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Tramadol

Also indexed as: Ultram®

Tramadol is a drug, unrelated to nonsteroidal anti-inflammatory drugs (NSAIDs) or opiates, used to relieve moderate to moderately severe pain.

Interactions with Dietary Supplements

5-Hydroxytryptophan (5-HTP) and L-tryptophan
Tramadol, which blocks serotonin reuptake in the brain, has been associated with two cases of serotonin syndrome.1 2 5-HTP and L-tryptophan are converted to serotonin in the brain. While no interactions have yet been reported with tramadol and 5-HTP or L-tryptophan, taking 5-HTP or L-tryptophan with tramadol may increase the risk of tramadol-induced side effects, including serotonin syndrome.

Interactions with Foods and Other Compounds

Food
Tramadol may be taken with or without food.3

Alcohol
Tramadol may impair mental ability and physical coordination.4 Alcohol may intensify these effects and increase the risk of accidental injury. People taking tramadol are cautioned to avoid alcohol.

Summary of Interactions for Tramadol

Depletion or interference None known
Adverse interaction 5-Hydroxytryptophan (5-HTP)*
L-tryptophan*
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Mason BJ, Blackburn KH. Possible serotonin syndrome associated with tramadol and sertraline coadministration. Ann Pharmacother 1997;31:175–7.

2. Hernandez AF, Montero MN, Pla A, Villanueva E. Fatal moclobemide overdose or death caused by serotonin syndrome? J Forensic Sci 1995;40:128–30.

3. Threlkeld DS, ed. Central Nervous System Drugs, Central Analgesics, Tramadol HCl. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1995, 246b–6f.

4. Threlkeld DS, ed. Central Nervous System Drugs, Central Analgesics, Tramadol HCl. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1995, 246b–6f.