Drug interactions
Sufentanil sl + Tramadol
Severity: Major
Sufentanil sl and Tramadol: major 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
Sublingual sufentanil combined with tramadol adds opioid effects that can cause profound sedation, respiratory depression, hypotension, coma and death. Tramadol also adds seizure and serotonergic risk.
What this interaction means in plain words
Sufentanil sl and Tramadol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive mu-opioid receptor agonism and CNS depression.
What to do
Avoid the combination unless alternatives are inadequate, then use the lowest doses for the shortest duration and monitor sedation and respiratory rate. Consider naloxone availability.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Sufentanil sl with Tramadol?
MediHelp rates the interaction as major. Sufentanil sl and Tramadol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Sublingual sufentanil combined with tramadol adds opioid effects that can cause profound sedation, respiratory depression, hypotension, coma and death. Tramadol also adds seizure and serotonergic risk.
How serious is the interaction between Sufentanil sl and Tramadol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination unless alternatives are inadequate, then use the lowest doses for the shortest duration and monitor sedation and respiratory rate. Consider naloxone availability.
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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