Major
Probable
Mô tả
Bupropion combined with tramadol increases the risk of both serotonin syndrome and seizures, representing a serious dual-hazard drug combination.
Cơ chế
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.
Ý nghĩa lâm sàng
Both serotonin syndrome and seizure events have been documented in case reports with this combination.
Xử trí
Avoid concurrent use; if necessary, use the lowest effective tramadol dose and monitor for neurological symptoms closely.