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Kokilambigai KS, Irina VM, Sheba Mariam KC, Adila K, Kathirvel S. Comprehensive overview of analytical and bioanalytical methodologies for the opioid analgesics - Tramadol and combinations. Anal Biochem 2024; 692:115579. [PMID: 38797485 DOI: 10.1016/j.ab.2024.115579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/09/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Synthetic opioids like Tramadol are used to treat mild to moderate pain. Its ability to relieve pain is about a tenth that of morphine. Furthermore, Tramadol shares similar effects on serotonin and norepinephrine to several antidepressants known as serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine and duloxetine. The present review paper discusses the recent developments in analytical methods for identifying drugs in pharmaceutical preparations and toxicological materials, such as blood, saliva, urine, and hair. In recent years, a wide variety of analytical instruments, including capillary electrophoresis, NMR, UV-visible spectroscopy, HPTLC, HPLC, LC-MS, GC, GC-MS, and electrochemical sensors, have been used for drug identification in pharmaceutical preparations and toxicological samples. The primary quantification techniques currently employed for its quantification in various matrices are highlighted in this research.
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Affiliation(s)
- K S Kokilambigai
- Department of Pharmaceutical Analysis, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur 603203, Chengalpattu District, Tamil Nadu, India
| | - V M Irina
- Dr. Moopen's College of Pharmacy, Naseera Nagar, Meppadi PO, Wayanad, 673577, Kerala, India
| | - K C Sheba Mariam
- Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post., Kozhikode, 673602, Kerala, India
| | - K Adila
- Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post., Kozhikode, 673602, Kerala, India
| | - S Kathirvel
- Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post., Kozhikode, 673602, Kerala, India.
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Massadeh AM, Al-Rawi NH, Fayyad MT, Shotar AM, Al-Farras MI, A Massadeh SA. Simultaneous determination of tramadol in earwax and urine samples: effects of age, duration time and sex. Bioanalysis 2024; 16:363-374. [PMID: 38380641 DOI: 10.4155/bio-2023-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024] Open
Abstract
Background: This study aims to determine the concentrations of tramadol in earwax (μg/g) and urine (μg/ml) samples taken from postoperative patients, to evaluate the sensitivity of earwax (cerumen) as an alternative analyte and compare it with the findings in urine samples. Results: The results indicated that tramadol concentrations in earwax samples were averaged 45.08 μg/g (range: 13.5-107.7 μg/g), whereas tramadol concentrations in urine samples were averaged 4.97 μg/ml (range: 1.57-10.11 μg/ml). There were significant differences when comparing age groups, duration and sex between earwax and urine samples (p < 0.05). Conclusion: Despite the significant differences between earwax and urine samples, earwax can be used as a bioindicator of tramadol detection.
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Affiliation(s)
- Adnan M Massadeh
- Department of Medicinal Chemistry & Pharmacognosy, Faculty of Pharmacy University of Science & Technology, Irbid, 2210, Jordan
| | | | - May T Fayyad
- Department of Forensic Medicine, Legal Medicine & Toxicology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Ali M Shotar
- Department of Forensic Medicine, Legal Medicine & Toxicology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
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Long T, Cristofoletti R, Cicali B, Michaud V, Dow P, Turgeon J, Schmidt S. Physiologically-based Pharmacokinetic Modeling to Assess the Impact of CYP2D6-Mediated Drug-Drug Interactions on Tramadol and O-Desmethyltramadol Exposures via Allosteric and Competitive Inhibition. J Clin Pharmacol 2021; 62:76-86. [PMID: 34383318 PMCID: PMC9293201 DOI: 10.1002/jcph.1951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/06/2021] [Indexed: 11/11/2022]
Abstract
Tramadol is an opioid medication used to treat moderately severe pain. Cytochrome P450 (CYP) 2D6 inhibition could be important for tramadol, as it decreases the formation of its pharmacologically active metabolite, O‐desmethyltramadol, potentially resulting in increased opioid use and misuse. The objective of this study was to evaluate the impact of allosteric and competitive CYP2D6 inhibition on tramadol and O‐desmethyltramadol pharmacokinetics using quinidine and metoprolol as prototypical perpetrator drugs. A physiologically based pharmacokinetic model for tramadol and O‐desmethyltramadol was developed and verified in PK‐Sim version 8 and linked to respective models of quinidine and metoprolol to evaluate the impact of allosteric and competitive CYP2D6 inhibition on tramadol and O‐desmethyltramadol exposure. Our results show that there is a differentiated impact of CYP2D6 inhibitors on tramadol and O‐desmethyltramadol based on their mechanisms of inhibition. Following allosteric inhibition by a single dose of quinidine, the exposure of both tramadol (51% increase) and O‐desmethyltramadol (52% decrease) was predicted to be significantly altered after concomitant administration of a single dose of tramadol. Following multiple‐dose administration of tramadol and a single‐dose or multiple‐dose administration of quinidine, the inhibitory effect of quinidine was predicted to be long (≈42 hours) and to alter exposure of tramadol and O‐desmethyltramadol by up to 60%, suggesting that coadministration of quinidine and tramadol should be avoided clinically. In comparison, there is no predicted significant impact of metoprolol on tramadol and O‐desmethyltramadol exposure. In fact, tramadol is predicted to act as a CYP2D6 perpetrator and increase metoprolol exposure, which may necessitate the need for dose separation.
