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Warfarin and tramadol — GPhC CRA MCQ

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HardDrug InteractionsWarfarin and tramadolGPhC CRA

A 76-year-old man taking warfarin asks whether he can take newly prescribed tramadol for severe shoulder pain. His INR has been stable. What is the most important interaction to flag?

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Correct answer: B — Tramadol with warfarin can increase INR and bleeding risk

Warfarin and tramadol have been associated with increased INR and bleeding, including serious cases. The prescriber or anticoagulation clinic should advise on analgesia choice and INR monitoring. The patient should be counselled to report bruising, bleeding or black stools.

Reference: BNF; MHRA Drug Safety Update