Accidental tramadol ingestion in children admitted in tertiary care centre

It is metabolized in the liver through the cytochrome P450 CYP2D6 being the main metabolizer conducting the O-demethylation. The pharmacodynamically active metabolite seems to have a 200-300 higher affinity for μ-opioid receptors than tramadol with elimination t1/2 6 hr for tramadol, 7.5 hr for its active metabolite. 3 The genetic polymorphism of those cytochromes explains the interindividual variability of tramadol pharmacokinetics. The usual dose is 1 to 2 mg/kg every 6 hours, not to exceed 8 mg/kg/24 hours, maximum adult dose is 400 mg.

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