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Affiliation(s)
- Tao Long
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Rodrigo Cristofoletti
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Brian Cicali
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA
| | - Veronique Michaud
- Tabula Rasa HealthCare, Precision Pharmacotherapy Research and Development Institute, Orlando, FL, USA.,Faculty of Pharmacy, Université de Montréal, Montréal, Quebec, Canada
| | - Pamela Dow
- Tabula Rasa HealthCare, Precision Pharmacotherapy Research and Development Institute, Orlando, FL, USA
| | - Jacques Turgeon
- Tabula Rasa HealthCare, Precision Pharmacotherapy Research and Development Institute, Orlando, FL, USA.,Faculty of Pharmacy, Université de Montréal, Montréal, Quebec, Canada
| | - Stephan Schmidt
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL, USA
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Rudzki PJ, Jarus-Dziedzic K, Filist M, Gilant E, Buś-Kwaśnik K, Leś A, Sasinowska-Motyl M, Nagraba Ł, Bujalska-Zadrożny M. Evaluation of tramadol human pharmacokinetics and safety after co-administration of magnesium ions in randomized, single- and multiple-dose studies. Pharmacol Rep 2021; 73:604-614. [PMID: 33686610 PMCID: PMC7994227 DOI: 10.1007/s43440-021-00239-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Magnesium ions (Mg2+) increase and prolong opioid analgesia in chronic and acute pain. The nature of this synergistic analgesic interaction has not yet been explained. Our aim was to investigate whether Mg2+ alter tramadol pharmacokinetics. Our secondary goal was to assess the safety of the combination. METHODS Tramadol was administered to healthy Caucasian subjects with and without Mg2+ as (1) single 100-mg and (2) multiple 50-mg oral doses. Mg2+ was administered orally at doses of 150 mg and 75 mg per tramadol dosing in a single- and multiple-dose study, respectively. Both studies were randomized, open label, laboratory-blinded, two-period, two-treatment, crossover trials. The plasma concentrations of tramadol and its active metabolite, O-desmethyltramadol, were measured. RESULTS A total of 25 and 26 subjects completed the single- and multiple-dose study, respectively. Both primary and secondary pharmacokinetic parameters were similar. The 90% confidence intervals for Cmax and AUC0-t geometric mean ratios for tramadol were 91.95-102.40% and 93.22-102.76%. The 90% confidence intervals for Cmax,ss and AUC0-τ geometric mean ratios for tramadol were 93.85-103.31% and 99.04-105.27%. The 90% confidence intervals for primary pharmacokinetic parameters were within the acceptance range. ANOVA did not show any statistically significant contribution of the formulation factor (p > 0.05) in either study. Adverse events and clinical safety were similar in the presence and absence of Mg2+. CONCLUSIONS The absence of Mg2+ interaction with tramadol pharmacokinetics and safety suggests that this combination may be used in the clinical practice for the pharmacotherapy of pain.
