Trabest Drug Interactions

Concomitant use is contraindicated with: Non-selective MAO Inhibitors: Risk of serotoninergic syndrome: diarrhoea, tachycardia, sweating, trembling, confusion, even coma.
Selective A-MAO Inhibitors: Extrapolation from non-selective MAO inhibitors. Risk of serotoninergic syndrome: diarrhoea, tachycardia, sweating, trembling, confusion, even coma.
Selective B-MAO Inhibitors: Central excitation symptoms evocative of a serotoninergic syndrome: diarrhoea, tachycardia, sweating, trembling, confusion, even coma.
In case of recent treatment with MAO inhibitors, a delay of two weeks should occur before treatment with tramadol.
Concomitant use is not recommended with: Alcohol: Alcohol increases the sedative effect of opioid analgesics.
The effect on alertness can make driving of vehicles and the use of machines dangerous.
Avoid intake of alcoholic drinks and of medicinal products containing alcohol.
Carbamazepine and other enzyme inducers: Risk of reduced efficacy and shorter duration due to decreased plasma concentrations of tramadol.
Opioid agonists-antagonists (buprenorphine, nalbuphine, pentazocine): Decrease of the analgesic effect by competitive blocking effect at the receptors, with the risk of occurrence of withdrawal syndrome.
Concomitant use which needs to be taken into consideration: In isolated cases, there have been reports of Serotonin Syndrome in a temporal connection with the therapeutic use of tramadol in combination with other serotoninergic medicines such as selective serotonin reuptake inhibitors (SSRIs) and triptans. Signs of Serotonin Syndrome may be for example, confusion, agitation, fever, sweating, ataxia, hyperreflexia, myoclonus and diarrhoea.
Other opioid derivatives (including antitussive drugs and substitutive treatments), barbiturates and benzodiazepines: Increased risk of respiratory depression which can be fatal in cases of overdose.
Other central nervous system depressants, such as other opioid derivatives (including antitussive drugs and substitutive treatments), barbiturates, benzodiazepines, other anxiolytics, hypnotics, sedative antidepressants, sedative antihistamines, neuroleptics, centrally-acting antihypertensive drugs, thalidomide and baclofen: These drugs can cause increased central depression. The effect on alertness can make driving of vehicles and the use of machines dangerous.
As medically appropriate, periodic evaluation of prothrombin time should be performed when Tramadol and Paracetamol and warfarin-like compounds are administered concurrently due to reports of increased INR.
Other drugs known to inhibit CYP3A4, such as ketoconazole and erythromycin, might inhibit the metabolism of tramadol (N-demethylation), and probably also the metabolism of the activeO-demethylated metabolite. The clinical importance of such an interaction has not been studied.
Medicinal products reducing the seizure threshold, such as bupropion, serotonin reuptake inhibitor antidepressants, tricyclic antidepressants and neuroleptics. Concomitant use of tramadol with these drugs can increase the risk of convulsions. The speed of absorption of paracetamol may be increased by metoclopramide or domperidone, and absorption reduced by cholestyramine.
In a limited number of studies the pre- or postoperative application of the antiemetic 5-HT3 antagonist ondansetron increased the requirement of tramadol in patients with postoperative pain.