Drug interactions
Rolapitant + Tramadol
Severity: Moderate
Rolapitant 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
Tramadol requires CYP2D6 to form its active opioid metabolite, and rolapitant inhibits this enzyme for weeks. Analgesia may be reduced while parent tramadol rises, increasing serotonergic and seizure risk.
What this interaction means in plain words
Rolapitant 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.
Rolapitant belongs to Gastrointestinal Tract; Tramadol belongs to Musculoskeletal.
Why it happens
Rolapitant inhibits CYP2D6, decreasing tramadol conversion to O-desmethyltramadol and raising parent drug levels.
What to do
Monitor for loss of analgesia and for serotonin toxicity or seizures. Consider an alternative analgesic not dependent on CYP2D6.
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 Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
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 Rolapitant with Tramadol?
MediHelp rates the interaction as moderate. Rolapitant 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. Tramadol requires CYP2D6 to form its active opioid metabolite, and rolapitant inhibits this enzyme for weeks. Analgesia may be reduced while parent tramadol rises, increasing serotonergic and seizure risk.
How serious is the interaction between Rolapitant 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 loss of analgesia and for serotonin toxicity or seizures. Consider an alternative analgesic not dependent on CYP2D6.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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