June 2024. Tramadol and warfarin drug interaction. The UK MHRA issued the following advice:
Taking warfarin and tramadol together can cause harmful drug interactions, which can raise the International Normalised Ratio (INR), and result in severe bruising and bleeding, which in some patients could be fatal.
Alternative remedies, including herbals, may potentially increase the risk of bleeding or potentiate the effects of warfarin therapy. Some of these include the following: angelica root, arnica flower, anise, asafetida, bogbean, borage seed oil, bromelain, dan-shen, devil’s claw, fenugreek, feverfew, garlic, ginger, ginkgo biloba, ginseng, horse chestnut, lovage root, meadowsweet, onion, parsley, passionflower herb, poplar, quassia, red clover, rue, turmeric and willow bark
BLEEDING RISK
See full prescribing information for complete boxed warning.