What the FDA labels say about taking them together
Carbamazepine and tramadol
Carbamazepine's FDA label of August 20, 2026 names tramadol in its drug interactions section, and tramadol's label names carbamazepine too. The tramadol label: “The concomitant use of Tramadol Hydrochloride Extended-Release Capsules and CYP3A4 inducers can decrease the plasma concentration of tramadol, resulting in decreased efficacy or onset of a withdrawal syndrome in …”
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026, Novartis Pharmaceuticals Corporation); the tramadol FDA label on DailyMed (effective March 5, 2026, Lupin Pharmaceuticals, Inc.).
What does the carbamazepine label say about tramadol?
Carbamazepine label, drug interactions… midazolam, olanzapine, oral and other hormonal contraceptives, oxcarbazepine, paliperidone, phensuximide, phenytoin, praziquantel, protease inhibitors, risperidone, sertraline, sirolimus, tadalafil, theophylline, tiagabine, topiramate, tramadol, trazodone, tricyclic antidepressants (e.g., imipramine, amitriptyline, nortriptyline), valproate, warfarin, ziprasidone, zonisamide.
Carbatrol label (Takeda Pharmaceuticals America, Inc., August 17, 2026), drug interactions… oral and other hormonal contraceptives (2), oxcarbazepine, paliperidone, phenytoin (3), praziquantel, protease inhibitors, quetiapine, risperidone, rivaroxaban (6), sertraline, sirolimus, tadalafil, theophylline, tiagabine, topiramate, tramadol, triazolam, trazodone (4), tricyclic antidepressants (e.g., imipramine, amitriptyline, nortriptyline), valproate, warfarin (5), ziprasidone, and zonisamide. (2) Concomitant use of Carbatrol with hormonal contraceptive products (e.g., oral and levonorgestrel subdermal implant contraceptives) may render the contraceptives less effective because the plasma concentrations of the hormones may be decreased.
Equetro label (Validus Pharmaceuticals LLC, August 19, 2025), drug interactions… midazolam, mirtazapine, nefazodone, olanzapine, oral and other hormonal contraceptives, oxcarbazepine, paliperidone, phenytoin, praziquantel, quetiapine, risperidone, sertraline, sirolimus, tadalafil, theophylline, topiramate, tiagabine, tramadol, triazolam, tricyclic antidepressants (e.g., imipramine, amitriptyline, nortriptyline), trazodone, valproate, warfarin, ziprasidone, and zonisamide.
Source: FDA drug label (Carbatrol, NDA020712), Takeda Pharmaceuticals America, Inc., effective August 17, 2026 (SPL set bc03e499-5bac-4293-bff4-6864153a624d), via openFDA
Source: FDA drug label (Equetro, NDA021710), Validus Pharmaceuticals LLC, effective August 19, 2025 (SPL set be478f3c-40f6-47cc-8ab9-f420a9372b1c), via openFDA
Source: FDA drug label (Tegretol), Novartis Pharmaceuticals Corporation, effective August 20, 2026 (SPL set 8d409411-aa9f-4f3a-a52c-fbcb0c3ec053), via openFDA; the full label on DailyMed
What does the tramadol label say about carbamazepine?
Tramadol label, drug interactionsCYP3A4 Inducers Clinical Impact: The concomitant use of tramadol hydrochloride extended-release tablets and CYP3A4 inducers can decrease the plasma concentration of tramadol, resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence to tramadol,. … for seizures and serotonin syndrome, and signs of respiratory depression and sedation. Patients taking carbamazepine, a CYP3A4 inducer, may have a significantly reduced analgesic effect of tramadol. …
Tramadol label, warnings and precautionsCytochrome P450 3A4 Interaction The concomitant use of tramadol hydrochloride extended-release tablets with cytochrome P450 3A4 inhibitors, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), and protease inhibitors (e.g., ritonavir) or discontinuation of a cytochrome P450 3A4 inducer such as rifampin, carbamazepine, and phenytoin, may result in an increase in tramadol plasma concentrations, which could increase or prolong adverse reactions, increase the risk for serious adverse events including seizures and serotonin syndrome, and may cause potentially fatal respiratory depression.
Source: FDA drug label (Tramadol Hydrochloride Extended-Release, NDA022370), Trigen Laboratories, LLC, effective January 23, 2026 (SPL set c0bc7218-3fd0-4646-96f4-25355fc84aa9), via openFDA
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
| Carbamazepine | Tramadol | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Pain |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.119 per tablet 200 mg tablet | $0.0248 per tablet 50 mg tablet |
| Shortage now | A presentation being discontinued | 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