My wife is on blood thinner, Coumadin and prior to going on Coumadin she was using Relafen to help her with her Arthritus and it worked really well. However, when she had to go on Coumadin to thin her blood due to blood clots in her lungs, she was told there was an interaction between the 2 medications and she had to stop Relafen. Her pain has returned and we were wondering if Tramadol will have a bad effect on the Coumadin??? In addition she is taking Abilify. She is also using Diltiazem following surgery for an Ablation.