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Can I take Sertraline and Tramadol together?

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Taking these two medicines together significantly increases the risk of a rare but very serious condition called 'serotonin syndrome'. This happens when there is too much of a chemical called serotonin in your brain.

Symptoms can include feeling very agitated, confused, or shaky, as well as sweating, a fast heartbeat, muscle twitching, or diarrhoea. In severe cases, it can lead to seizures or loss of consciousness.

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It is generally recommended that you do not take sertraline och tramadol together, unless specifically told to by your doctor.

Combining them significantly increases the risk of serotonin syndrome.

If your doctor decides you must take both, they will monitor you closely or may prefer to prescribe an alternative painkiller that does not affect serotonin.

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Varför detta händer

Both sertraline (an SSRI antidepressant) and tramadol (a strong painkiller) increase the levels of serotonin in the brain. When used together, the effect is additive, which can push serotonin levels into a dangerous range.

Additionally, sertraline can slow down the way the body breaks down tramadol, leading to higher levels of the painkiller in your system.

You may be experiencing an interaction between sertraline and tramadol if you are experiencing:

  • Agitation or restlessness.

  • Förvirring.

  • Rapid heart rate.

  • Sweating or shivering.

  • Muscle twitching, stiffness, or tremors.

  • Diarré.

  • Fever.

If you have any of the above symptoms, you should seek medical help immediately.

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Depression and anxiety disorders

You may experience an increase in suicidal thoughts or the urge to self-harm when first starting sertraline or changing the dose. This is more common in young adults under 25. Contact your doctor or go to hospital immediately if you notice any changes in your mood or behaviour.

Serotonin Syndrome

Taking these two medicines together significantly increases the risk of serotonin syndrome, a potentially life-threatening condition. Seek immediate medical help if you experience high fever, agitation, confusion, shivering, or rapid muscle contractions.

Bleeding disorders

Sertraline can increase your risk of bleeding, particularly from the stomach. Use with caution if you take blood-thinning medicines (like warfarin) or anti-inflammatory painkillers (like ibuprofen or aspirin), as this significantly increases the risk of serious bleeding.

Seizure risk (fits)

Tramadol can increase the risk of having a seizure, even at normal doses. This risk is higher if you are already taking an antidepressant like sertraline.

Breathing problems or asthma

Tramadol can cause dangerous breathing difficulties, especially if you have existing lung conditions or asthma. Seek immediate medical help if you experience slow or shallow breathing.

Alkohol

It is best to avoid or strictly limit alcohol while taking these medicines. Combining alcohol with sertraline or tramadol can significantly increase drowsiness, dizziness, and the risk of breathing difficulties. Both medicines, when combined with alcohol, can also increase the risk of liver damage.

Grapefruit juice

You should avoid drinking large amounts of grapefruit juice while taking sertraline. Grapefruit can increase the level of sertraline in your blood, which may increase the risk of side effects.

Caffeine (Coffee, Tea, Energy Drinks)

Be cautious with high caffeine intake. Tramadol can lower the seizure threshold, and high doses of caffeine may further increase the risk of experiencing a seizure.

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Taking multiple medicines? Our Interaktionskontroll för läkemedel helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Ansvarsfriskrivning

Denna information är endast avsedd för allmän utbildning och bör inte användas som en ersättning för professionell medicinsk rådgivning. Rådfråga alltid din läkare, apotekare eller annan kvalificerad vårdpersonal innan du fattar beslut om dina mediciner. Individuella omständigheter kan variera, och endast en vårdpersonal som känner till din medicinska historia kan ge personlig vägledning.

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Artikelhistorik

Informationen på denna sida är skriven och granskad av kvalificerade kliniker.

  • 25 jan 2026 | Ursprungligen publicerad
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