I am seeing a new doctor after three new diagnosis' and he added tramadol 100mg 4x/ day to my list of meds. the pharmacist said i should not take this with my 40mg adderall and 1800mg neurontin (gabapentin)?

Discuss with doctor: You should discuss your concerns with the doctor who prescribed the Tramadol. Tramadol and Neurontin (gabapentin) are both sedating drugs and taken in combination may increase side effects such as dizziness, drowsiness, and difficulty concentrating, impairing thinking and judgment. Tramadol and Adderall both lower seizure threshold and increase the risk of having a seizure.

Pharmacist is right.: The combination of neurontin (gabapentin) & tramadol can have the additive side effect of sleepiness, drowsiness and decreased reaction time. The combination of all 3 drugs can increase the risk of seizures. Also 400 mg/day of Tramadol is risky even if it were the only med you were taking. And you have a list of meds that I don't know about. Proceed with caution!!!!!!!

Drug-drug: interactions is the reason . Please call the doctor who prescribed the medication. Tramadol needs to be replaced by another medication so you can take your medications.

Polypharmacy: Your pharmacist is right. Drug drug interaction can lead to seizures. Also please be careful about the speed with which you are given diagnoses. Too many diagnoses lead to poly pharmacy and once diagnoses are entered into EHRs, they are nearly impossible to correct

Serious interactions: Tramadol interaction with Adderall (dextroamphetamine and racemic amphetamine) has a risk of causing seizures. Tramadol interaction with Neuronton causes a risk of dizziness, cloudy thinking and problems with information processing.

Complicated: You sound like a very complex case. Your pharmacist has some reasonable concerns, but only your doctor can fully assess the complexity involved, including your diagnoses, the medication side effects, and the medication interactions. It is possible to me that this choice is sound: but there is no down side to your taking the concern to the doctor.

AGREE: You pharmacist is correct on 2 points. First your total Tramadol dose of 400 mg is SKY HIGH, and far beyond any reasonable starting dosage. Furthermore, there are potential seizure risks at this level, besides potential serotonin reaction. Not having more information about your background or issues, think that further advice should be handled via Concierge program on HealthTap