What other drugs will affect tramadol?

You may be more likely to have a seizure (convulsions) if you take tramadol while you are using certain other medicines. Do not take tramadol without telling your doctor if you also use any of the following:

an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam); or

an antidepressant such as amitriptyline (Elavil), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor); paroxetine (Paxil), or sertraline (Zoloft).

Before taking tramadol, tell your doctor if you also use:

carbamazepine (Tegretol);

warfarin (Coumadin);

digoxin (Lanoxin, Lanoxicaps);

ketoconazole (Nizoral);

erythromycin (E-Mycin, E.E.S., Ery-Tab);

rifampin (Rifadin, Rimactane, Rifater);

St. John's wort;

quinidine (Quinaglute, Quinadex, Cardioquin, Quinora); or

drugs that make you sleepy (such as cold medicine, other pain medications, muscle relaxants, and medicine for seizures, depression or anxiety).

If you are using any of these drugs, you may not be able to use tramadol or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect tramadol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.