Sign Out
Carbamazepine is reported to diminish the analgesic activity of Tramadol by reducing serum concentrations. The risk of seizures is increased if Tramadol is used with other drugs that have the potential to lower the seizure threshold. Tramadol inhibits reuptake of noradrenaline and serotonin and enhances serotonin release and there is the possibility that it may interact with other drugs that enhance monoaminergic neurotransmission including lithium, tricyclic antidepressants, and SSRIs; it should not be given to patients receiving MAOIs or within 14 days of their discontinuation. Metabolism of Tramadol is mediated by the cytochrome P450 isoenzyme CYP2D6. Use with specific inhibitors of this enzyme, such as quinidine, may increase concentrations of Tramadol and lower concentrations of its active metabolite but the clinical consequences of this effect are unclear.
The risk of Paracetamol toxicity may be increased in patients receiving other potentially hepatotoxic drugs or drugs that induce liver microsomal enzymes. The absorption of Paracetamol may be accelerated by drugs such as metoclopramide. Excretion may be affected and plasma concentrations altered when given with probenecid. Colestyramine reduces the absorption of Paracetamol if given within 1 hour of Paracetamol.
