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Pharmacy and Medications

Tramodal half-life and drug interaction

02/14/2007

Question:

What is the half-life of Tramadol and what medicines does it not interact very well with?

Thank you.

Answer:

Immediate-release is 6.3 hours, extended-release is 7.9-8.8 hours.

Interactions:

Increased risk of seizures when taken with:

Amoxapine   Bromperidol   Carbamazepine   Chlorpromazine  Chlorprothixene   Citalopram   Clomipramine   Clovoxamine  Clozapine   Desipramine   Cyclobenzaprine   Doxepin  Dothiepin   Escitalopram   Ethopropazine   Femoxetine Fluoxetine   Flupenthixol   Fluphenazine   Fluvoxamine  Haloperidol   Imipramine   Lofepramine   Penfluridol   Loxapine   Melperone   Mesoridazine   Methotrimeprazine   Nortriptyline   Molindone   Perphenazine   Pimozide   Pipotiazine   Prochlorperazine   Promazine   Promethazine   Propiomazine   Protriptyline   Remoxipride   Risperidone   Sulpiride   Thiethylperazine   Thioridazine   Thiothixene   Trifluoperazine   Triflupromazine   Trimeprazine   Trimipramine   Zuclopenthixol

Interaction Effect: nausea, vomiting, cardiovascular collapse, respiratory depression, seizures with: Clorgyline   Isocarboxazid

Interaction Effect: increased tramadol exposure with: Erythromycin Ketoconazole

Interaction Effect: an increased risk of digoxin toxicity (nausea, vomiting, cardiac arrhythmias) with: Digoxin

Interaction Effect: an increased risk of respiratory depression and excessive CNS depression with: Ketamine

Interaction Effect: increased risk of serotonin syndrome (hyperthermia, hyperreflexia, myoclonus, mental status changes) with: Linezolid, Mirtazapine, Paroxetine Sertraline Venlafaxine

Interaction Effect: nausea, vomiting, cardiovascular collapse, respiratory depression, seizures with: Moclobemide, Phenelzine Selegiline Tranylcypromine

Interaction Effect: an increased risk of bleeding with: Phenprocoumon

Interaction Effect: increased concentrations of tramadol and decreased concentrations of tramadol active metabolite with: Quinidine

Interaction Effect: coma, severe hypertension or hypotension, severe respiratory depression, convulsions, malignant hyperpyrexia, excitation, peripheral vascular collapse, death with: Rasagiline

Interaction Effect: decreased tramadol exposure with: Rifampin St John's Wort

Interaction Effect: increased tramadol serum concentrations and potential toxicity (extreme sedation and respiratory depression) with: Ritonavir

Interaction Effect: an increase in prothrombin time and an increased risk of bleeding with: Warfarin

Interaction Effect: an increased risk of respiratory depression and excessive CNS depression with Ethanol

Many other medicines may also interact with tramadol.  Be sure to tell your doctor about all medicines you take, even those not on this list.

Submitted by Bridget Factor, Pharm D Candidate, The Ohio State University.

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Response by:

Carmen M Hadley, RPh, CSPI
Former Clinical Instructor
College of Pharmacy
The Ohio State University