About us Contacts Drug interactions: 390 212
Drug search by name

Luvox and Ryzolt

Determining the interaction of Luvox and Ryzolt and the possibility of their joint administration.

Check result:
Luvox <> Ryzolt
Relevance: 04.03.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using traMADol together with fluvoxaMINE. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. Using traMADol with fluvoxaMINE may also increase the risk of seizures not related to the serotonin syndrome. The interaction may be more likely if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Due to its serotonergic activity, coadministration of tramadol with selective serotonin reuptake inhibitors (SSRIs) may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. Patients receiving tramadol with SSRIs may also have an increased risk of seizures due to additive epileptogenic effects of these agents. Pharmacokinetically, coadministration with certain SSRIs, namely fluoxetine, paroxetine and possibly sertraline, may decrease the plasma concentrations of the active O-demethylated (M1) metabolite of tramadol due to inhibition of CYP450 2D6, the isoenzyme responsible for the formation of the metabolite. The clinical significance of this potential interaction is unknown. However, M1 is thought to possess up to 6 times the analgesic effect of tramadol, thus diminished therapeutic response to tramadol should be considered.

MANAGEMENT: In general, the use of tramadol in combination with SSRIs should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when initiating or increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life (e.g., fluoxetine, vortioxetine).

References
  • Kitson R, Carr B "Tramadol and severe serotonin syndrome." Anaesthesia 60 (2005): 934-5
  • "Product Information. Paxil (paroxetine)." GlaxoSmithKline, Research Triangle Park, NC.
  • Mills KC "Serotonin syndrome: A clinical update." Crit Care Clin 13 (1997): 763
  • Alfaro CL, Lam YWF, Simpson J, Ereshefsky L "CYP2D6 status of extensive metabolizers after multiple-dose fluoxetine, fluvoxamine, paroxetine, or sertraline." J Clin Psychopharmacol 19 (1999): 155-63
  • Chan BSH, Graudins A, Whyte IM, Dawson AH, Braitberg G, Duggin GG "Serotonin syndrome resulting from drug interactions." Med J Aust 169 (1998): 523-5
  • Mason BJ, Blackburn KH "Possible serotonin syndrome associated with tramadol and sertraline coadministration." Ann Pharmacother 31 (1997): 175-7
  • "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  • Lantz MS, Buchalter EN, Giambanco V "Serotonin syndrome following the administration of tramadol with paroxetine." Int J Geriatr Psychiatry 13 (1998): 343-5
  • Lange-Asschenfeldt C, Weigmann H, Hiemke C, Mann K "Serotonin syndrome as a result of fluoxetine in a patient with tramadol abuse: plasma level-correlated symptomatology." J Clin Psychopharmacol 22 (2002): 440-1
  • Shakoor M, Ayub S, Ahad A, Ayub Z "Transient serotonin syndrome caused by concurrent use of tramadol and selective serotonin reuptake inhibitor." Am J Case Rep 15 (2014): 562-4
  • US Food and Drug Administration (FDA) "FDA Drug Safety Communication: FDA warns about several safety issues with opioid pain medicines; requires label changes. Available from: URL: https://www.fda.gov/downloads/Drugs/DrugSafety/UCM491302.pdf." ([2016, Mar 22]):
  • Egberts AC, ter Borg J, Brodie-Meijer CC "Serotonin syndrome attributed to tramadol addition to paroxetine therapy." Int Clin Psychopharmacol 12 (1997): 181-2
  • "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  • Gonzalez-Pinto A, Imaz H, De Heredia JL, Gutierrez M, Mico JA "Mania and tramadol-fluoxetine combination. " Am J Psychiatry 158 (2001): 964-5
  • "Venlafaxine + tramadol: serotonin syndrome." Prescrire Int 13 (2004): 57
  • Martin TG "Serotonin syndrome." Ann Emerg Med 28 (1996): 520-6
  • "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  • Mahlberg R, Kunz D, Sasse J, Kirchheiner J "Serotonin syndrome with tramadol and citalopram." Am J Psychiatry 161 (2004): 1129
  • Mittino D, Mula M, Monaco F "Serotonin syndrome associated with tramadol-sertraline coadministration." Clin Neuropharmacol 27 (2004): 150-1
  • "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  • "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc, Marietta, GA.
  • Kesavan S, Sobala GM "Serotonin syndrome with fluoxetine plus tramadol." J R Soc Med 92 (1999): 474-5
  • "Product Information. Brintellix (vortioxetine)." Takeda Pharmaceuticals America, Lincolnshire, IL.
  • Sternbach H "The serotonin syndrome." Am J Psychiatry 148 (1991): 705-13
  • "Product Information. Ultram (tramadol)." McNeil Pharmaceutical, Raritan, NJ.
  • Houlihan DJ "Serotonin syndrome resulting from coadministration of tramadol, venlafaxine, and mirtazapine." Ann Pharmacother 38 (2004): 411-3
Luvox

Generic Name: fluvoxamine

Brand name: Luvox, Luvox CR

Synonyms: n.a.

Ryzolt

Generic Name: tramadol

Brand name: ConZip, Rybix ODT, Ryzolt, Ultram, Ultram ER

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction