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.