Drug interactions
Tramadol + Vortioxetine
Severity: Major
Tramadol and Vortioxetine: 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
Combining tramadol with vortioxetine increases the chance of serotonin syndrome and may also raise seizure risk. Vortioxetine is a CYP2D6 substrate and tramadol activation depends on CYP2D6, so the pharmacokinetic effects are modest, but the serotonergic overlap is the main concern.
What this interaction means in plain words
Tramadol and Vortioxetine 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; Vortioxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic activity through serotonin reuptake inhibition by both drugs, plus vortioxetine's 5-HT receptor modulation.
What to do
Choose a non-serotonergic analgesic where possible. If coadministered, start low, monitor for signs of serotonin toxicity, and discontinue if it occurs.
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 Vortioxetine
- Isocarboxazid + Vortioxetine Contraindicated
- Linezolid + Vortioxetine Contraindicated
- Methylene blue + Vortioxetine Contraindicated
- Phenelzine + Vortioxetine Contraindicated
- Rasagiline + Vortioxetine Contraindicated
- Selegiline transdermal + Vortioxetine Contraindicated
Frequently asked questions
Can I take Tramadol with Vortioxetine?
MediHelp rates the interaction as major. Tramadol and Vortioxetine 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. Combining tramadol with vortioxetine increases the chance of serotonin syndrome and may also raise seizure risk. Vortioxetine is a CYP2D6 substrate and tramadol activation depends on CYP2D6, so the pharmacokinetic effects are modest, but the serotonergic overlap is the main concern.
How serious is the interaction between Tramadol and Vortioxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose a non-serotonergic analgesic where possible. If coadministered, start low, monitor for signs of serotonin toxicity, and discontinue if it occurs.
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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