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Ryzolt and Savella Titration Pack

Determining the interaction of Ryzolt and Savella Titration Pack and the possibility of their joint administration.

Check result:
Ryzolt <> Savella Titration Pack
Relevance: 15.10.2022 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 milnacipran. 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, blurred vision, muscle spasm or stiffness, tremor, 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 milnacipran 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 serotonin-enhancing drugs such as SSRIs and SNRIs 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 serotonin-enhancing drugs may also have an increased risk of seizures due to additive epileptogenic effects of these agents.

MANAGEMENT: In general, the use of tramadol in combination with serotonergic agents 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.

References
  • Sternbach H "The serotonin syndrome." Am J Psychiatry 148 (1991): 705-13
  • "Product Information. Ultram (tramadol)." McNeil Pharmaceutical, Raritan, NJ.
  • Freeman WD, Chabolla DR "36-Year-old woman with loss of consciousness, fever, and tachycardia." Mayo Clin Proc 80 (2005): 667-70
  • Houlihan DJ "Serotonin syndrome resulting from coadministration of tramadol, venlafaxine, and mirtazapine." Ann Pharmacother 38 (2004): 411-3
  • Mills KC "Serotonin syndrome: A clinical update." Crit Care Clin 13 (1997): 763
  • Kesavan S, Sobala GM "Serotonin syndrome with fluoxetine plus tramadol." J R Soc Med 92 (1999): 474-5
  • "Product Information. Nucynta (tapentadol)." PriCara Pharmaceuticals, Raritan, NJ.
  • "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals, St. Louis, MO.
  • Mason BJ, Blackburn KH "Possible serotonin syndrome associated with tramadol and sertraline coadministration." Ann Pharmacother 31 (1997): 175-7
  • "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories, Philadelphia, PA.
  • Duggal HS, Fetchko J "Serotonin syndrome and atypical antipsychotics." Am J Psychiatry 159 (2002): 672-3
  • "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC, New Haven, CT.
  • "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  • Kitson R, Carr B "Tramadol and severe serotonin syndrome." Anaesthesia 60 (2005): 934-5
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • Ciraulo DA, Shader RI "Fluoxetine drug-drug interactions. II." J Clin Psychopharmacol 10 (1990): 213-7
  • "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company, Indianapolis, IN.
  • Egberts AC, ter Borg J, Brodie-Meijer CC "Serotonin syndrome attributed to tramadol addition to paroxetine therapy." Int Clin Psychopharmacol 12 (1997): 181-2
  • 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
  • Martin TG "Serotonin syndrome." Ann Emerg Med 28 (1996): 520-6
  • "Product Information. Savella (milnacipran)." Forest Pharmaceuticals, St. Louis, MO.
  • 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
  • Gonzalez-Pinto A, Imaz H, De Heredia JL, Gutierrez M, Mico JA "Mania and tramadol-fluoxetine combination. " Am J Psychiatry 158 (2001): 964-5
Ryzolt

Generic Name: tramadol

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

Synonyms: n.a.

Savella Titration Pack

Generic Name: milnacipran

Brand name: Savella, Savella Titration Pack

Synonyms: Savella

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.

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