Drug interactions
Pregabalin + Tramadol
Severity: Major
Pregabalin and Tramadol: major interaction.
Last updated Sources: US FDA label
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
Pregabalin combined with an opioid such as tramadol can increase sedation and respiratory depression. Regulators have warned about serious breathing problems when gabapentinoids are used with opioids, especially in older patients or those with lung disease.
What this interaction means in plain words
Pregabalin 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.
Pregabalin belongs to Central Nervous System; Tramadol belongs to Musculoskeletal.
Why it happens
Additive central nervous system and respiratory depression.
What to do
Use the lowest effective doses and start low when adding either drug. Monitor for sedation and slowed breathing, particularly in elderly patients or those with respiratory impairment.
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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References
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 Pregabalin
Frequently asked questions
Can I take Pregabalin with Tramadol?
MediHelp rates the interaction as major. Pregabalin 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. Pregabalin combined with an opioid such as tramadol can increase sedation and respiratory depression. Regulators have warned about serious breathing problems when gabapentinoids are used with opioids, especially in older patients or those with lung disease.
How serious is the interaction between Pregabalin 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: Use the lowest effective doses and start low when adding either drug. Monitor for sedation and slowed breathing, particularly in elderly patients or those with respiratory impairment.
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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