Trazodone (Greater Than 50 mg)/Meperidine; Tramadol Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of these medicines can increase the level of serotonin in your body.

What might happen:

High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. The severity of Serotonin Syndrome varies from mild to potentially life threatening.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together.If you experience muscle twitching, tremors, shivering and stiffness, fever, heavy sweating, heart palpitations, restlessness, confusion, agitation, trouble with coordination, or severe diarrhea contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Ultram (tramadol) US prescribing information. Janssen Pharmaceutical, Inc. October, 2019.
  • 2.Demerol (meperidine hydrochloride) US prescribing information. Validus Pharmaceuticals LLC. December, 2023.
  • 3.Oleptro (trazodone hydrochloride) US prescribing information. Angelini Labopharm Inc. November, 2012.
  • 4.Wen B, Ma L, Rodrigues AD, Zhu M. Detection of novel reactive metabolites of trazodone: evidence for CYP2D6-mediated bioactivation of m-chlorophenylpiperazine. Drug Metab Dispos 2008 May;36(5):841-50.
  • 5.Kast RE. Trazodone generates m-CPP: in 2008 risks from m-CPP might outweigh benefits of trazodone. World J Biol Psychiatry 2009;10(4 Pt 2):682-5.
  • 6.Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med 2005 Mar 17; 352(11):1112-20.
  • 7.Kovaleva J, Devuyst E, De Paepe P, Verstraete A. Acute chlorophenylpiperazine overdose: a case report and review of the literature. Ther Drug Monit 2008 Jun;30(3):394-8.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.