Drug & supplement interaction

Rauwolscine + Tramadol

Tramadol brand names: Ultram, Zytram XL, Qdolo.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Tramadol falls into 2 drug categories that Rauwolscine can interact with; the most serious is rated moderate. Theoretically, taking rauwolscine with seizure threshold lowering drugs might increase the risk of adverse convulsant effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Rauwolscine and Tramadol

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Rauwolscine interacts with whole categories of medication. Tramadol falls into 2 of those categories, so it can interact with Rauwolscine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

SEIZURE THRESHOLD LOWERING DRUGS

1 of 2

Why this applies to Tramadol

Tramadol falls under SEIZURE THRESHOLD LOWERING DRUGS — the group Rauwolscine interacts with.

Theoretically, taking rauwolscine with seizure threshold lowering drugs might increase the risk of adverse convulsant effects.
In animal research, intraperitoneal rauwolscine lowered the seizure threshold level of the drug metrazol.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing worth knowing about pairing rauwolscine with tramadol. Tramadol is one of the few pain medicines that, on its own, can already lower your seizure threshold, meaning it makes a seizure a little easier to trigger. This is especially true at higher doses or if you take it with other things that nudge in the same direction.

Rauwolscine, a stimulant cousin of yohimbine, may also lower that threshold. So in theory, using both together could add up and slightly raise the chance of a seizure or twitching. I'll be honest with you though: this concern comes from animal lab research, not human studies, so it's mostly a caution flag. Still, please run this combo by your pharmacist or doctor before mixing them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.
Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

2 of 2

Tramadol also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.

Theoretically, rauwolscine might increase levels of drugs metabolized by CYP2D6.
Rauwolscine is structurally related to yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's a wrinkle that's easy to miss with tramadol. Your body actually turns tramadol into its stronger painkilling form using an enzyme called CYP2D6. So tramadol is a bit of a 'prodrug' that needs that enzyme to do its real work. Rauwolscine is a cousin of yohimbine, and in lab dish studies yohimbine appears to slow down CYP2D6. If that holds true in people, it could mean less of the active pain-relieving form, so your tramadol might not work as well for pain.

I want to be clear: this is theoretical, based on lab data and chemical similarity, not solid human studies. Still, since rauwolscine itself raises heart rate, blood pressure, and anxiety, it's worth a quick chat with your pharmacist or doctor before pairing the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Rauwolscine Also Interacts With Other Medications

Rauwolscine has 676 moderate known drug interactions in our database — the Tramadol one above is among them. If you take anything else, check it against the full list below.

Moderate 676 No known interaction 2,154 (incl. Tramadol)
Taking anything else?

Check Another of Your Medications Against Rauwolscine

Covers the 2,830 medications we’ve checked against Rauwolscine. Pick one to open its full report.

From our Q&A

Questions About Rauwolscine or Tramadol

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Rauwolscine or Tramadol, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Tramadol

This page covers Rauwolscine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tramadol page lists 223 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 174 moderate · 39 minor.

From our pharmacist’s overview on the Tramadol page

“Tramadol (Ultram, Qdolo) is an opioid, and its supplement interactions worry me more than most because the worst of them compound the drug's most dangerous effects. Alcohol and dozens of calming herbs deepen its sedation, sometimes to the point of slowed breathing.”

Reviewed by 2 · Jul 18, 2026

Open the Tramadol interaction page

One more smart check

Taking Rauwolscine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 196 real supplement products containing Rauwolscine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauwolscine. Your product may carry other ingredients that interact with Tramadol too, on top of Rauwolscine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Rauwolscine and Tramadol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Rauwolscine
Top half

#388 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tramadol
Top 25%

#545 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Rauwolscine

What is Rauwolscine?

  • Fat loss and weight management
  • Bodybuilding and physique support
  • Energy and stimulant effects
  • Athletic performance
  • Libido support

Rauwolscine (alpha-yohimbine) is a stimulant alkaloid closely related to yohimbine that is marketed mainly in fat-burning and pre-workout supplements. Human evidence for its benefits is very limited, and it can raise heart rate and blood pressure and cause anxiety, so it should be used with caution and is not recommended for people with heart conditions, anxiety, or during pregnancy or breastfeeding.

Read the full Rauwolscine monograph & all interactions
Medication

About Tramadol

What Is Tramadol Used For?

Brand names: Ultram, Zytram XL, Qdolo

Tramadol is used in adults for pain that is severe enough to need an opioid-strength medication and where non-opioid treatments haven't been enough. It's typically reserved for situations where milder options have failed or aren't expected to work.

It is not meant for everyday or long-term use unless the pain remains severe and alternatives continue to fall short. Prescribers carefully weigh the benefits against the real risks before starting tramadol.

See full Tramadol drug information
Keep checking

Other Drugs & Rauwolscine

Browse every other medication we’ve checked against Rauwolscine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
676Moderate
0Minor
2,153No known interaction
676 Moderate 2,153 No interaction
Moderate

676 interactions

Showing 60 of 676 moderate interactions — see all 676 on the Rauwolscine page.

No interaction 2,153 drugs checked — show the list

We also checked Rauwolscine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,153 medications checked with no known interaction — see the full Rauwolscine list.

See the full Rauwolscine interactions page
See every supplement checked against Tramadol, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

Keep exploring
Rauwolscine monograph › Uses, safety, and every drug interaction in one place Tramadol supplement interactions › Every supplement checked against Tramadol, ranked by severity Tramadol drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Rauwolscine and Tramadol Together: Common Questions

Can you take Rauwolscine with Tramadol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Rauwolscine and Tramadol?
Tramadol belongs to more than one drug category, and Rauwolscine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Rauwolscine and Tramadol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tramadol and Rauwolscine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.