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Use With Quinidine Tramadol is metabolized to M1 by CYP2D6. Quinidine is a selective inhibitor of that isoenzyme; so that con-comitant administration of quinidine and tramadol results in increased concentrations of tramadol and reduced concentrations of M1. The clinical consequences of these findings are unknown. In vitro drug interaction studies in human liver microsomes indicate that tramadol has no effect on quinidine metabolism. Use With Inhibitors of CYP2D6 Text Continues Below
In vitro drug interaction studies in human liver microsomes indicate that concomitant administration with inhibitors of CYP2D6 such as fluoxetine, paroxetine, and amitripty-line could result in some inhibition of the metabolism of tramadol. Use With Cimetidine Concomitant administration of ULTRACET and cime-tidine
has not been studied. Concomitant administration of tramadol and cimetidine does not result in clinically significant changes in tramadol pharmacokinetics. Therefore, no alteration of the ULTRACET dosage reg-imen is recommended. Use With MAO Inhibitors Interactions with MAO Inhibitors, due to interference with detoxification mechanisms, have been reported for some centrally acting drugs (see WARNINGS, Use With MAO Inhibitors). Use With Digoxin Post-marketing surveillance of tramadol has revealed rare reports of digoxin toxicity. Use With Warfarin Like Compounds Post-marketing surveillance of both tramadol and acetaminophen individual products have revealed rare alterations of warfarin effect, including elevation of prothrombin times. While such changes have been generally of limited clin-ical significance for the individual products, periodic evaluation of prothrombin time should be performed when ULTRACET and warfarin-like compounds are administered concurrently. Carcinogenesis, Mutagenesis, Impairment of Fertility There are no animal or laboratory studies on the com-bination product (tramadol and acetaminophen) to evaluate carcinogenesis, mutagenesis, or impairment of fertility. Page: << Prev | 1 | 2 | 3 | 4 | 5 | Next >>
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