What the FDA labels say about taking them together
Selegiline and tramadol
Selegiline's FDA label (Zelapar) of June 1, 2021 names tramadol in its contraindications section; tramadol's label does not name selegiline itself but warns about its class (MAO inhibitors). The selegiline label: “CONTRAINDICATIONS ZELAPAR is contraindicated in patients with: Concomitant use of opioid drugs.”
Check it at the source: the selegiline FDA label on DailyMed (effective August 7, 2024, Rising Pharma Holdings, Inc.); the tramadol FDA label on DailyMed (effective March 5, 2026, Lupin Pharmaceuticals, Inc.).
What does the selegiline label say about tramadol?
Zelapar label (Bausch Health US, LLC, June 1, 2021), contraindicationsCONTRAINDICATIONS ZELAPAR is contraindicated in patients with: Concomitant use of opioid drugs (e.g., meperidine, tramadol, or methadone).
Zelapar label (Bausch Health US, LLC, June 1, 2021), drug interactionsDRUG INTERACTIONS 7.1 Opioid Drugs Because serious, sometimes fatal reactions have been precipitated with concomitant use of opioid drugs (e.g., meperidine and its derivatives, methadone, or tramadol) and MAOIs, including selective MAO-B inhibitors, concomitant use of these drugs with ZELAPAR is contraindicated [see Contraindications ( 4 ) and Warnings and Precautions ( 5.2 )].
Emsam label (Viatris Specialty LLC, May 15, 2020), contraindicationsEMSAM (selegiline transdermal system) is contraindicated with selective serotonin reuptake inhibitors (SSRIs, e.g., fluoxetine, sertraline, and paroxetine); serotonin and norepinephrine reuptake inhibitors (SNRIs, e.g., venlafaxine and duloxetine); the tricyclic antidepressants clomipramine and imipramine, the opiate analgesics meperidine, tramadol, methadone, pentazocine, and propoxyphene; and the antitussive agent dextromethorphan because of a risk of serotonin syndrome when EMSAM is used with these agents [see Warnings and Precautions (5.2) and Drug Interactions (7.1) ].
Source: FDA drug label (Zelapar, NDA021479), Bausch Health US, LLC, effective June 1, 2021 (SPL set 380d7717-2a79-42f3-a712-efe5e7696ba0), via openFDA
Source: FDA drug label (Emsam, NDA021336), Viatris Specialty LLC, effective May 15, 2020 (SPL set b891bd9f-fdb8-4862-89c5-ecdd700398a3), via openFDA
Source: FDA drug label (Selegiline Hydrochloride), Rising Pharma Holdings, Inc., effective August 7, 2024 (SPL set 23c4481f-d150-40c6-addb-b3e454ca914f), via openFDA; the full label on DailyMed
What does the tramadol label say about selegiline?
Tramadol's label does not name selegiline itself; it warns about its class (MAO inhibitors):
Tramadol label, contraindicationsSignificant respiratory depression [see Warnings and Precautions ( 5.3 )] Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment [see Warnings and Precautions ( 5.12 )] Known or suspected gastrointestinal obstruction, including paralytic ileus [see Warnings and Precautions ( 5.15 )] Hypersensitivity to tramadol (e.g., anaphylaxis) [see Warnings and Precautions (5.16), Adverse Reactions ( 6.2 )] Concurrent use of monoamine oxidase inhibitors (MAOIs) or use within the …
Tramadol label, contraindicationsChildren younger than 12 years of age ( 4 ) Postoperative management in children younger than 18 years of age following tonsillectomy and/or adenoidectomy. ( 4 ) Significant respiratory depression ( 4 ) Acute or severe bronchial asthma in an unmonitored setting or in absence of resuscitative equipment ( 4 ) Known or suspected gastrointestinal obstruction, including paralytic ileus ( 4 ) Hypersensitivity to tramadol ( 4 ) Concurrent use of monoamine oxidase inhibitors (MAOIs) or use within the last 14 days
Source: FDA drug label (TRAMADOL HYDROCHLORIDE), Lupin Pharmaceuticals, Inc., effective March 5, 2026 (SPL set 46bb9ae6-3ee8-463c-badb-c7a45a89b84b), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Selegiline | Tramadol | |
|---|---|---|
| Labeled for | Parkinson's disease, Depression | Pain |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.756 per capsule 5 mg capsule | $0.0248 per tablet 50 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once