Interaction between Tramadol and Selegiline
Major
Synergy
| ID | DDInter1841 and DDInter1653 |
| Interaction | Monoamine oxidase inhibitors (MAOIs) may potentiate the serotonergic activity of tramadol and increase the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. The mechanism is an additive pharmacodynamic effect resulting from MAOI inhibition of serotonin metabolism. Patients receiving this combination of drugs may also experience an increased risk of seizures due to lowering of seizure threshold. |
| Management | Concurrent use of tramadol and MAOIs or other agents that possess MAOI activity (e.g., furazolidone, procarbazine) is considered contraindicated. At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with tramadol. |
| References | |
| Alternative for Tramadol |
N02A
|
| Alternative for Selegiline |
N04B
|
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.