Table 1.

Pharmacokinetic, pharmacodynamic, and clinical complications of tramadol

Parameter	Descriptions
Absorption	Oral, SQ, injectable
Excretion	Kidney
Mechanism of action	μ-ORs, NE, and serotonin inhibition
Therapeutic dose	0.1–0.3 mg/l (adults); 1–2 mg/kg/dose (children)
Lethal dose	0.15–39 mg/l
Pregnancy time	Category C
Drug interaction	Antidepressants, digoxin, rifampin carbamazepine, MAOIs, quinidine
Antidote	BZDs, naloxone
Complications	Pupil	Miosis, mydriasis
	Brain	Seizures
	Heart	Dysrhythmia
	Lung	Apnea
	Neurology	Serotonin syndrome
	Kidney	Renal failure
	Shoulder	Dislocation
	Muscle	Rhabdomyolysis

BZDs, benzodiazepines; MAOIs, monoamine oxidase inhibitors; NE, norepinephrine; μ-ORs, μ-opioid receptors; SQ, subcutaneous.