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What the FDA labels say about taking them together

Tramadol and trimipramine

Trimipramine's FDA label of March 17, 2026 names tramadol in its warnings section; tramadol's label does not name trimipramine itself but warns about its class (Tricyclic antidepressants). The trimipramine label: “Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including trimipramine capsules, alone, but particularly with concomitant use of other …”

Check it at the source: the tramadol FDA label on DailyMed (effective March 5, 2026, Lupin Pharmaceuticals, Inc.); the trimipramine FDA label on DailyMed (effective March 17, 2026, Breckenridge Pharmaceutical, Inc.).

What does the tramadol label say about trimipramine?

Tramadol's label does not name trimipramine itself; it warns about its class (Tricyclic antidepressants):

Tramadol label, warnings and precautions

Syndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported with the use of tramadol products, including tramadol hydrochloride extended-release tablets, particularly during concomitant use with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that …

Tramadol label, warnings and precautions

Cases of serotonin syndrome, a potentially life-threatening condition, have been reported with the use of tramadol products, including Tramadol Hydrochloride Extended-Release Capsules, particularly during concomitant use with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonergic neurotransmitter system (e.g. …

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

What does the trimipramine label say about tramadol?

Trimipramine label, warnings

Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including trimipramine capsules, alone, but particularly with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's wort) and with drugs that impair metabolism of serotonin (in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue).

Source: FDA drug label (Trimipramine), Breckenridge Pharmaceutical, Inc., effective March 17, 2026 (SPL set 4f31df66-7dc2-1f04-e054-00144ff88e88), 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

39Tramadol generic labelers
3Trimipramine generic labelers
TramadolTrimipramine
Labeled forPainDepression
Boxed warningYesYes
Pharmacy cost (NADAC)$0.0248 per tablet 50 mg tabletn/a
Shortage nowNo current entryNo current entry

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

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