Drug interactions
Rifampin + Tramadol
Severity: Moderate
Rifampin 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
Rifampin is a potent enzyme inducer that lowers tramadol and O-desmethyltramadol exposure, which can reduce pain control. After rifampin is stopped, tramadol levels may rise again, increasing the risk of adverse effects.
What this interaction means in plain words
Rifampin 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.
Why it happens
Induction of CYP3A4 and CYP2B6 by rifampin, increasing tramadol clearance.
What to do
Monitor analgesic response and consider a higher tramadol dose or alternative analgesic. When rifampin is discontinued, reassess for opioid and serotonergic toxicity 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
Frequently asked questions
Can I take Rifampin with Tramadol?
MediHelp rates the interaction as moderate. Rifampin 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. Rifampin is a potent enzyme inducer that lowers tramadol and O-desmethyltramadol exposure, which can reduce pain control. After rifampin is stopped, tramadol levels may rise again, increasing the risk of adverse effects.
How serious is the interaction between Rifampin 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 analgesic response and consider a higher tramadol dose or alternative analgesic. When rifampin is discontinued, reassess for opioid and serotonergic toxicity 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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