Influence of CYP2D6 phenotype on the pharmacokinetics and pharmacodynamics of tramadol in patients treated for post-operative pain management
Authors' conclusion
Our results support current pharmacogenetic guidelines
Study context
- Population
- Patients receiving post-operative intravenous (IV) tramadol, with CYP2D6 genotyping and phenotypingPK data available
- Participants
- 285 patients
- Exposure
- CYP2D6 poor metabolizers vs other phenotypes
- Outcome
- Relationship between CYP2D6 phenotype and tramadol PK/PD: tramadol and O-dT AUC; pain by NRS, responders NRS < 4
- Follow-up
- 24 h and 48 h
Methodological detailsmulticentre, Pain scores available for 273 (24 h) and 204 (48 h) patients
- Multicentre
- Pain scores available for 273 (24 h) and 204 (48 h) patients
Main finding
As reported in the abstract
- Mean AUC of O-demethyl tramadol (O-dT) two-fold lower in poor metabolizers (PM) vs non-PM
- Pain scores significantly higher in PM vs non-PM at 48 h
Observational data: associations, not effects.
Further findings
Analgesic response (NRS < 4) · 48 h
Morphine use · 48 h
Analgesic response (Numeric Rating Scale (NRS) < 4) · 48 h
- Significantly lower response rate in PM; CYP2D6 phenotype not an independent predictor of response in the entire population
Original publication
Influence of CYP2D6 phenotype on the pharmacokinetics and pharmacodynamics of tramadol in patients treated for post-operative pain management. Anaesth Crit Care Pain Med. Published 4 March 2026. doi:10.
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