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Lethal interactions

Specific substances

  • Tramadollethal

By drug class

  • MAOIslethal6 mechanismsconfidence high

Dangerous interactions

33 dangerous interactions recorded for this substance.

See the full interactions table

Contraindications

Cardiovascular

  • structural cardiac abnormalitiesabsolute

    Includes cardiomyopathy, serious cardiac arrhythmias, coronary artery disease, and other structural heart defects. FDA prescribing information lists as absolute contraindication.

  • moderate-to-severe hypertensionabsolute

    FDA prescribing information lists as contraindication. Blood pressure must be assessed before initiation and monitored during treatment.

Neurological

  • tic disordersrelative

    Pre-existing tic disorders including Tourette syndrome are a relative contraindication. Monitor for tic emergence or worsening.

  • seizure disordersrelative

    Patients with epilepsy or history of seizures should be monitored. Risk is dose-dependent and increases at supratherapeutic doses.

Psychiatric

  • bipolar disorderrelative

    Undiagnosed or comorbid bipolar disorder increases risk of treatment-emergent mania. Psychiatric screening recommended before initiation.

  • psychotic disordersrelative

    Personal or family history of psychosis is a relative contraindication. Screening recommended before initiation. New-onset psychotic symptoms documented in post-marketing surveillance.

  • agitated statesabsolute

    FDA prescribing information lists as contraindication.

Metabolic

  • hyperthyroidismabsolute

    FDA prescribing information lists as contraindication due to additive sympathomimetic activation.

Pregnancy & Breastfeeding

  • pregnancyrelative

    Use during pregnancy only if potential benefit justifies potential risk to the fetus. Limited human data available.

Other

  • hypersensitivity to amphetamine productsabsolute

    Standard drug allergy contraindication per FDA prescribing information.

  • MAOI use (current or within 14 days)absolute

    Absolute contraindication per FDA prescribing information. A 14-day washout period is required after MAOI discontinuation before initiating LDX. Case report documents hypertensive emergency with ST-elevation MI from MAOI + amphetamine combination.

  • glaucomaabsolute

    FDA prescribing information lists as contraindication. Applies specifically to narrow-angle (angle-closure) glaucoma.

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