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Tramadol may interact with certain antidepressants and anxiolytics (particularly SSRIs, SNRIs, MAOIs, and TCAs) other opioid analgesics (pethidine, tapentadol, oxycodone, and fentanyl), dextromethorphan, certain migraine medications (triptans, ergots), certain antibiotics (namely, linezolid and isoniazid), certain herbs (e.g. St. John’s wort, passiflora, etc.), stimulants (including amphetamines, phenethylamine and, phentermine), lithium, methylene blue as well as numerous other therapeutic agents.[5][12] As it is a substrate of CYP3A4 and CYP2D6, any agents with the ability to inhibit or induce these enzymes will likely interact with tramadol.
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