Pain management discussion forum: serious interaction among frequently used drugs for chronic pain

J Pain Palliat Care Pharmacother. 2014 Jun;28(2):170-1. doi: 10.3109/15360288.2014.911798. Epub 2014 May 7.

Abstract

A query and response regarding a patient who was taking high-dose tramadol and duloxetine is presented. The patient developed serotonin syndrome. Risks for this clinically important drug interaction and management of the syndrome are discussed.

Keywords: cyproheptadine; drug; duloxetine; interaction; pain; serotonin syndrome; tramadol.

Publication types

  • Case Reports

MeSH terms

  • Analgesics / adverse effects
  • Analgesics / therapeutic use
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Chronic Pain / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Interactions
  • Duloxetine Hydrochloride
  • Female
  • Humans
  • Middle Aged
  • Serotonin Syndrome / chemically induced*
  • Thiophenes / adverse effects*
  • Thiophenes / therapeutic use
  • Tramadol / administration & dosage
  • Tramadol / adverse effects*
  • Tramadol / therapeutic use

Substances

  • Analgesics
  • Analgesics, Opioid
  • Thiophenes
  • Tramadol
  • Duloxetine Hydrochloride