MajorClass III antiarrhythmic×Other opioids
Updated · Methodology
Mechanism
Additive QT risk. Tramadol weakly prolongs QT and blocks serotonin/norepinephrine reuptake. Dronedarone is a potent QT prolonger. Tramadol also lowers seizure threshold.
Symptoms
QT prolongation on ECG. Dizziness, syncope, palpitations. Severe cases: polymorphic ventricular tachycardia (torsades de pointes). Risk is higher with hypokalaemia and hypomagnesaemia.
Management
Avoid the combination. For analgesia on dronedarone, use paracetamol, an NSAID, or morphine/oxycodone (no QT effect).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Multaq (dronedarone) prescribing information (2020)– ; DailyMed setid 7fa41601-7fb5-4155-8e50-2ae903f0d2d6