Increased liability of tramadol-warfarin interaction in individuals with mutations in the cytochrome p450 2D6 gene

• Objective  This study aimed to investigate the importance of cytochrome P450 enzymes for the reported interaction between tramadol and warfarin.Materials and methods  Cases of suspected interaction between tramadol and warfarin resulting in International Normalised Ratios increases that were reported to the Swedish Adverse Drug Reactions Advisory Committee until March 2003 were included. Ten cases had been genotyped for known polymorphisms of CYP2D6, CYP2C9 and CYP2C19.Results  Seven of ten patients carried defective CYP2D6 alleles (population prevalence 42.2%) (one-sided binomial test, P=0.07). A further patient received concomitant drug treatments that may have resulted in CYP2D6 enzyme inhibition.Conclusion  The liability to an interaction between tramadol and warfarin may be related to the CYP2D6 activity.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)

Keyword

Tramadol

Warfarin

Cytochrome P450

Clinical pharmacology

Klinisk farmakologi

Clinical Pharmacology

Klinisk farmakologi

Publication and Content Type

ref (subject category)

art (subject category)