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Hi to all on-list
I'm after any PK information on Tramadol ('Ultram'), but more specifically
references about potential drug interactions. I know that the main M1
metabolite (active) is influenced by debrisoquine-type polymorphism, but
additional information would be most welcome.
Chris Davie
Department of Pharmacokinetics
SmithKline Beecham Pharmaceuticals
The Frythe
Welwyn, UK
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Chris,
For a brief review of drug interactions with Tramadol, see Katz WA.
Pharmacology and Clinical Experience with Tramadol in Osteoarthritis. Drugs
52 (Suppl. 3): 39-47, 1996.
Rod Sayce
Adis International
(rods.at.smtp.adis-usa.com)
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Hi to all on-list
I'm after any PK information on Tramadol ('Ultram'), but more specifically
references about potential drug interactions. I know that the main M1
metabolite (active) is influenced by debrisoquine-type polymorphism, but
additional information would be most welcome.
Chris Davie
Department of Pharmacokinetics
SmithKline Beecham Pharmaceuticals
The Frythe
Welwyn, UK
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Also note that tramadol is a selective serotonin reuptake inhibitor, so drug
interactions with drugs that can result in the serotonin sydrome should also be
considered. (MAOIs).
Marc Semprebon, RPh
DHMC
Lebanon, NH 03756
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> I'm after any PK information on Tramadol ('Ultram'), but more specifically
> references about potential drug interactions. I know that the main M1
> metabolite (active) is influenced by debrisoquine-type polymorphism, but
> additional information would be most welcome.
>
Tramadol, a drug indicated for cancer pain, is unique in that both the
drug and M1 metabolite (mono-O-desmethyl tramadol) bind to the mu-opioid
receptor as well as it (tramadol) causes inhibition of NE and serotonin
uptake. A review article appeared in the journal Drugs in 1993, followed
by another in American Journal of Medicine (1995/1996) on its PK and there
have been reports of its metabolism in human liver microsomes. Tramadol
does seem to exhibit adverse drug interactions with antidepressants
resulting in hallucinations. Trust this is of some help.
Raj Krishna
http://members.tripod.com/~rkrishna/
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We suspect a drug-disease interaction between tramadol and a patient
with a clotting disorder. This might indicate a problem between
tramadol and anticoagulants. I am a practitioner, not a scientist, but
this might be worth some research. I did speak to the
medical/scientific staff for the company who manfacturers tramadol, but
they did not have any feedback.
Back to the Top
We suspect a drug-disease interaction between tramadol and a patient
with a clotting disorder. This might indicate a problem between
tramadol and anticoagulants. I am a practitioner, not a scientist, but
this might be worth some research. I did speak to the
medical/scientific staff for the company who manfacturers tramadol, but
they did not have any feedback.
This might not be an unrealistic assumption about the clotting issues
given serotonin's effects on platelets. Since again tramadol has serotonin
reuptake inhibitor activity, this might be the basis for your assumptions.
Please note the following references:
Calhoun JW, Calhoun DD. Prolonged bleeding time in a patient treated with
sertraline
[letter]. American journal of psychiatry 1996 Mar;153(3):443. (NLM UI:
96180620)
Skop BP, Brown TM. Potential vascular and bleeding complications of treatment
with
selective serotonin reuptake inhibitors. Psychosomatics 1996
Jan-Feb;37(1):12-6. (NLM UI: 96166503)
Pai VB, Kelly MW. Bruising associated with the use of fluoxetine. Ann
Pharmacother 1996 Jul-Aug;30(7-8):786-8. (NLM UI: 96423962)
Marc Semprebon, RPh
Dartmouth-Hiutchcock Medical Center
Lebanon, NH
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