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A pressor response similar to the so-called “cheese effect” was noted in combinations of amphetamine and tramadol, which appears to cause dysfunction of or toxicity to epinephrine/norepinephrine receptors.[12][22] Cyclobenzaprine, a commonly-used muscle relaxant, atypical analgesic adjunct, as well as a potentiator often used with analgesics like codeine, dihydrocodeine, hydrocodone and the like, is structurally related to the tricyclic antidepressants [38] and therefore should not be used with tramadol; this is also the case for trazodone.[39]
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Q: I take tramadol for pain and it doesn’t really help. Can I stop taking it? A: Tramadol is a narcotic-like pain reliever commonly used to treat moderate to severe pain. Tramadol should be taken exactly as prescribed by your physician. Follow the directions on your prescription. Take your tramadol dose with a full glass of water with or without food. Tell your doctor if you feel the medicine is not working as well in relieving your pain. Do not change your dose without talking to your doctor.
A pressor response similar to the so-called “cheese effect” was noted in combinations of amphetamine and tramadol, which appears to cause dysfunction of or toxicity to epinephrine/norepinephrine receptors.[12][22] Cyclobenzaprine, a commonly-used muscle relaxant, atypical analgesic adjunct, as well as a potentiator often used with analgesics like codeine, dihydrocodeine, hydrocodone and the like, is structurally related to the tricyclic antidepressants [38] and therefore should not be used with tramadol; this is also the case for trazodone.[39]
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