Abstract
Cytochrome P450 gene polymorphism is involved in the metabolism of tramadol. We investigated the effect of CYP2D6 gene polymorphism on tramadol metabolism by studying CYP2D6*1, CYP2D6*DUP, CYP2D6*4, and CYP2D6*10. CYP2D6 genotyping was performed using the xTAG CYP2D6 Kit v3 which incorporates multiplex PCR (Luminex kit). Tramadol levels were assessed using enzyme immunoassay. Our Study was done on 100 Egyptian patients with acute tramadol intoxication and 100 healthy control subjects. The patients were admitted to NECTR center. CYP2D6*1 was the most presented allelic variant in both groups The CYP2D6*DUP is associated with severe intoxication. There was a significant association between CYP2D6 allelic variants and tramadol metabolites level. In conclusion, our data suggests that studying CYP2D6 allelic variants may help clinicians to predict the severity of tramadol intoxication and individualize the drug treatment.
Highlights
IntroductionTramadol is an orally-active and centrally-acting opioid analgesic used for the treatment of moderate to severe pain [1]
Tramadol is an orally-active and centrally-acting opioid analgesic used for the treatment of moderate to severe pain [1].Tramadol was approved for marketing as a non-controlled analgesic in 1995 under the trade name of Ultram
The 100 Egyptian tramadol intoxicated patients (90 males and 10 females) were admitted to (NECTR); their mean age was 27.6 ± 6.6 years. 100 healthy subjects (90 males and 10 females), their mean age was 24.5 ± 5.1 years were studied as a control group Table 2
Summary
Tramadol is an orally-active and centrally-acting opioid analgesic used for the treatment of moderate to severe pain [1]. Tramadol was approved for marketing as a non-controlled analgesic in 1995 under the trade name of Ultram. The producing company claimed that this substance produced weak narcotic effects, researches demonstrated that opioid activity is one of the drug’s pharmacological activity. Many physicians felt that this drug was safe to prescribe, because tramadol’s products had inadequate labeling and established abuse potential. Numerous reports of abuse, dependence and side effects had been received [2]. An increasingly alarming phenomenon of Tramadol abuse has been heavily demonstrated in the Egyptian community in the last four years as it is provided at cheap cost despite of it being scheduled [2]
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