Utramal Tramadol Hydrochloride Amitriptyline Hydrochloride
MajorIncreased risk of serotonin syndrome and seizures; amitriptyline also potentiates opioid CNS depression.
These medicines can affect each other in a serious way. Do not start taking them together unless your doctor has said it is OK. If you already take both, do not stop either one on your own: speak to your doctor or pharmacist soon.
Clinical management: Avoid if possible; otherwise use low doses and monitor closely.