When two or more
medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a
Drug Interaction.
Paracetamol/Tramadol interacts with
carbamazepine, which is used to prevent and control
seizures. When
carbamazepine is used with Paracetamol+Tramadol, the pain-reducing effect of Paracetamol+Tramadol is reduced, and the breakdown or elimination of Paracetamol+Tramadol is increased. Paracetamol+Tramadol should not be used in combination with carbamazepine.
There may be an interaction of
Paracetamol+Tramadol with triptans, which are used to treat
migraine. Patients taking triptans in combination with Paracetamol+Tramadol may experience increased serotonergic activity in the central nervous system (serotonin
syndrome). Take necessary precautions while using Paracetamol+Tramadol in combination with triptans.
Paracetamol/Tramadol may interact with monoamine oxidase inhibitors, which are used to treat
depression. The use of Paracetamol+Tramadol with monoamine oxidase (MAO) inhibitors may cause
diarrhea,
confusion, increased heartbeat, trembling, excessive sweating,
seizures or
coma. In patients taking MAO inhibitors, Paracetamol+Tramadol should be given after two weeks of MAO inhibitors treatment.
Your doctor's guidelines may need to be followed while taking this medicine along with
quinidine, which is used to treat or prevent irregular heartbeat. The use of
quinidine with
tramadol may increase the level of
tramadol and lowers the level of the amount of metabolite of Paracetamol+Tramadol.
Special instructions need to be followed while taking this medicine along with
alcohol, which is used for sleepiness effect.
Alcohol may increase sleepiness effect of Paracetamol+Tramadol. Thus, the use of alcohol with Paracetamol+Tramadol while using machines and driving vehicles may be dangerous. The use of alcohol or alcohol containing products should be avoided while taking Paracetamol+Tramadol.
Your doctor's guidelines may need to be followed while taking this medicine along with serotonergic drugs, used to treat
depression. The use of Paracetamol+Tramadol with serotonin and
norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (
SSRIs), monoamine oxidase inhibitors (MAOIs), tricyclic
antidepressants, antipsychotics may cause
seizures and serotonin
syndrome in the patients. The use of α2-adrenergic blockers, triptans, St. John’s Wort,
lithium or
linezolid may cause a life-threatening condition (called as, serotonin syndrome) in the patients. Take necessary precautions while using Paracetamol+Tramadol in combination with serotonergic drugs.
Special instructions need to be followed while taking this medicine along with
cytochrome 2D6 and cytochrome 3A4 inducers or inhibitors. The use of Paracetamol+Tramadol with cytochrome 2D6 (for example,
paroxetine,
fluoxetine, and
amitriptyline) and cytochrome 3A4 inhibitors (for example,
erythromycin,
ketoconazole) or inducers (for example, St. John’s Wort and
rifampin) may affect the breakdown and amount of Paracetamol+Tramadol. These patients may suffer from
seizures and a life-threatening condition (called as, serotonin
syndrome).
Paracetamol/Tramadol interacts with
opioid agonists-antagonists, which are used to treat
pain. When the Paracetamol+Tramadol is used with opioid agonists-antagonists (for example,
buprenorphine,
nalbuphine,
pentazocine), the pain-relieving effect gets reduced and increases the risk of withdrawal symptoms. Paracetamol+Tramadol should not be used along with opioid agonists-antagonists.
There may be an interaction of
Paracetamol+Tramadol with
warfarin like compounds, which are used to prevent blood clottimg. The use of Paracetamol+Tramadol with warfarin-like compounds may cause an increase in the blood clotting time.
Regularly monitoring of the prothrombin time should be done in the patients using Paracetamol+Tramadol together with warfarin-like compounds.
Paracetamol/Tramadol may interact with
digoxin, which is used to treat heart failure. When Paracetamol+Tramadol is used in combination with
digoxin, an increase in the level of digoxin may occur.
Special instructions need to be followed while taking this medicine along with other central nervous system depressants, which are used to treat
anxiety and
insomnia. If the Paracetamol+Tramadol is used with other central nervous system depressants, such as other anxiolytics, sedative
antidepressants, hypnotics, sedative
antihistamines, centrally-acting antihypertensive drugs, neuroleptics,
thalidomide and
baclofen, the patient may suffer from increased central
depression and the impact on alertness can cause driving and use of machines harmful. Take necessary precautions while using Paracetamol+Tramadol in such patients.
Paracetamol/Tramadol interacts with
mirtazapine, which is used to treat
depression. The use of Paracetamol+Tramadol with mirtazapine may cause
seizures and a life-threatening condition (called as, serotonin
syndrome) in the patients. Use this medicine with caution in such patients.
There may be an interaction of
Paracetamol+Tramadol with
seizure threshold-lowering medicines. The use of Paracetamol+Tramadol with seizure threshold-lowering medicines (for example, tetrahydrocannabinol,
mirtazapine,
bupropion) may cause seizures in the patients. Take necessary precautions while using Paracetamol+Tramadol in combination with seizure threshold-lowering medicines.
Paracetamol/Tramadol may interact with other
opioid derivatives (including antitussive drugs and substitutive treatments), benzodiazepines and barbiturates, which are used to treat
anxiety. When the Paracetamol+Tramadol is used with other opioid derivative drugs, barbiturates, or benzodiazepines the risk of slow and ineffective breathing increases that can result in the fatality in cases of overdose. Use this medicine with caution in such patients.
This page does not contain all the possible interactions of Paracetamol/Tramadol. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any
medicines without the approval of your doctor.