Drug interactions
Selegiline transdermal + Tramadol
Severity: Contraindicated
Selegiline transdermal and Tramadol: contraindicated 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
Selegiline given transdermally at antidepressant doses inhibits both MAO-A and MAO-B, and tramadol is a serotonin and norepinephrine reuptake inhibitor. The combination can cause serotonin syndrome, hypertensive crisis, hyperpyrexia and in severe cases death. Tramadol labeling warns against use with MAO inhibitors.
What this interaction means in plain words
Selegiline transdermal and Tramadol are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
MAO inhibition combined with serotonin and norepinephrine reuptake inhibition, leading to excess monoamine activity.
What to do
Do not use together; use a non-serotonergic analgesic instead. Allow an appropriate washout interval, at least 2 weeks after stopping tramadol before starting an MAOI and a corresponding period after stopping the MAOI.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Selegiline transdermal with Tramadol?
MediHelp rates the interaction as contraindicated. Selegiline transdermal and Tramadol are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Selegiline given transdermally at antidepressant doses inhibits both MAO-A and MAO-B, and tramadol is a serotonin and norepinephrine reuptake inhibitor. The combination can cause serotonin syndrome, hypertensive crisis, hyperpyrexia and in severe cases death. Tramadol labeling warns against use with MAO inhibitors.
How serious is the interaction between Selegiline transdermal and Tramadol?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; use a non-serotonergic analgesic instead. Allow an appropriate washout interval, at least 2 weeks after stopping tramadol before starting an MAOI and a corresponding period after stopping the MAOI.
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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