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Tramadol, a centrally-acting opioid analgesic, is utilized in the treatment of moderate to moderately severe pain. Tramadol acts as an opiate agonist through the binding of the parent drug and its O-desmethyl (M1) metabolite to mu-opioid receptors and through the weak inhibition of norepinephrine and serotonin reuptake. The active metabolite, O-desmethyltramadol, is a considerably more potent mu-opioid receptor agonist than its parent drug. In urine, approximately 30% of tramadol is excreted as unchanged drug while approximately 60% is excreted as metabolites (N- and O-desmethyltramadol). The half-life of tramadol and O-desmethyltramadol is approximately 7 hours.
Monitoring of compliance utilizing tramadol
Detection and confirmation of the illicit use of tramadol
The presence of tramadol or O-desmethyltramadol >50 ng/mL is a strong indicator that the patient has used tramadol.
Urine concentrations do not correlate well with serum drug levels and are not intended for therapeutic drug management.
Results are intended to be interpreted by a physician or health care professional. This test is not intended for use in employment-related testing.
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2. Dayer P, Collart L, Desmeules J: The pharmacology of tramadol. Drugs 1994;47 Suppl 1:3-7