconazole is a strong CYP3A4 inhibitor and can raise tramadol concentrations by blocking its N-demethylation, shunting metabolism toward other pathways. Higher exposure may increase risk of opioid toxicity, serotonin syndrome and seizures.
What this interaction means in plain words
Posaconazole 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.
Posaconazole belongs to Anti Fungals; Tramadol belongs to Musculoskeletal.
Why it happens
CYP3A4 inhibition by posaconazole reduces tramadol clearance.
What to do
Monitor for sedation, respiratory depression and serotonergic symptoms, and reduce the tramadol dose if they occur. Reassess when the azole is stopped.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Posaconazole with Tramadol?
MediHelp rates the interaction as moderate. Posaconazole 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. Posaconazole is a strong CYP3A4 inhibitor and can raise tramadol concentrations by blocking its N-demethylation, shunting metabolism toward other pathways. Higher exposure may increase risk of opioid toxicity, serotonin syndrome and seizures.
How serious is the interaction between Posaconazole 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 sedation, respiratory depression and serotonergic symptoms, and reduce the tramadol dose if they occur. Reassess when the azole is stopped.
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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