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The bioactivation of tramadol by CYP2D6 is a vital source of variability as a result of drug interaction. The analgesic efficacy of tramadol could be appreciably lowered by CYP2D6 inhibitors, such as some SSRIs or terbinafine [114, a hundred and fifteen].Consider prescribing naloxone concomitantly for clients who're at amplified threat of opiate ov