Tramadol may interact with St. John’s Wort, increasing serotonin levels and the risk of serotonin syndrome. Avoid this combination.

Using tramadol with kava can enhance CNS depression. Caution is advised as this can lead to increased dizziness and sedation.

Ginseng may accelerate tramadol metabolism, potentially reducing its efficacy. Monitor for decreased pain relief.

Combining tramadol with valerian can increase central nervous system depression, heightening risks of sedation and dizziness.