Tramadol Duloxetine

Additional dual 5HT-NE reuptake inhibitors include sibutramine, which is approved for the treatment of obesity but not depression. Tramadol is a kappa opiate agonist approved for the treatment of pain, but it also has serotonin and norepinephrine reuptake inhibitor properties. Dual reuptake inhibitors in clinical testing as antidepressants include milnacipran and duloxetine. 

DULOXETINE OPIOIDS t serotonin effects, including possible cases of serotonin syndrome, when opioids (oxycodone, pethidine, pentazocine, tramadol) are given Uncertain Look for signs oft serotonin activity, particularly on initiating therapy... 

If patient Is taking any agent that can Inhibit serotonin reuptake (e.g., SSRIs, sibutramlne, tramadol, mllnacipran, duloxetine, venlafaxine, clomipramine, etc.)... 

Tramadol increases the risk of seizures in patients taking TCAs Use of TCAs/tetracyclics with anticholinergic drugs may result in paralytic ileus or hyperthermia Fluoxetine, paroxetine, bupropion, duloxetine, and other CYP450 2D6 inhibitors may increase TCA/tetracyclic concentrations... 

Clinically important, potentially hazardous interactions with alprazolam, amphetamines, astemizole, clarithromycin, clozapine, desipramine, dexibuprofen, dextroamphetamine, diethylpropion, droperidol, duloxetine, erythromycin, haloperidol, imipramine, isocarboxazid, linezolid, lithium, MAO inhibitors, mazindol, meperidine, methamphetamine, midazolam, moclobemide, nortriptyline, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, phenytoin, pimozide, pseudoephedrine, selegiline, serotonin agonists, sibutramine, St John s wort, sumatriptan, sympathomimetics, tramadol, tranylcypromine, trazodone, tricyclic antidepressants, troleandomycin, tryptophan, zolmitriptan... 

Because the concurrent use of more than one serotonergic drug has rarely resulted in the serotonin syndrome , (p.9), the manufacturer advises caution if duloxetine is used with tricyclic antidepressants , (p.l240), or other antidepressants , (above), triptans, tramadol, and pethidine. ... 

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