intoxicant.wiki2catechol4school
← All metabolic timelinesMetabolic highway

Tramadol

Follow one dose of tramadol from the moment it enters the body until the last of it leaves.

Tramadolweak opioid, serotonergicO-DSMTvia CYP2D6, strong opioidOther metabolitesCYP3A4, CYP2B6Urine95%

The clock, on a log scale

Each bar runs from the dose to about five half-lives, roughly when 97% of that molecule has been converted or cleared. The scale is logarithmic so minutes and days fit on one line.

  1. < 1 honset

    Dose taken by mouth

    68% absorbed

    About 68% of an oral dose reaches the blood.1 Pain relief from an immediate-release tablet usually begins within an hour.1

  2. hoursliver

    Tramadol → O-desmethyltramadol (O-DSMT)

    CYP2D6CYP3A4CYP2B6O-DSMT is active

    The liver breaks tramadol down with CYP2B6, CYP2D6 and CYP3A4.1 The main metabolite, desmetramadol (O-DSMT), has 200 times the μ-opioid affinity of (+)-tramadol.1

    Genes and other drugs change the effect: about 6% of people have reduced CYP2D6 activity and may need about 30% more for the same pain relief. People with extra copies of CYP2D6 make O-DSMT faster.1 The CYP2D6 blocker quinidine markedly reduced O-DSMT levels.1 Any drug that blocks or boosts these enzymes may interact with tramadol.1
  3. ~6 htramadol half-life

    Half the tramadol is gone

    tramadol 6.3 hO-DSMT 9 h

    Tramadol's half-life is about 6.3 hours. O-DSMT is cleared more slowly, with a half-life of about 9 hours.1

    Serotonin and seizures: tramadol can add to a serotonin overload, especially with antidepressants, and it lowers the seizure threshold.1 TripSit rates tramadol with SSRIs, MAOIs, MDMA, alcohol or benzodiazepines as Dangerous.2
  4. 1–2 daysexit

    Out through the kidneys

    urine 95%

    Phase II metabolism makes the metabolites water-soluble, and the kidneys remove them. About 95% leaves in urine.1

Sources

  1. Wikipedia, Tramadol (pharmacokinetics and infobox), CC BY-SA
  2. TripSit combination chart (combos.json, read 2026-10-24)

Half-lives vary between people, doses and routes. This page explains what the body does with a drug. It is not dosing advice.