A coroner has called for action to raise awareness of the interaction between tramadol and warfarin, after a Hertfordshire patient taking the combination died from a brain bleed in January 2021.The woman had been prescribed tramadol for lower back pain and had also been taking warfarin for a number of years. The woman’s inquest concluded she “died as a result of a generally unknown interaction between warfarin and tramadol, which caused exceptional thinning of her blood”.
This interaction has now been added to the BNF (British National Formulary), from January 2024.  As these medicines are commonly used in adult care services, please make sure you and your staff are aware of this interaction.

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