Compatibility «Amitriptyline» and «Paracetamol+Tramadol»

• Interactions Amitriptyline with Paracetamol+Tramadol

  • Dangerous interactions
    • ⓘ Combined use with drugs that lower the threshold of epileptiform seizures (for example, selective serotonin uptake inhibitors, tricyclic antidepressants, neuroleptics) may increase the risk of seizures.
    • ⓘ Inducers of microsomal liver enzymes or potentially hepatotoxic substances (for example, alcohol, rifampicin, isoniazid, hypnotics and antiepileptic drugs, including phenobarbital, phenytoin and carbamazepine) increase the toxicity of paracetamol, can lead to liver damage even with non-toxic doses of paracetamol, therefore liver function should be monitored.
    • ⓘ Amitriptyline (N06AA09) + Opioid narcotic analgesics (N02A) => Dangerous inhibition occurs. The narcotic effect increases.
    • ⓘ Amitriptyline; Imipramine(N06AA) + Opioid narcotic analgesics(N02A) => Respiratory depression. The effects of opioid analgesics are potentiated. (These drugs should be used together with caution and only in small doses).
    • ⓘ Tricyclic antidepressants (N06A) + Narcotic analgesics => Respiratory depression.
    • ⓘ Inhibitors of CYP2D6 isoenzymes (such as fluoxetine, paroxetine and amitriptyline) and CYP3A4 (such as ketoconazole, erythromycin) can reduce tramadol metabolism and increase the risk of serious side effects, including seizures and serotonin syndrome.
    • ⓘ Tramadol can cause seizures and enhance the effect of selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SSRIs), tricyclic antidepressants, neuroleptics and other drugs that lower the threshold of convulsive readiness (for example, bupropion, mirtazapine), thus leading to the development of seizures.
    • ⓘ Opioid narcotic analgesics (N02A) + Amitriptyline; Imipramine(N06AA) => Respiratory depression.
  • Negative interactions
    • ⓘ Inducers of microsomal oxidation (in pm carbamazepine, phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) reduce the analgesic effect and its duration.
    • ⓘ Concomitant use of tramadol with antidepressants and anti-migraine medications may lead to a risk of developing serotonin syndrome.
    • ⓘ With other drugs that depress the central nervous system, such as other opioids (including antitussives and drugs for the treatment of withdrawal syndrome), barbiturates, benzodiazepines, anxiolytics, hypnotics, antidepressants with sedative effect, H₁‑receptor blockers with sedative effect, neuroleptics, antihypertensive drugs with The central mechanism of action is thalidomide and baclofen.
    • ⓘ Increases the effect of indirect anticoagulants (coumarin derivatives) and the likelihood of liver damage with hepatotoxic drugs.
    • ⓘ Inducers of microsomal oxidation (in pm carbamazepine, barbiturates) reduce the severity of the analgesic effect of tramadol and the duration of action.
    • ⓘ Serotonergic drugs such as SSRI antidepressants, MAO inhibitors, anti-migraine drugs (triptans), linezolid (an antibiotic that is a reversible non-selective MAO inhibitor), as well as lithium preparations when combined with tramadol can cause serotonin syndrome.
    • ⓘ Concomitant use of tramadol with other serotonergic drugs such as SSRIs, SSRIs, MAO inhibitors, tricyclic antidepressants and mirtazapine may lead to the development of serotonin syndrome.
  • Unclear interactions
    • ⓘ With drugs that lower the threshold of convulsive readiness (such as bupropion, mirtazapine, tetrahydrocannabinol), selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants and antipsychotics.
    • ⓘ With serotonergic drugs such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SSRIs), MAO inhibitors, tricyclic antidepressants, mirtazapine.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 170,023,408 possible combinations of drugs and their components were found 412,559 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2025-11-20

Category - medicine