Ultram (tramadol) Drug Interactions

Ultram and Ultram ER may interact with other medicines. It is extremely important for you to tell your doctor about all the medicines you are currently taking, including your over-the-counter (non-prescription) medicines. The migraine journal can help you keep a list of all of your medicines so that any possible drug interactions can be evaluated. Do not stop taking any medicine without telling your doctor.


Ultram/Ultram ER Drug Interactions With Drugs that Affect Liver Enzymes (CYP2D6 and CYP3A4 Inhibitors)

Inhibitors of liver enzymes CYP2D6 (such as quinidine, fluoxetine, paroxetine and amitriptyline) and CYP3A4 (ketoconazole and erythromycin), may prevent Ultram from being eliminated from your body and can increase your risk of serious side effects including seizures and serotonin syndrome.

Ultram/Ultram ER Drug Interactions With Serotonin Like Drugs

Your risk of serotonin syndrome increases when you take Ultram along with:

  • SSRIs/SNRIs (medicines for depression and mental illness)
  • Triptans (medicine for migraines)
  • MAOIs (medicine for depression)
  • Beta blockers (medicines for your heart)

Use Ultram with caution if you are taking any of the following medicines:

  • Linezolid (an antibiotic which is a reversible non-selective MAOI)
  • Lithium (medicine for mental illness)
  • St. John’s Wort (an herb available in health food stores)
  • Rifampin (an antibiotic medicine)

If you are using any of the above medicines along with Ultram your doctor should carefully monitor you as you start using Ultram and whenever your doses are increased.


Ultram/Ultram ER Drug Interactions With Carbamazepine

Taking carbamazepine (an epilepsy and bipolar disorder medicine)along with Ultrammay significantly reduce the pain relieving effectiveness of Ultram. Because carbamazepine causes Ultram to be absorbed into your body faster than normal and because of the increased risk of seizure, Ultram and carbamazepine should not be taken together.


Ultram/Ultram ER Drug Interactions With Digoxin and Warfarin

There have been rare reports of digoxin poisoning and changes in the effectiveness of warfarin effect when taken with Ultram.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010.
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