Описание
Duloxetine, a serotonin-norepinephrine reuptake inhibitor, combined with tramadol markedly elevates the risk of serotonin syndrome.
Механизм
Both agents inhibit serotonin reuptake; duloxetine also inhibits norepinephrine reuptake, and tramadol's weak monoamine reuptake inhibition is additive.
Клиническое значение
Regulatory agencies (FDA, EMA) include SNRI + tramadol as a named serotonin syndrome risk combination.
Тактика ведения
Avoid concomitant use; select an opioid analgesic without serotonergic activity when treating pain in patients on duloxetine.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.