Drug General Information (ID: DDIJGH35RL)
Drug Name			Tramadol		Drug Info		Dezocine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Analgesics
Structure

Mechanism of Tramadol-Dezocine Interaction (Severity Level: Major)
Additive cardiorespiratory depression effects Click to Show/Hide Mechanism Graph
Drug Name		Tramadol				Dezocine
Mechanism 1		Respiratory depression effects				Respiratory depression effects
Key Mechanism Factor 1
		Factor Name		Cardiorespiratory depression effects
		Factor Description		Cardiorespiratory depression is a reduction or inhibition of the normal function of the heart and lungs. The heart and lungs are the most important organs of the body's circulatory system, and when excessively depressed may result in decreased heart rate, decreased blood pressure, heart failure, slowed breathing (little to no visible chest movement), apnea, narrowed or pinpoint pupils, and seizures.
Mechanism Description		Additive cardiorespiratory depression effects by the combination of Tramadol and Dezocine
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Tramadol				Dezocine
Mechanism 2		CNS depression effects				CNS depression effects
Key Mechanism Factor 2
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Tramadol and Dezocine
Increased risk of lowers seizure threshold Click to Show/Hide Mechanism Graph
Drug Name		Tramadol				Dezocine
Mechanism 3		Lower seizure threshold				Lower seizure threshold
Key Mechanism Factor 3
		Factor Name		Lowers seizure threshold
		Factor Description		The combination of medications that lower the seizure threshold is a factor that makes people with epilepsy more likely to have seizures. A seizure is a sudden, uncontrolled electrical disturbance in the brain that can cause changes in your behavior, movements or sensations, and level of consciousness.
Mechanism Description		Increased risk of lowers seizure threshold by the combination of Tramadol and Dezocine

Recommended Action
Management		Concomitant use of tramadol and other opioids, including mixed agonist/antagonist analgesics, should be avoided in general. Tramadol should not be used in opioid-dependent patients, and use in patients who are chronically on opioids is also not recommended. Tramadol is contraindicated in patients with acute opioid intoxication. Tramadol dosage should be reduced if it must be used in patients receiving opioids. Patients should be monitored for development of seizures and CNS and respiratory depression.

References
1	Product Information. Ultram (tramadol). McNeil Pharmaceutical, Raritan, NJ.
2	D'Arcy PF "Tobacco smoking and drugs: a clinically important interaction?" Drug Intell Clin Pharm 18 (1984): 302-7.[PMID: 6370644]
3	Miller LG "Recent developments in the study of the effects of cigarette smoking on clinical pharmacokinetics and clinical pharmacodynamics." Clin Pharmacokinet 17 (1989): 90-108.[PMID: 2673608]