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Affiliation(s)
- Piotr J Rudzki
- Łukasiewicz Research Network - Pharmaceutical Research Institute, ul. Rydygiera 8, 02-091, Warsaw, Poland
| | | | - Monika Filist
- Łukasiewicz Research Network - Pharmaceutical Research Institute, ul. Rydygiera 8, 02-091, Warsaw, Poland
| | - Edyta Gilant
- Łukasiewicz Research Network - Pharmaceutical Research Institute, ul. Rydygiera 8, 02-091, Warsaw, Poland
| | - Katarzyna Buś-Kwaśnik
- Łukasiewicz Research Network - Pharmaceutical Research Institute, ul. Rydygiera 8, 02-091, Warsaw, Poland
| | - Andrzej Leś
- Łukasiewicz Research Network - Pharmaceutical Research Institute, ul. Rydygiera 8, 02-091, Warsaw, Poland
| | - Małgorzata Sasinowska-Motyl
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, ul. Banacha 1b, 01-793, Warsaw, Poland
| | - Łukasz Nagraba
- Orthopedic and Rehabilitation Department, Medical University of Warsaw, ul. Kondratowicza 8, 03-242, Warsaw, Poland
| | - Magdalena Bujalska-Zadrożny
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, ul. Banacha 1b, 01-793, Warsaw, Poland.
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Izes AM, Kimble B, Govendir M. Intrinsic clearance rate of O-desmethyltramadol (M1) by glucuronide conjugation and phase I metabolism by feline, canine and common brush-tailed possum microsomes. Xenobiotica 2019; 50:776-782. [PMID: 31755346 DOI: 10.1080/00498254.2019.1697014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Quantitative aspects of in vitro phase II glucuronidative metabolism of O-desmethyltramadol (O-DSMT or M1), the active metabolite of the analgesic drug tramadol, by feline, canine and common brush-tailed possum hepatic microsomes are described.Whilst previous studies have focused on the phase I conversion of tramadol to M1, this is the first report in which the phase II glucuronidative metabolic pathway of M1 has been isolated by an in vitro comparative species study.Using the substrate depletion method, microsomal phase II glucuronidative in vitro intrinsic clearance (Clint) of M1 was determined.The in vitro Clint (mean ± SD) by pooled common brush-tailed possum microsomes was 9.9 ± 1.7 μL/min/mg microsomal protein whereas the in vitro Clint by pooled canine microsomes was 1.9 ± 0.07 μL/min/mg microsomal protein. The rate of M1 depletion by feline microsomes, as measured solely by high pressure liquid chromatography, was too slow to determine. Liquid chromatography-mass spectrometry identified O-DSMT glucuronide in samples generated from all three species' microsomes, although the amount detected under the feline condition was minimal.This study indicates that M1 likely undergoes in vitro phase II glucuronidation by canine and common brush-tailed possum microsomes and, to a minor extent, by feline microsomes. The rate of depletion of M1 by phase I metabolism was also undertaken.When incubated with phase I co-factors and common brush-tailed possum microsomes or canine microsomes, M1 had an in vitro Clint of 47.6 and 22.8 μL/min/mg microsomal protein, respectively. However, due to a lack of CYP2B-like activity in the feline liver, unsurprisingly, M1 did not deplete when incubated with feline microsomes. Consequently, major M1 elimination pathways, using feline microsomes, were not determined."
