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Drugs that inhibit CYP3A4 and CYP2D6 liver enzymes include erythromycin, ketoconazole, and ritonavir which can increase the extent of opioids in the body and improve the chance of unintended effects.

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In a study within the Journal of Pain Symptom Management, authors report that amphetamines used in combination with medicine like tramadol tend to increase the effects of the opioids.

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