Tracidol Drug Interactions

Concomitant use is contra-indicated with: Non-selective MAO inhibitors: Risk of serotoninergic syndrome: diarrhoea, tachycardia, sweating, tremor, confusion, even coma.
Selective-A MAO inhibitors: Extrapolation from non-selective MAO inhibitors: Risk of serotoninergic syndrome: diarrhoea, tachycardia, sweating, tremor, confusion, even coma.
Selective-B-MAO inhibitors: Central excitation, symptoms evocative of a serotoninergic syndrome: diarrhoea, tachycardia, sweating, tremor, 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 alcohol drinks and 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 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 serotoninergic syndrome with a temporal relationship with tramadol intake in combination with other serotoninergic medicines such as selective serotonin re-uptake inhibitors (SSRIs) and triptans. Signs of serotonin syndrome may be for example, confusion, agitation, fever, sweating, ataxia, hyperreflexia, myoclonus and diarrhoea. The treatment with medicinal products depends on the nature and severity of the symptoms.
Other opioid derivatives (including antitussive drugs and substitutive treatments), benzodiazepines and barbiturates. Increased risk of respiratory depression which can be fatal in cases of overdose.
Other depressants of central nervous system, such as other opioid derivatives (including antitussive drugs and substitutive treatments), barbiturates, benzodiazepines, other anxiolytics, hypnotics, sedative antidepressants, 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 warfarin like compounds are administered concurrently due to reports of increase INR.
Other drugs known to inhibit CYP3A4, such as ketoconazole and erythromycin, might inhibit the metabolism of tramadol (N-demethylation) probably also the metabolism of the active O-demethylated metabolite.The clinical importance of such an interaction has not been studied.
Medicinal products reducing the seizure threshold, such as bupropion, serotonin re-uptake inhibitor antidepressants, tricyclic antidepressants and neuroleptics concomitant use of tramadol with these drugs can increase the risk of convulsions.