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Tramadol

Also indexed as: Ultram

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Tramadol is a drug, unrelated to nonsteroidal anti-inflammatory drugs (NSAIDs) or opiates, used to relieve moderate to moderately severe pain.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

5-Hydroxytryptophan (5-HTP)*

L-tryptophan*

Depletion or interference

None known

Side effect reduction/prevention

None known

Supportive interaction

None known

Reduced drug absorption/bioavailability

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

5-Hydroxytryptophan (5-HTP) and L-tryptophan
Tramadol, which blocks serotonin reuptake in the brain, has been associated with two cases of serotonin syndrome.1 2 5-HTP and L-tryptophan are converted to serotonin in the brain. While no interactions have yet been reported with tramadol and 5-HTP or L-tryptophan, taking 5-HTP or L-tryptophan with tramadol may increase the risk of tramadol-induced side effects, including serotonin syndrome.

Interactions with Foods and Other Compounds

Food
Tramadol may be taken with or without food.3

Alcohol
Tramadol may impair mental ability and physical coordination.4 Alcohol may intensify these effects and increase the risk of accidental injury. People taking tramadol are cautioned to avoid alcohol.


1. Mason BJ, Blackburn KH. Possible serotonin syndrome associated with tramadol and sertraline coadministration. Ann Pharmacother 1997;31:175–7.

2. Hernandez AF, Montero MN, Pla A, Villanueva E. Fatal moclobemide overdose or death caused by serotonin syndrome? J Forensic Sci 1995;40:128–30.

3. Threlkeld DS, ed. Central Nervous System Drugs, Central Analgesics, Tramadol HCl. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1995, 246b–6f.

4. Threlkeld DS, ed. Central Nervous System Drugs, Central Analgesics, Tramadol HCl. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, May 1995, 246b–6f.




*The information in this newsletter is for educational use only. Do not attempt to self-diagnose or treat any condition. Please consult your healthcare practitioner if you believe you may have any of the signs or symptoms discussed above before using any of the nutrients discussed.

You should also consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem.
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