Drug interactions
Tramadol + Voxelotor
Severity: Moderate
Tramadol and Voxelotor: 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
Voxelotor inhibits CYP3A4 and may increase exposure to sensitive CYP3A4 substrates. Tramadol is partly metabolised by CYP3A4, so levels of the parent drug may increase and enhance serotonergic and seizure risk. The effect is expected to be modest because CYP2D6 is also involved.
What this interaction means in plain words
Tramadol and Voxelotor 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; Voxelotor belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4-mediated metabolism of tramadol by voxelotor.
What to do
Monitor for sedation, respiratory depression and signs of serotonin toxicity, and consider reducing the tramadol dose. Choose a non-CYP3A4-dependent analgesic if risk is high.
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 Voxelotor
- Amobarbital + Voxelotor Major
- Apalutamide + Voxelotor Major
- Carbamazepine + Voxelotor Major
- Cyclosporin + Voxelotor Major
- Efavirenz + Voxelotor Major
- Enzalutamide + Voxelotor Major
Frequently asked questions
Can I take Tramadol with Voxelotor?
MediHelp rates the interaction as moderate. Tramadol and Voxelotor 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. Voxelotor inhibits CYP3A4 and may increase exposure to sensitive CYP3A4 substrates. Tramadol is partly metabolised by CYP3A4, so levels of the parent drug may increase and enhance serotonergic and seizure risk. The effect is expected to be modest because CYP2D6 is also involved.
How serious is the interaction between Tramadol and Voxelotor?
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 and signs of serotonin toxicity, and consider reducing the tramadol dose. Choose a non-CYP3A4-dependent analgesic if risk is high.
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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