Tramadol and Carbamazepine Interaction
Drug interaction information between Tramadol and Carbamazepine.
Tramadol and Carbamazepine have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Tramadol and Carbamazepine. 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
Carbamazepine makes your body break down the pain medicine too quickly, so it may not work. It also increases your risk of having a seizure.
FDA Label Information
Patients taking carbamazepine, a CYP3A4 inducer, may have a significantly reduced analgesic effect of tramadol. Because carbamazepine increases tramadol metabolism and because of the seizure risk associated with tramadol, concomitant administration of tramadol hydrochloride extended-release tablets and carbamazepine is not recommended. Examples: Rifampin, carbamazepine, phenytoin Benzodiazepines and Other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can...
Tramadol Also Interacts With
- Safinamide major
- Rifampin moderate
- Phenytoin moderate
- Gabapentin minor
- Bupropion minor
Carbamazepine Also Interacts With
- Nirmatrelvir/Ritonavir major
- Ranolazine major
- Risperidone major
- Lithium moderate
- Apixaban moderate
Frequently Asked Questions
What SPL severity band is on file for Tramadol + Carbamazepine?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Carbamazepine has 129 labeled pairs on file vs Tramadol's 38. In the moderate band specifically: Tramadol has 3 (also Rifampin, Phenytoin); Carbamazepine has 16 (also Lithium, Apixaban, Desmopressin, Dronedarone).
What mechanism field is on file for Tramadol and Carbamazepine?
Carbamazepine makes your body break down the pain medicine too quickly, so it may not work. It also increases your risk of having a seizure.
Carbamazepine carries more major-labeled pairs than Tramadol
SPL source-record counts only. This page's band is moderate · classes on file: Tramadol (Opioid Analgesic); Carbamazepine (Anticonvulsant).
Carbamazepine has 3 major-labeled pairs vs Tramadol's 1. This page itself is in the moderate band, not the major band.
1 major · 3 moderate · 34 minor · 38 total
3 major · 16 moderate · 110 minor · 129 total
- Other moderate peers for Carbamazepine
- Lithium
- Apixaban
- Desmopressin
- Dronedarone
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.