Atomoxetine
Severe
Textbook
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: G&G 14e · p462
Drug reference
tapentadol
Weak mu-opioid receptor agonist, norepinephrine reuptake inhibitor, serotonin reuptake inhibitor · Analgesic
Weak mu-opioid receptor agonist, norepinephrine reuptake inhibitor, serotonin reuptake inhibitorAnalgesic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
- AtomoxetineSevereTextbookG&G 14e · p462
- DapoxetineSevereTextbookG&G 14e · p462
- Escitalopram + ClonazepamSevereTextbookG&G 14e · p462
- MoclobemideSevereTextbookG&G 14e · p462
Mechanism
Tapentadol is structurally and mechanistically similar to tramadol, acting as a weak mu-opioid receptor agonist and an inhibitor of norepinephrine and serotonin reuptake.
Indications
moderate pain
Pharmacokinetics
Metabolism
Largely by glucuronidation
Contraindications
- patients taking selective serotonin reuptake inhibitors
- patients taking serotonin-norepinephrine reuptake inhibitors
- patients taking tricyclic antidepressants
- patients taking MAO inhibitors
Side effects
Serious
- serotonin syndrome
Drug interactions
Dapoxetine
Severe
Textbook
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: G&G 14e · p462
Escitalopram + Clonazepam
Severe
Textbook
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: G&G 14e · p462
Moclobemide
Severe
Textbook
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: G&G 14e · p462
Reboxetine
Severe
Textbook
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: G&G 14e · p462
Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Almotriptan
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alprazolam
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Amitriptyline
Severe
Database
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: DDInter
Amobarbital
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amoxapine
Severe
Database
Risk of serotonin syndrome.
Monitor closely for signs of serotonin syndrome. Avoid co-administration if possible.
Source: DDInter
Amphetamine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Ask House about tapentadol
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Harrison 22e·Verified: 2026-05-10 · House clinical team