View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Bern Open Repository and Information System (BORIS) 374 PharmGKB summary PharmGKB summary: tramadol pathway Li Gonga, Ulrike M. Stamerc,d, Mladen V. Tzvetkove, Russ B. Altmana,b and Teri E. Kleina Pharmacogenetics and Genomics 2014, 24:374–380 Correspondence to Teri E. Klein, PhD, Department of Genetics, Stanford University Medical Center, 318 Campus Drive, Clark Center Room S221A, MC Keywords: analgesic, CYP2D6, OCT1, opioids, OPRM1, pathway, 5448, Stanford, CA 94305, USA pharmacogenomics, pharmacokinetics, tramadol Tel: + 1 650 725 0659; fax: + 1 650 725 3863; e-mail:
[email protected] a b Departments of Genetics, Bioengineering, Stanford University, Stanford, Received 14 January 2014 Accepted 5 April 2014 California, USA, cDepartment of Anaesthesiology and Pain Medicine, Inselspital, dDepartment of Clinical Research, University of Bern, Bern, Switzerland and eInstitute of Clinical Pharmacology, University Medical Center, Göttingen, Germany Background (tramadol : morphine) and 10 : 1 to 12 : 1 ratio parenterally Tramadol is a mixed centrally acting opioid analgesic [13–16]. Some patients experience inadequate pain relief used to relieve moderate to severe pain. It is commonly or adverse effects with tramadol. The main reported used alone or in combination with nonopioid analgesics, adverse drug reactions (ADRs) for tramadol are nausea, for example, paracetamol (acetaminophen) in the treat- vomiting, sweating, itching, constipation, headache, and ment for postoperative, dental, cancer, neuropathic, and central nervous system stimulation. Most of these reac- acute musculoskeletal pain [1–3]. It can also be used as tions are dose dependent. Neurotoxicity to tramadol may an adjuvant to NSAID therapy in osteoarthritis patients manifest as seizures, which have been reported in [4].