Drug interactions
Quinidine + Tramadol
Severity: Moderate
Quinidine 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
Quinidine is a potent CYP2D6 inhibitor and blocks formation of the active opioid metabolite of tramadol, which reduces analgesia. Parent tramadol concentrations rise, which may increase serotonergic and seizure risk.
What this interaction means in plain words
Quinidine 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.
Quinidine belongs to Anti Parasitic; Tramadol belongs to Musculoskeletal.
Why it happens
Potent CYP2D6 inhibition by quinidine reduces O-desmethyltramadol formation.
What to do
Expect reduced analgesia and consider a non-CYP2D6-dependent analgesic. Monitor for serotonin toxicity and seizures if used together.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Quinidine and Tramadol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Frequently asked questions
Can I take Quinidine with Tramadol?
MediHelp rates the interaction as moderate. Quinidine 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. Quinidine is a potent CYP2D6 inhibitor and blocks formation of the active opioid metabolite of tramadol, which reduces analgesia. Parent tramadol concentrations rise, which may increase serotonergic and seizure risk.
How serious is the interaction between Quinidine 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: Expect reduced analgesia and consider a non-CYP2D6-dependent analgesic. Monitor for serotonin toxicity and seizures if used together.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
