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. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
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.
What To Do
You should avoid taking these two drugs together. Ask your doctor for a different way to manage your pain or seizures.
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
Can I take Tramadol and Carbamazepine together?
This is a moderate interaction. You should avoid taking these two drugs together. Ask your doctor for a different way to manage your pain or seizures.
How serious is the interaction between Tramadol and Carbamazepine?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Tramadol and Carbamazepine 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.
Understanding the Tramadol and Carbamazepine Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Tramadol belongs to the Opioid Analgesic class and Carbamazepine belongs to the Anticonvulsant class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Carbamazepine makes your body break down the pain medicine too quickly, so it may not work. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Tramadol has 38 total documented interactions on file in this dataset, and Carbamazepine has 129. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: You should avoid taking these two drugs together. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Tramadol or Carbamazepine based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.