Compatibility «Paracetamol+Tramadol» and «Ciclosporin»

• Interactions Paracetamol+Tramadol with Ciclosporin

  • Dangerous interactions
    • ⓘ Increases the risk of myopathy and rhabdomyolysis when prescribing lipid-lowering drugs (HMG-CoA reductase inhibitors), impaired renal function - against the background of aminoglycosides, amphotericin B, trimethoprim, co-trimoxazole, ciprofloxacin, some cephalosporins, NSAIDs, propafenone.
    • ⓘ 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.
  • Negative interactions
    • ⓘ Drugs that inhibit cytochrome P450 isoenzyme CYP3A4, such as ketoconazole and erythromycin, can slow down the metabolism of tramadol (N-demethylation) and the active O-demethylated metabolite.
    • ⓘ Microsomal oxidation inhibitors (cimetidine) reduce the risk of hepatotoxic effects of paracetamol.
    • ⓘ with drugs with nephrotoxic effects: aminoglycosides (including gentamicin, tobramycin), amphotericin B, ciprofloxacin, mannitol, melphalan, co-trimoxazole (trimethoprim + sulfamethoxazole), vancomycin, nonsteroidal anti‑inflammatory drugs (including diclofenac, indomethacin, naproxen, sulindac), blockers H₂-histamine receptors (including cimetidine, ranitidine), methatrexate with tacrolimus, etc.
    • ⓘ Nonsteroidal anti-inflammatory drugs with a pronounced 'first pass' effect through the liver (for example, diclofenac) should be used in lower doses than in patients who do not receive cyclosporine.
    • ⓘ Other inhibitors of the CYP3A4 isoenzyme, for example, ketoconazole and erythromycin, may slow down the metabolism of tramadol (N-demethylation) and possibly active O-demethyl-tramadol.
  • Unclear interactions
    • ⓘ With the simultaneous use of nonsteroidal anti-inflammatory drugs with a less pronounced 'first pass' effect (for example, acetylsalicylic acid) with cyclosporine, an increase in their bioavailability is not expected.

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: 170,041,552 possible combinations of drugs and their components were found 412,577 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2026-06-18

Category - medicine