MajorFirst-generation antipsychotics. Butyrophenone derivatives×Other opioids
Updated · Methodology
Mechanism
Tramadol lowers seizure threshold and prolongs QT. Haloperidol is a strong QT prolonger, especially parenterally. Additive seizure and torsades de pointes risk.
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 haloperidol, use paracetamol, an NSAID, or morphine/oxycodone. Alternative antipsychotics: olanzapine or aripiprazole.
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: Tramadol hydrochloride tablet (Amneal Pharmaceuticals NY LLC) – Prescribing Information (2017)– ; DailyMed setid 8ec4e4e5-a56e-4198-8428-6b770b9bf27d