Drug interactions
Tramadol + Trimipramine
Severity: Major
Tramadol and Trimipramine: 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
Tricyclic antidepressants combined with tramadol raise the risk of serotonin syndrome and seizures. Sedation is additive. Trimipramine is partly metabolized by CYP2D6, and tramadol may raise tricyclic exposure.
What this interaction means in plain words
Tramadol and Trimipramine 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.
Tramadol belongs to Musculoskeletal; Trimipramine belongs to Central Nervous System.
Why it happens
Additive serotonergic and seizure-threshold-lowering effects, with additive CNS depression and possible CYP2D6 competition.
What to do
Avoid the combination where possible; otherwise use low doses and monitor for serotonin toxicity, seizures and sedation.
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
Other interactions of Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Frequently asked questions
Can I take Tramadol with Trimipramine?
MediHelp rates the interaction as major. Tramadol and Trimipramine 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. Tricyclic antidepressants combined with tramadol raise the risk of serotonin syndrome and seizures. Sedation is additive. Trimipramine is partly metabolized by CYP2D6, and tramadol may raise tricyclic exposure.
How serious is the interaction between Tramadol and Trimipramine?
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 where possible; otherwise use low doses and monitor for serotonin toxicity, seizures and sedation.
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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