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Tramadol must not be combined with an MAO-inhibitor, or within 14 days of discontinuation of it, as potentiation or serotonergic and noradrenergic effects may result.
Simultaneous administration with cimetidine is associated with clinically insignificant changes in serum concentrations of tramadol. Therefore, no alteration of the tramadol dosage regimen is recommended for patients receiving chronic cimetidine therapy.
Animal studies have shown that the duration of anesthesia is prolonged when tramadol is combined with barbiturates. The analgesic effect and duration of action may be reduced on concomitant or previous use of carbamazepine.
The concomitant administration of tramadol with centrally acting depressants may produce intensified effects. On the other hand, combining tramadol, combining tramadol with a tranquilizer may produce favorable effects on pain sensation and management.
