Taking tramadol with other medicines and herbal supplements

Some medicines can affect the way tramadol works and increase the chances of you having side effects.

Before taking tramadol, tell your doctor if you're already taking any other medicines, including any medicines that:

• treat depression or other mental health problems
• relieve pain
• help you sleep
• reduce tension or anxiety
• treat symptoms of an allergy
• help prevent blood clots (such as warfarin)
• treat an infection

Some medicines may weaken or shorten the effect of tramadol. Tell your doctor if you're taking:

• carbamazepine to treat epilepsy
• buprenorphine, a painkiller
• ondansetron, to stop you feeling sick
• rifampicin, an antibiotic

These are not all the medicines that may cause problems if you take them with tramadol. For a full list, see the leaflet inside your medicine packet.

Do not take medicines called monoamine oxidase inhibitors or MAOIs with tramadol. Examples of MAOIs include moclobemide or phenelzine which are used to treat depression, or rasagiline or selegiline which are used to treat Parkinson's disease. The combination can cause serious side effects such as anxiety, confusion and hallucinations.

It's safe to take tramadol with paracetamol, ibuprofen or aspirin (aspirin is only suitable for people aged 16 and over).

Do not take medicines that contain codeine with tramadol because you are more likely to get side effects. This includes some painkillers you can buy from pharmacies, such as co-codamol,  ibuprofen and codeine (Nurofen Plus) and Solpadeine.

There's very little information about taking complementary medicines, herbal remedies or supplements with tramadol. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.