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Affiliation(s)
- Aaron M Izes
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
| | - Benjamin Kimble
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
| | - Merran Govendir
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
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Ezoddin M, Adlnasab L, Afshari Kaveh A, Karimi MA, Mahjoob B. Development of air‐assisted dispersive micro‐solid‐phase extraction‐based supramolecular solvent‐mediated Fe
3
O
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@Cu–Fe–LDH for the determination of tramadol in biological samples. Biomed Chromatogr 2019; 33:e4572. [DOI: 10.1002/bmc.4572] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 04/19/2019] [Accepted: 04/30/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Maryam Ezoddin
- Department of ChemistryPayame Noor University Tehran Iran
| | - Laleh Adlnasab
- Department of Chemistry and Polymer, Faculty of Chemistry and Petrochemical EngineeringStandard Research Institute Karaj Iran
| | | | | | - Behnaz Mahjoob
- Department of ChemistryUniversity of Environment Karaj Iran
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Asari Y, Ikeda Y, Tateno A, Okubo Y, Iijima T, Suzuki H. Acute tramadol enhances brain activity associated with reward anticipation in the nucleus accumbens. Psychopharmacology (Berl) 2018; 235:2631-2642. [PMID: 29951769 DOI: 10.1007/s00213-018-4955-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 06/19/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Tramadol is an analgesic with monoamine reuptake inhibition and μ-opioid receptor activation. Although tramadol has been widely used for treatment of various pain conditions, there is controversy over the risk of abuse potential. We examined the effects of tramadol on the reward system in humans using functional magnetic resonance imaging (fMRI) to assess the potential of tramadol for drug abuse or dependence. METHODS A randomized, double-blind, placebo-controlled, crossover study was conducted for 19 healthy adults under tramadol or placebo. In association with subjective mood questionnaires, monetary incentive delay (MID) task was performed to assess the neural response to reward anticipation during fMRI. Subjective mood measures and blood oxygenation level-dependent (BOLD) signal during gain and loss anticipation were compared between tramadol and placebo. RESULTS Tramadol significantly reduced anxiety (Z = - 2.513, p = 0.012) and enhanced vigor (Z = - 2.725, p = 0.006) compared with placebo. By Mood Rating Scale, tramadol provoked contented (Z = - 2.316, p = 0.021), relaxed (Z = - 2.236, p = 0.025), and amicable feelings (Z = - 2.015, p = 0.044) as well as increased alertness (Z = - 1.972, p = 0.049) and contentedness domains (Z = - 2.174, p = 0.030) compared with placebo. Several brain regions including nucleus accumbens (NAc) were activated during gain anticipation in the MID task under both tramadol and placebo. Tramadol increased the %BOLD signal change in NAc at +¥500 cue significantly more than the placebo (Z = - 2.295, p = 0.022). CONCLUSION Tramadol enhances the reward system and thereby may have abuse potential or precipitate drug abuse in human.
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Affiliation(s)
- Yuki Asari
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Yumiko Ikeda
- Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Yoshiro Okubo
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Hidenori Suzuki
- Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
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Abbasian M, Balali-Mood M, Mozaffari SA, Amoli HS. Solid-phase microextraction of ultra-trace amounts of tramadol from human urine by using a carbon nanotube/flower-shaped zinc oxide hollow fiber. J Sep Sci 2016; 39:4449-4457. [PMID: 27696671 DOI: 10.1002/jssc.201600729] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 09/20/2016] [Accepted: 09/21/2016] [Indexed: 02/03/2023]
Abstract
A new method is successfully developed for the separation and determination of a very low amount of tramadol in urine using functionalized multiwalled carbon nanotubes/flower-shaped zinc oxide before solid-phase microextraction combined with gas chromatography. Under ultrasonic agitation, a sol of multiwalled carbon nanotubes and flower-shaped zinc oxide were forced into and trapped within the pore structure of the polypropylene and the sol solution immobilized into the hollow fiber. Flower-shaped zinc oxide was synthesized and characterized by Fourier transform infrared spectroscopy. The morphology of the fabricated solid-phase microextraction surface was investigated by scanning electron microscopy and X-ray diffraction. The parameters affecting the extraction efficiencies were investigated and optimized. Under the optimized conditions, the method shows linearity in a wide range of 0.12-7680 ng/mL, and a low detection limit (S/N = 3) of 0.03 ng/mL. The precision of the method was determined and a relative standard deviation of 3.87% was obtained. This method was successfully applied for the separation and determination of tramadol in urine samples. The relative recovery percentage obtained for the spiked urine sample at 1000 ng/mL was 94.2%.
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Affiliation(s)
- Maryam Abbasian
- Separation Science Lab, Department of Chemical Technology, Iranian Research Organization for Science and Technology (IROST), Tehran, Iran
| | - Mahdi Balali-Mood
- Medical Toxicology Research Centre, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayed Ahmad Mozaffari
- Separation Science Lab, Department of Chemical Technology, Iranian Research Organization for Science and Technology (IROST), Tehran, Iran
| | - Hossein Salar Amoli
- Separation Science Lab, Department of Chemical Technology, Iranian Research Organization for Science and Technology (IROST), Tehran, Iran
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