. . . "Je kontraindikov\u00E1no u\u017E\u00EDv\u00E1n\u00ED soub\u011B\u017En\u011B s\u00A0t\u011Bmito l\u00E1tkami:\nNeselektivn\u00ED inhibitory MAO\nRiziko serotoninov\u00E9ho syndromu: pr\u016Fjem, tachykardie, pocen\u00ED, t\u0159as, zmatenost a p\u0159\u00EDpadn\u011B k\u00F3ma.\nSelektivn\u00ED inhibitory MAO-A \nExtrapolace z\u00A0neselektivn\u00EDch inhibitor\u016F MAO.\nRiziko serotoninov\u00E9ho syndromu: pr\u016Fjem, tachykardie, pocen\u00ED, t\u0159as, zmatenost a p\u0159\u00EDpadn\u011B k\u00F3ma.\nSelektivn\u00ED inhibitory MAO-B\nSymptomy centr\u00E1ln\u00ED excitace podobn\u00E9 jako u serotoninov\u00E9ho syndromu: pr\u016Fjem, tachykardie, pocen\u00ED, t\u0159es, zmatenost a p\u0159\u00EDpadn\u011B k\u00F3ma.\nPokud byl pacient doned\u00E1vna l\u00E9\u010Den inhibitory MAO, je t\u0159eba mezi zah\u00E1jen\u00EDm l\u00E9\u010Dby tramadolem a ukon\u010Den\u00EDm l\u00E9\u010Dby MAO ponechat dvout\u00FDdenn\u00ED prodlevu.\nNedoporu\u010Duje se u\u017E\u00EDv\u00E1n\u00ED soub\u011B\u017En\u011B s\u00A0t\u011Bmito l\u00E1tkami:\nAlkohol\nAlkohol zvy\u0161uje sedativn\u00ED \u00FA\u010Dinek opioidn\u00EDch analgetik.\nSn\u00ED\u017Een\u00ED pozornosti m\u016F\u017Ee b\u00FDt nebezpe\u010Dn\u00E9 p\u0159i \u0159\u00EDzen\u00ED vozidel a obsluze stroj\u016F.\nJe t\u0159eba, aby se pacienti vyvarovali po\u017E\u00EDv\u00E1n\u00ED alkoholick\u00FDch n\u00E1poj\u016F a u\u017E\u00EDv\u00E1n\u00ED l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F, kter\u00E9 alkohol obsahuj\u00ED.\nKarbamazepin a dal\u0161\u00ED induktory enzym\u016F\nRiziko sn\u00ED\u017Een\u00ED \u00FA\u010Dinnosti a zkr\u00E1cen\u00ED doby \u00FA\u010Dinku v\u00A0d\u016Fsledku sn\u00ED\u017Een\u00E9 koncentrace tramadolu v\u00A0plazm\u011B.\nAgonist\u00E9/antagonist\u00E9 opioid\u016F (buprenorfin, nalbufin, pentazocin)\nSn\u00ED\u017Een\u00ED analgetick\u00E9ho \u00FA\u010Dinku konkuren\u010Dn\u00EDm blokov\u00E1n\u00EDm receptor\u016F s\u00A0rizikem vzniku abstinen\u010Dn\u00EDho syndromu.\nSou\u010Dasn\u00E9 u\u017E\u00EDv\u00E1n\u00ED s\u00A0dal\u0161\u00EDmi l\u00E1tkami, kter\u00E9 je nutn\u00E9 zv\u00E1\u017Eit:\nP\u0159i l\u00E9\u010Db\u011B tramadolem v\u00A0\u010Dasov\u00E9 souvislosti s\u00A0jin\u00FDmi serotoninergn\u00EDmi l\u00E9ky, jako jsou selektivn\u00ED inhibitory zp\u011Btn\u00E9ho vychyt\u00E1v\u00E1n\u00ED serotoninu (SSRI) nebo triptany, byly zaznamen\u00E1ny ojedin\u011Bl\u00E9 p\u0159\u00EDpady serotoninov\u00E9ho syndromu. K\u00A0p\u0159\u00EDznak\u016Fm serotoninov\u00E9ho syndromu pat\u0159\u00ED nap\u0159\u00EDklad zmatenost, agitovanost, hore\u010Dka, pocen\u00ED, ataxie, hyperreflexie, myoklonus a pr\u016Fjem.