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Q: How does tramadol affect the liver? A: Tramadol (Ultram) is a non-narcotic opioid analgesic medication. Tramadol works similarly to narcotic pain relievers to manage moderate to moderately severe pain in adults. The action of tramadol to alleviate pain is not fully understood. Tramadol is extensively metabolized (broken down in the body), following oral administration, by several pathways in the liver, including the cytochrome P450 enzymes CYP2D6 and CYP3A4.
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