Tramadol pathway summary published in PG&G
Tramadol is a centrally acting opioid analgesic used to relieve moderate to severe pain. It is administered as a racemic mixture of (+) and (-) enantiomers and exerts its analgesic effect via activating the µ-opioid receptor and inhibiting the neurotransmitter reuptake. Tramadol metabolism to its major active metabolite O-desmethyl tramadol (M1)