\nOstatn\u00ED deriv\u00E1ty opioid\u016F (v\u010Detn\u011B antitusik a l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F k substitu\u010Dn\u00ED terapii), barbitur\u00E1ty a benzodiazepiny.\nZv\u00FD\u0161en\u00E9 riziko respira\u010Dn\u00ED deprese, kter\u00E1 m\u016F\u017Ee b\u00FDt p\u0159i p\u0159ed\u00E1vkov\u00E1n\u00ED fat\u00E1ln\u00ED.\nOstatn\u00ED l\u00E1tky p\u016Fsob\u00EDc\u00ED tlumiv\u011B na centr\u00E1ln\u00ED nervovou soustavu, jako jsou dal\u0161\u00ED deriv\u00E1ty opioid\u016F (v\u010Detn\u011B antitusiv a l\u00E9\u010Div\u00FDch p\u0159\u00EDpravk\u016F k substitu\u010Dn\u00ED terapii), barbitur\u00E1ty, benzodiazepiny, dal\u0161\u00ED anxiolytika, hypnotika, sedativn\u00ED antidepresiva, sedativn\u00ED antihistaminika, neuroleptika, centr\u00E1ln\u011B p\u016Fsob\u00EDc\u00ED antihypertenziva, thalidomid a baclofen.\nTyto l\u00E9\u010Div\u00E9 p\u0159\u00EDpravky mohou zesilovat tlumiv\u00FD \u00FA\u010Dinek na centr\u00E1ln\u00ED nervovou soustavu. Sn\u00ED\u017Een\u00ED pozornosti m\u016F\u017Ee b\u00FDt nebezpe\u010Dn\u00E9 p\u0159i \u0159\u00EDzen\u00ED vozidel a obsluze stroj\u016F. \nJeliko\u017E p\u0159i soub\u011B\u017En\u00E9m u\u017E\u00EDv\u00E1n\u00ED p\u0159\u00EDpravku Tramylpa s\u00A0l\u00E9ky typu warfarinu bylo zaznamen\u00E1no zv\u00FD\u0161en\u00ED INR, je zapot\u0159eb\u00ED pravideln\u011B vyhodnocovat protrombinov\u00FD \u010Das.\nDal\u0161\u00ED l\u00E9\u010Diva, o nich\u017E je zn\u00E1mo, \u017Ee inhibuj\u00ED CYP3A4, jako je ketokonazol nebo erytromycin, mohou blokovat metabolismus tramadolu (N-demetylace) a pravd\u011Bpodobn\u011B i metabolismus aktivn\u00EDho O-demetylovan\u00E9ho metabolitu. Klinick\u00FD v\u00FDznam t\u00E9to interakce nebyl dosud prozkoum\u00E1n.\nL\u00E9\u010Div\u00E9 p\u0159\u00EDpravky sni\u017Euj\u00EDc\u00ED pr\u00E1h pohotovosti ke k\u0159e\u010D\u00EDm, jako je bupropion, antidepresiva na b\u00E1zi inhibitor\u016F zp\u011Btn\u00E9ho vychyt\u00E1v\u00E1n\u00ED serotoninu, tricyklick\u00E1 antidepresiva a neuroleptika. P\u0159i soub\u011B\u017En\u00E9m u\u017E\u00EDv\u00E1n\u00ED tramadolu a t\u011Bchto l\u00E9k\u016F se m\u016F\u017Ee zvy\u0161ovat riziko vzniku k\u0159e\u010D\u00ED. Metoklopramid nebo domperidon m\u016F\u017Eou zvy\u0161ovat rychlost absorpce paracetamolu. Cholestyramin m\u016F\u017Ee absorpci sni\u017Eovat.\nV omezen\u00E9m po\u010Dtu studi\u00ED bylo pozorov\u00E1no, \u017Ee u\u017E\u00EDv\u00E1n\u00ED antiemetika ondansetronu, antagonisty receptor\u016F 5-HT3, v\u00A0p\u0159edopera\u010Dn\u00EDm nebo poopera\u010Dn\u00EDm obdob\u00ED vyvolalo u pacient\u016F s\u00A0poopera\u010Dn\u00EDmi bolestmi zv\u00FD\u0161enou pot\u0159ebu tramadolu.\n"@cs . "4.5\tInterakce s\u00A0jin\u00FDmi l\u00E9\u010Div\u00FDmi p\u0159\u00EDpravky a jin\u00E9 formy interakce"@cs . . . . . . . "004.005" . . . . . . . . . . . . . .