Drug interactions
Tramadol + Tucatinib
Severity: Moderate
Tramadol and Tucatinib: 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
Tucatinib is a moderate CYP3A inhibitor and may raise exposure to CYP3A substrates. Tramadol is partly metabolised by CYP3A4 to an inactive metabolite, so inhibition may raise parent tramadol levels and increase serotonergic effects and seizure risk while reducing formation of active M1 only if CYP2D6 is also affected.
What this interaction means in plain words
Tramadol and Tucatinib 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 belongs to Musculoskeletal; Tucatinib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated tramadol N-demethylation, which increases parent drug exposure.
What to do
Monitor for sedation, respiratory depression, serotonin toxicity and seizures, and consider a lower tramadol dose. Reassess if tucatinib is stopped, since tramadol levels will fall.
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
Other interactions of Tucatinib
- Cisapride + Tucatinib Contraindicated
- Eletriptan + Tucatinib Contraindicated
- Ergotamine + Tucatinib Contraindicated
- Flibanserin + Tucatinib Contraindicated
- Ranolazine + Tucatinib Contraindicated
- Amobarbital + Tucatinib Major
Frequently asked questions
Can I take Tramadol with Tucatinib?
MediHelp rates the interaction as moderate. Tramadol and Tucatinib 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. Tucatinib is a moderate CYP3A inhibitor and may raise exposure to CYP3A substrates. Tramadol is partly metabolised by CYP3A4 to an inactive metabolite, so inhibition may raise parent tramadol levels and increase serotonergic effects and seizure risk while reducing formation of active M1 only if CYP2D6 is also affected.
How serious is the interaction between Tramadol and Tucatinib?
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 sedation, respiratory depression, serotonin toxicity and seizures, and consider a lower tramadol dose. Reassess if tucatinib is stopped, since tramadol levels will fall.
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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