• J Palliat Med · Sep 2021

    Case Reports

    Acute Pain Crisis Caused by Tramadol Remdesivir Drug-Drug Interaction.

    • Dac Teoli, Virginia Thompson, Jessica Wright, Ivana Ho, Brittany Vlaminck, Gina Miller, and Molly Feely.
    • Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
    • J Palliat Med. 2021 Sep 1; 24 (10): 158215841582-1584.

    AbstractDrug interactions are common and can affect patient outcomes. Drugs that undergo emergency approval have less preapproval drug testing to identify potential interactions. Tramadol is an effective pain medication prodrug with a complex mechanism of action that requires extensive metabolism. Remdesivir is an antiviral medication given emergency approval to treat hospitalized patients with COVID-19 infections. Remdesivir is also a nucleotide analogue prodrug that undergoes intracellular metabolic conversions to its active metabolite. We discuss the case of a hospitalized patient in the United States diagnosed with COVID-19 pneumonia who developed acute pain crisis secondary to a drug-drug interaction between tramadol and remdesivir, and we propose a possible mechanism of interaction.

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