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Tramadol undergoes extensive metabolism in the liver, primarily via the cytochrome P450 enzyme system, particularly the CYP2D6 isoenzyme. The metabolism of Tramadol produces active metabolites, including O-desmethyltramadol (M1), which contributes to its analgesic effects. Genetic variations in the CYP2D6 enzyme can affect Tramadol metabolism and lead to differences in drug response among individuals. Poor metabolizers may experience reduced efficacy of Tramadol, while ultra-rapid metabolizers may be at increased risk of adverse effects, including toxicity and overdose.
Date: 04/20/2024
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