Buprenorphine/Naloxone and Tramadol Interaction
Drug interaction information between Buprenorphine/Naloxone and Tramadol.
Buprenorphine/Naloxone and Tramadol have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Buprenorphine/Naloxone and Tramadol. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Both of these medicines affect serotonin levels and can cause heavy sedation. This increases the risk of a serious reaction called serotonin syndrome and can make you very sleepy.
FDA Label Information
Examples: Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase (MAO) inhibitors (those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue).
Buprenorphine/Naloxone Also Interacts With
- Gabapentin minor
- Trazodone minor
- Cyclobenzaprine minor
- Pregabalin minor
- Mirtazapine minor
Tramadol Also Interacts With
- Safinamide major
- Carbamazepine moderate
- Rifampin moderate
- Phenytoin moderate
- Gabapentin minor
Frequently Asked Questions
What SPL severity band is on file for Buprenorphine/Naloxone + Tramadol?
Compiled FDA labeling labels this pair minor. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Tramadol has 38 labeled pairs on file vs Buprenorphine/Naloxone's 19. In the minor band specifically: Buprenorphine/Naloxone has 19 (also Gabapentin, Trazodone, Cyclobenzaprine, Pregabalin); Tramadol has 34 (also Gabapentin, Bupropion, Fluoxetine, Cyclobenzaprine).
What mechanism field is on file for Buprenorphine/Naloxone and Tramadol?
Both of these medicines affect serotonin levels and can cause heavy sedation. This increases the risk of a serious reaction called serotonin syndrome and can make you very sleepy.
Tramadol carries more major-labeled pairs than Buprenorphine/Naloxone
SPL source-record counts only. This page's band is minor · classes on file: Buprenorphine/Naloxone (Partial Opioid Agonist / Antagonist); Tramadol (Opioid Analgesic).
Tramadol has 1 major-labeled pair vs Buprenorphine/Naloxone's 0. This page itself is in the minor band, not the major band.
0 major · 0 moderate · 19 minor · 19 total
- Other minor peers for Buprenorphine/Naloxone
- Gabapentin
- Trazodone
- Cyclobenzaprine
- Pregabalin
1 major · 3 moderate · 34 minor · 38 total
- Other minor peers for Tramadol
- Gabapentin
- Bupropion
- Fluoxetine
- Cyclobenzaprine
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.