Talk:Dangerous drug combinations
WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! See below the graphic for important information regarding specific combinations.
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & lsd Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
cocaine & lsd Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
tramadol & lsd Status: Unsafe
Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
cannabis & mushrooms Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & mushrooms Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
cocaine & mushrooms Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
tramadol & mushrooms Status: Unsafe
Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
cannabis & dmt Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & dmt Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
cocaine & dmt Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
tramadol & dmt Status: Unsafe
Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
5-meo-xxt & mescaline Status: Caution
Note: The 5-MeO class of tryptamines can be unpredictable in their interactions
cannabis & mescaline Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & mescaline Status: Caution
Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops
cocaine & mescaline Status: Caution
Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops
caffeine & mescaline Status: Low Risk & No Synergy
Note: High doses of caffeine are uncomfortable and this will be magnified by psychedelics
tramadol & mescaline Status: Unsafe
Note: This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.
5-meo-xxt & dox Status: Caution
Note: The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.
cannabis & dox Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
ketamine & dox Status: Low Risk & Synergy
Note: Ketamine and psychedelics tend to potentiate each other - go slowly.
mxe & dox Status: Caution
Note: As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense
dxm & dox Status: Unsafe
Note: The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.
pcp & dox Status: Unsafe
Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
amphetamines & dox Status: Unsafe
Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.
mdma & dox Status: Caution
Note: The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.
cocaine & dox Status: Unsafe
Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic
caffeine & dox Status: Caution
Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.
alcohol & dox Status: Low Risk & Decrease
Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.
opioids & dox Status: Low Risk & No Synergy
Note: No unexpected interactions.
tramadol & dox Status: Unsafe
Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
maois & dox Status: Caution
Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably
5-meo-xxt & nbomes Status: Caution
Note: The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided
cannabis & nbomes Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
mxe & nbomes Status: Caution
Note: As an NMDA antagonist MXE potentiates NBOMes which can be unpleasantly intense
amphetamines & nbomes Status: Unsafe
Note: Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.
cocaine & nbomes Status: Unsafe
Note: Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
caffeine & nbomes Status: Caution
Note: Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping
tramadol & nbomes Status: Unsafe
Note: Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures
maois & nbomes Status: Caution
Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably
5-meo-xxt & 2c-x Status: Caution
Note: The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics
cannabis & 2c-x Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & 2c-x Status: Caution
Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.
cocaine & 2c-x Status: Caution
Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.
caffeine & 2c-x Status: Low Risk & No Synergy
Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.
tramadol & 2c-x Status: Unsafe
Note: Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.
maois & 2c-x Status: Caution
Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably
5-meo-xxt & 2c-t-x Status: Caution
Note: Both classes of compounds can be unpredictable alone
cannabis & 2c-t-x Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & 2c-t-x Status: Unsafe
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
cocaine & 2c-t-x Status: Unsafe
Note: Cocaine and 2c-t-x both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
caffeine & 2c-t-x Status: Low Risk & No Synergy
Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.
alcohol & 2c-t-x Status: Low Risk & Decrease
Note: Both these classes of compound can interact unpredictably. Caution should be exercised.
opioids & 2c-t-x Status: Low Risk & No Synergy
Note: No expected interactions, some opioids have serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.
maois & 2c-t-x Status: Caution
Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably, which could be dangerous given the unpredictability of the 2C-T-x series
cannabis & amt Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics. Small amounts can reduce nausea with aMT but take care.
caffeine & amt Status: Caution
Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.
alcohol & amt Status: Caution
Note: aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable
opioids & amt Status: Low Risk & No Synergy
Note: No unexpected interactions
maois & amt Status: Dangerous
Note: aMT is an MAOI on its own. Using enzyme inhibitors can greatly reduce predictability of effects.
mxe & 5-meo-xxt Status: Low Risk & Synergy
Note: Little information exists about this combination.
dxm & 5-meo-xxt Status: Unsafe
Note: Little information exists about this combination.
cannabis & 5-meo-xxt Status: Caution
Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.
amphetamines & 5-meo-xxt Status: Unsafe
Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.
mdma & 5-meo-xxt Status: Caution
Note: Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care
cocaine & 5-meo-xxt Status: Unsafe
Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.
caffeine & 5-meo-xxt Status: Low Risk & No Synergy
Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.
amphetamines & cannabis Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
mdma & cannabis Status: Low Risk & Synergy
Note: Large amounts of either or both may cause strong and somewhat unpredictable experiences, which can be as intense as psychedelics. Consider rather Set and Setting are good, before you combine these. Cannabis should be saved for towards the end of the MDMA experience if possible, where the psychedelic alike effect won't come to play.
cocaine & cannabis Status: Caution
Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences
alcohol & cannabis Status: Low Risk & Synergy
Note: In excess, this combination can cause nausea.
amphetamines & ketamine Status: Caution
Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.
mdma & ketamine Status: Low Risk & Synergy
Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.
cocaine & ketamine Status: Caution
Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.
caffeine & ketamine Status: Low Risk & No Synergy
Note: No unexpected interactions.
alcohol & ketamine Status: Dangerous
Note: Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
ghb/gbl & ketamine Status: Dangerous
Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
opioids & ketamine Status: Dangerous
Note: Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
benzodiazepines & ketamine Status: Caution
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
maois & ketamine Status: Caution
Note: MAO-B inhibitors appear to increase the potency of Ketamine. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available
pcp & mxe Status: Caution
Note: There are no reports available about this combination
amphetamines & mxe Status: Caution
Note: Risk of tachycardia, hypertension, and manic states
mdma & mxe Status: Caution
Note: There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.
