Kratom - Tapentadol Interaction
Herbal: Kratom
Also Known As: Mitragyna speciosa, Biak-Biak, Cratom, Gratom, Ithang, Kakuam, Katawn, Kedemba, Ketum, Krathom, Kraton, Kratum, Madat, Maeng Da Leaf, Mambog, Mitragynine, Mitragynine Extract, Thang, Thom
Drug: Tapentadol
Brand names:
Nucynta, Nucynta ER
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jun 29, 2025
Interaction Details
Tapentadol is classified as belonging to the following category: Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, kratom might increase the levels of drugs metabolized by CYP2C19.
In vitro research shows that kratom extract weakly inhibits CYP2C19 enzyme activity.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Kong WM, Chik Z, Ramachandra M, et al. Evaluation of the effects of Mitragyna speciosa alkaloid extract on cytochrome P450 enzymes using a high throughput assay. Molecules. 2011;16(9):7344-7356.
Interaction Details
Tapentadol is classified as belonging to the following category: Serotonergic Drugs
Theoretically, taking kratom in combination with serotonergic drugs may increase levels of serotonin, increasing the risk of serotonin syndrome.
A 63-year-old male presented with possible serotonin syndrome after taking an unknown dose of kratom for up to 3 months along with serotonergic prescription medications bupropion, buspirone, desvenlafaxine, trazodone, and ziprasidone. It was hypothesized that kratom inhibited the cytochrome P450 3A4-, 2C9-, 2D6-, and 1A2-mediated metabolism of several of these serotonergic medications, consequently increasing systemic exposure to serotonin.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Eudaley ST, Brooks SP, Hamilton LA. Case Report: Possible Serotonin Syndrome in a Patient Taking Kratom and Multiple Serotonergic Agents. J Pharm Pract 2022.
Kratom Overview
Kratom is a tropical tree from Southeast Asia, and its leaves are known for their potent effects. The leaves contain mitragynine and 7-hydroxymitragynine, which interact with the brain's opioid receptors, producing effects similar to opioids. Mitragynine acts as a partial agonist, providing pain relief and mood enhancement, while 7-hydroxymitragynine is even more potent, estimated to be about 10 times stronger than morphine. These compounds can stimulate opioid receptors, leading to effects such as euphoria and pain relief at lower doses, while higher doses can cause sedation and opioid-like effects. Kratom's safety and legal status are hotly debated, and it's banned or restricted in many places.
Tapentadol Overview
-
Tapentadol tablets are used to treat moderate to severe acute pain (pain that begins suddenly, has a specific cause, and is expected to go away when the cause of the pain is healed). Tapentadol extended-release tablets are used to treat severe neuropathic pain (pain caused by nerve damage) in people who have diabetes. Tapentadol extended-release tablets are only used to treat people who are expected to need medication around-the-clock to relieve pain that cannot be controlled by the use of other pain medications. Tapentadol is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.
Kratom - More Interactions
Kratom interacts with 967 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
Return to the main supplement interaction checker page
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
Ask A Pharmacist About Your Herbal Questions!
Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
Ask A Pharmacist