Major
Probable
설명
Bupropion combined with tramadol increases the risk of both serotonin syndrome and seizures, representing a serious dual-hazard drug combination.
기전
Bupropion inhibits dopamine and norepinephrine reuptake and is a CYP2D6 inhibitor that elevates tramadol's serotonergic M1 metabolite; the combination raises CNS serotonin and lowers the seizure threshold.
임상적 중요성
Both serotonin syndrome and seizure events have been documented in case reports with this combination.
관리 방법
Avoid concurrent use; if necessary, use the lowest effective tramadol dose and monitor for neurological symptoms closely.