Tramadol - Toxicology
Due to different CYP-2D6 genotypes, people variably metabolize tramadol into its active metabolite, M1
This leads to an unpredictable mix of SNRI and opioid effects in patients
• Ultra-rapid metabolizers
- Some people are ultra-rapid metabolizers of tramadol (By the same CYP2D6 polymorphism resulting in codeine ultra-rapid metabolism)
- Death and life threatening respiratory depression have occurred following a single dose of tramadol inchildren
- Risk of infant respiratory depression in breast-feeding if mother or child are ultra-rapid metabolizers
• Poor metabolizers - In poor metabolizers, people may experience little, or no analgesic activity as the M1 metabolite cannot be created. (By the same CYP-2D6 polymorphism resulting in poor codeine metabolism and little to no analgesic activity).
By Dr. Kathryn Watson @Kat_Watson
#Tramadol #Toxicology #Toxicity #Diagnosis #Pharmacology
