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Serotonergic Drugs: Combining Tramadol with medications that affect serotonin levels (such as SSRIs, SNRIs, or MAOIs) can increase the risk of serotonin syndrome, a potentially life-threatening condition.
Central Nervous System (CNS) Depressants: The concomitant use of Tramadol with other CNS depressants (like benzodiazepines, alcohol, or sedatives) can enhance CNS depression, leading to respiratory distress or severe sedation.
Anticoagulants: Tramadol may enhance the anticoagulant effect of drugs like warfarin, requiring close monitoring of INR levels.
