Serotonin Syndrome Risk
The development of a potentially life-threatening serotonin syndrome may occur with
use of tramadol
products, including ULTRAM ER, particularly with
concomitant use of serotonergic drugs such as SSRIs, SNRIs, TCAs, MAOIs and triptans, with drugs which impair metabolism of serotonin (including MAOIs) and with drugs which impair metabolism of tramadol (CYP2D6 and CYP3A4 inhibitors). This may occur within the recommended dose.