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Tramadol-venlafaxine serotonin risk — GPhC CRA MCQ

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HardDrug InteractionsTramadol-venlafaxine serotonin riskGPhC CRA

A patient established on venlafaxine 225 mg daily presents a new prescription for tramadol after surgery. They previously had a seizure during antidepressant initiation. What is the most appropriate action?

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Correct answer: B — Request a non-serotonergic alternative analgesic from the prescriber

Option B is correct because tramadol has serotonergic activity and can provoke seizures; high-dose venlafaxine and the seizure history intensify both hazards, so a non-serotonergic analgesic should be selected. Option E relies on monitoring despite two avoidable hazards. Option D cannot prevent a pharmacodynamic interaction. Option A makes an unsafe antidepressant change. Option C confuses shorter exposure with absence of risk, which can occur early.

Reference: Tramadol SmPC: https://www.medicines.org.uk/emc/product/14589/smpc; venlafaxine SmPC: https://www.medicines.org.uk/emc/product/764/smpc