MAJOR — Use With Caution
Tianeptine and Kratom — CONTRAINDICATED (Additive Opioid Toxicity)
Evidence level: LIMITED
DANGEROUS COMBINATION. Both tianeptine and kratom activate opioid receptors in your brain. Taking both is like doubling your opioid dose, which can dangerously suppress breathing and cause overdose.
Both tianeptine and kratom are mu-opioid receptor agonists. Tianeptine has documented opioid activity at therapeutic and supratherapeutic doses. Kratom's alkaloids (mitragynine, 7-hydroxymitragynine) are partial mu-opioid agonists. Combined use produces additive opioid receptor activation with risk of respiratory depression, excessive sedation, and overdose.
Do not combine tianeptine and kratom. Both act on opioid receptors and together create serious overdose risk. If you use both for mood or withdrawal management, seek medical help for safer alternatives.
Take Kratom and Tianeptine with food for optimal absorption. These can generally be taken at the same meal or different meals based on your preference. Consistency in daily timing matters more than the exact hour.
Generally safe for most adults. Exercise caution if: pregnant or nursing, under 18, managing a chronic condition, or taking 5+ daily supplements. Start with lower doses if you are new to either supplement.
Extreme drowsiness, pinpoint pupils, slowed or stopped breathing, blue skin, unresponsiveness. Call 911 immediately.
Disclose use of both substances. Both have opioid activity and dependence potential. Discuss medically supervised alternatives for mood support or withdrawal management.
Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.
DANGEROUS COMBINATION. Both tianeptine and kratom activate opioid receptors in your brain. Taking both is like doubling your opioid dose, which can dangerously suppress breathing and cause overdose.
Take Kratom and Tianeptine with food for optimal absorption. These can generally be taken at the same meal or different meals based on your preference. Consistency in daily timing matters more than the exact hour.
Extreme drowsiness, pinpoint pupils, slowed or stopped breathing, blue skin, unresponsiveness. Call 911 immediately.
Discuss safer alternatives with your healthcare provider. They can recommend substitutions based on your specific health goals while minimizing interaction risks. Always bring a complete list of everything you take to your appointments.
Disclose use of both substances. Both have opioid activity and dependence potential. Discuss medically supervised alternatives for mood support or withdrawal management.
Or browse the full interaction database (121,000+ pairs).