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Thursday, September 18, 2014
Pharmacy and Medications
Tramodal half-life and drug interaction
What is the half-life of Tramadol and what medicines does it not interact very well with?
Immediate-release is 6.3 hours, extended-release is 7.9-8.8 hours.
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.
Carmen M Hadley, RPh, CSPI
Former Clinical Instructor
College of Pharmacy
The Ohio State University