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Evaluation of the Ecstasy influence on tramadol and its main metabolite plasma concentration in rats

Bardia Jamali, Behjat Sheikholeslami, Yalda Hosseinzadeh Ardakani, Hoda Lavasani, Mohammad-reza Rouini

Drug Metabolism and Personalized Therapy January 26, 2017 Peer reviewed DOI: 10.1515/dmpt-2017-0018

Summary

MDMA affects how tramadol is absorbed and metabolized in male rats, reducing its absorption rate when administered intraperitoneally and increasing its concentration with intravenous administration. The study suggests that MDMA inhibits not only CYP2D6 but also CYP3A4 isoenzymes, which may lead to increased risks for users. Consequently, those who abuse MDMA while taking tramadol might not achieve the desired effects at standard doses if taken orally, highlighting potential dangers of intravenous use.

Study at a glance

Population male rats
Key finding MDMA treatment altered the pharmacokinetics of tramadol, affecting its absorption and metabolism.

Abstract

AbstractBackground:Tramadol is prone to be abused alone, or in combination with 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy). It was reported that 95% of people with a history of substance abuse in the United States used tramadol in 2004. According to the WHO report in 2016, there was a growing number of tramadol abusers alone or in combination with psychoactive substances such as MDMA in particular in some Middle East countries. Higher concentrations of tramadol in plasma may lead to adverse drug reactions or lethal intoxication. In this study, the effect of MDMA on the pharmacokinetics of tramadol was examined in male rats.Methods:The effect of MDMA on TResults:When tramadol administered intraperitoneally, the absorption rate of this drug was reduced, and a lower CConclusions:According to the obtained data, MDMA treatment affected the absorption, distribution and metabolism phases of tramadol. This treatment increased the concentration of tramadol if administered intravenously and can latent the absorption of tramadol in oral route. However, MDMA was introduced as CYP2D6 inhibitor; in this study, MDMA inhibited CYP3A4 isoenzymes as well. This finding is important for the compounds that are metabolized through CYP3A4. It can be proposed that in abusers of MDMA who only receive tramadol for medical or nonmedical purposes in short intervals, the dangers of the intravenous administration of tramadol should be considered, and if tramadol is administered orally, the desired effect may not be achieved at the routine dose.

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