cocaine & mxe Status: Caution
Note: Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.
caffeine & mxe Status: Low Risk & No Synergy
Note: No likely interactions
alcohol & mxe Status: Dangerous
Note: There is a high risk of memory loss, vomiting and severe ataxia from this combination.
ghb/gbl & mxe Status: Dangerous
Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
opioids & mxe Status: Dangerous
Note: This combination can potentiate the effects of the opioid
benzodiazepines & mxe Status: Caution
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.
maois & mxe Status: Unsafe
Note: MAO-B inhibitors appear to increase the potency of MXE. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available
ssris & mxe Status: Caution
Note: Depending on the SSRI this combination can be unpredictable
amphetamines & dxm Status: Unsafe
Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
cocaine & dxm Status: Unsafe
Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues
caffeine & dxm Status: Low Risk & No Synergy
Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.
alcohol & dxm Status: Dangerous
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.
ghb/gbl & dxm Status: Dangerous
Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict
opioids & dxm Status: Dangerous
Note: CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.
benzodiazepines & dxm Status: Caution
Note: Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
maois & dxm Status: Dangerous
Note: High risk of serotonin syndrome
ssris & dxm Status: Dangerous
Note: High risk of serotonin syndrome.
amphetamines & pcp Status: Unsafe
Note: This combination can easily lead to hypermanic states
mdma & pcp Status: Unsafe
Note: This combination can easily lead to hypermanic states
cocaine & pcp Status: Unsafe
Note: This combination can easily lead to hypermanic states
caffeine & pcp Status: Caution
Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
alcohol & pcp Status: Unsafe
Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
ghb/gbl & pcp Status: Dangerous
Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
opioids & pcp Status: Caution
Note: PCP can reduce opioid tolerance, increasing the risk of overdose
benzodiazepines & pcp Status: Unsafe
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely
maois & pcp Status: Dangerous
Note: This combination is very poorly explored
ssris & pcp Status: Unsafe
Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
alcohol & nitrous Status: Caution
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
ghb/gbl & nitrous Status: Caution
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
opioids & nitrous Status: Caution
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
tramadol & nitrous Status: Caution
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
mdma & amphetamines Status: Low Risk & Synergy
Note: Amphetamines increase the neurotoxic effects of MDMA
cocaine & amphetamines Status: Caution
Note: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine
caffeine & amphetamines Status: Caution
Note: This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.
alcohol & amphetamines Status: Caution
Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.
ghb/gbl & amphetamines Status: Caution
Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
opioids & amphetamines Status: Caution
Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
tramadol & amphetamines Status: Dangerous
Note: Tramadol and stimulants both increase the risk of seizures.
benzodiazepines & amphetamines Status: Low Risk & Decrease
Note: Both can dull each other's effects, so if one wears off before the other it's possible to overdose due to the lack of counteraction
maois & amphetamines Status: Dangerous
Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises.
cocaine & mdma Status: Caution
Note: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.
caffeine & mdma Status: Caution
Note: Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA
alcohol & mdma Status: Caution
Note: Both MDMA and alcohol cause dehydration. Approach this combination with caution, moderation and sufficient hydration. More than a small amount of alcohol will dull the euphoria of MDMA
ghb/gbl & mdma Status: Caution
Note: Large amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown.
tramadol & mdma Status: Dangerous
Note: Tramadol and stimulants both increase the risk of seizures.
maois & mdma Status: Dangerous
Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with MDMA will lead to hypertensive crises.
caffeine & cocaine Status: Caution
Note: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
alcohol & cocaine Status: Unsafe
Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.
ghb/gbl & cocaine Status: Caution
Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind
opioids & cocaine Status: Dangerous
Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
tramadol & cocaine Status: Dangerous
Note: Tramadol and stimulants both increase the risk of seizures.
maois & cocaine Status: Dangerous
Note: This combination is poorly explored
ssris & cocaine Status: Low Risk & No Synergy
Note: May reduce each others' effectiveness. Cocaine can reduce mental stability and therefore exacerbate conditions which SSRIs are used to treat.
ghb/gbl & alcohol Status: Dangerous
Note: Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.
opioids & alcohol Status: Dangerous
Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely
tramadol & alcohol Status: Dangerous
Note: Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.
benzodiazepines & alcohol Status: Dangerous
Note: Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.
maois & alcohol Status: Unsafe
Note: Tyramine found in many alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.
ssris & alcohol Status: Caution
Note: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
opioids & ghb/gbl Status: Dangerous
Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position
tramadol & ghb/gbl Status: Dangerous
Note: The sedative effects of this combination can lead to dangerous respiratory depression.
benzodiazepines & ghb/gbl Status: Dangerous
Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
tramadol & opioids Status: Dangerous
Note: Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present
benzodiazepines & opioids Status: Dangerous
Note: Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely
maois & opioids Status: Caution
Note: Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.
ssris & opioids Status: Low Risk & No Synergy
Note: There have been very infrequent reports of a risk of serotonin syndrome with this combination, though this should not be a practical concern.
benzodiazepines & tramadol Status: Dangerous
Note: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.