Drug interactions
Propafenone + Tramadol
Severity: Moderate
Propafenone 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
Propafenone inhibits CYP2D6, reducing conversion of tramadol to its more potent opioid metabolite, so analgesia may be weaker. Parent tramadol levels may rise, which can increase serotonergic and seizure risk.
What this interaction means in plain words
Propafenone 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.
Propafenone belongs to Cardiovascular; Tramadol belongs to Musculoskeletal.
Why it happens
CYP2D6 inhibition by propafenone reduces O-desmethyltramadol formation.
What to do
Monitor pain control and consider an alternative analgesic if response is inadequate. Watch for serotonergic effects and seizures.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Propafenone with Tramadol?
MediHelp rates the interaction as moderate. Propafenone 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. Propafenone inhibits CYP2D6, reducing conversion of tramadol to its more potent opioid metabolite, so analgesia may be weaker. Parent tramadol levels may rise, which can increase serotonergic and seizure risk.
How serious is the interaction between Propafenone 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 consider an alternative analgesic if response is inadequate. Watch for serotonergic effects and seizures.
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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