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How Long Does Tramadol Stay in Your System or body, blood, urine?

How Long Does Tramadol Stay in Your System?

Tramadol is sold under the brand name ‘Ultram’ among many others. In 1995, the drug hit the market as an effective remedy for the pain management. Thereafter, formats like ER (extended release) capsules also came in the markets. The drug has an action on a wide range of neurotransmitters that make it distinctive from other pain killers. Tramadol binds to the mu-opioid receptors and facilitates the release of beta-endorphins and enkephalins. It plays an antagonist role on TRPV1, nAChRs, NMDA, M1, M3, and 5-HT2C receptors. An enhanced mood, neurophysiologic relaxation, and pain relief are the primary effects produced by the drug. Along with the beneficial effects, Tramadol also produces short and long-term adverse effects. It is important to understand how long does Tramadol stays in the body, its half-life and pharmacodynamics of drug, to estimate its clearance rate from the body.

How long does Tramadol stay in your system?

The continuous use of Tramadol is associated with many side-effects. These effects continue to appear for as long as the drug keeps circulating in the system. It is important to understand the half-life of Tramadol in order to derive the accurate clearance time of the drug.

The elimination half life is the time taken by 50% of the drug to get out of the body. Medical literature has stated half-life of Tramadol as 6.3 hours. After the complete cessation of drug use, Tramadol will take almost 1.44 days to get eliminated from the system. Though the drug tends to take about 1.44 days, the metabolites continue to linger in the body for a longer duration of about 1.77 days. It is due to the long half-life of O-desmethyltramadol, which is almost 7.4 hours.

Factors that influence how long Tramadol stays in your system:

The time rate of clearance is dependent on several factors. It is due to a set of variables that come to play while determining the time duration of metabolism and excretion.

Individual attributes:

  • The half-life of a drug is increased in elderly individuals. It is due to a reduced physiological efficiency and use of medications for various other disorders.
  • Body size also has a correlation with the rate of excretion. A larger body size can metabolize the drug faster and more efficiently as compared to a smaller body size.
  • The fat percentage in the body has an inverse relation with drug excretion rate. A higher fat content reduces the clearance rate of the drug.
  • The genetics also play a paramount role. Some people have a more efficient hepatic enzymatic system concerned with Tramadol metabolism.
  • A full stomach delays the absorption and metabolism of drug.
  • Any impairment or dysfunction of the hepatic or renal system can significantly slow down the rate of drug clearance from the body.
  • A higher metabolic rate favors the fast metabolism.
  • Acidic urine prevents the reabsorption and recirculation of Tramadol into the blood.  Alkaline urine is associated with a slower excretion rate.

Dosage amounts of the drug:

Higher doses are associated with more production of metabolites of Tramadol. A longer time will be required by the body to metabolize a large number of constituents of the drug.

Duration of drug abuse:

A long-term use of Tramadol leads to a slower metabolic and excretion rate. This is due to the physiological adaptation and accumulation of drug in the fatty tissues.

Co-ingestion of drugs:

There are many drugs that interact with Tramadol. Some tend to enhance the metabolism of Tramadol through the alteration in enzymatic activities and others act to slow it down. Phenobarbital, Carbamazepine, Modafinil, and Phenytoin enhance the metabolism. Whereas Cinacalcet, Prozac, Paxil, Rifampicin, and Dexamethasone down-regulate the function of enzymes linked to Tramadol metabolism.

Tramadol absorption, metabolism, and excretion:

After administration, Tramadol is rapidly absorbed from the gastrointestinal tract into the bloodstream. The peak concentrations in blood are reached within 1.5-3 hours of drug consumption. A 100 mg dose has a bioavailability of 75% and about 20% of the dose binds to the plasma proteins. After absorption, Tramadol is then distributed throughout the body.

The steady state concentration of the drug is attained within two days of taking the IR (immediate Release) format. The ER (extended release) format takes about 4 days to reach the steady state concentration. The drug has a lipophilic property that allows it to accumulate within the fat cells. After getting absorbed, it undergoes extensive metabolism in the liver.

The metabolic pathways that act to convert Tramadol into its metabolites include N-demethylation, O-demethylation, glucuronidation, and sulfation. CYP2D6 enzymes are involved in the conversion process of Tramadol to O-desmethyltramadol through the activity of O-demethylation (M1). CYP3A4 and CYP2B6 enzymes act to convert Tramadol into N-desmethyltramadol (M2).

Both the metabolites N-desmethyl and O-desmethyl undergo a secondary metabolism to create N, N-didesmethytramadol (M3),  N,O-didesmethyltramadol (M5) and N, N, O-tridesmethyltramadol (M3).  The enzymes UGT1A8 and UGT2B7 facilitate the hepatic Glucuronidation. Tramadol and all of its metabolites are excreted through the kidneys.

The research studies have indicated the presence of 30% unchanged Tramadol and 60% metabolites of the drug in urine samples. The primary metabolite (M1) takes about 7.1 hours, which means the total clearance duration will be approximately 48 hours.

Different types of Tramadol drug tests:

Tramadol cannot be detected on the standard SAMHSA-5 screening tests. An advanced panel of screening is needed for detecting Tramadol. Some tests that are used for Tramadol include urine tests, saliva tests, hair tests, and blood tests.

  • Urine Tests:

Urine tests involve the collection of urine samples of a Tramadol user. The sample is then sent to the laboratory for testing. It is analyzed by Gas chromatography/mass spectrometry (GC/MS) for the determination of constituents of the drug. Mostly, the metabolites M1 and M2 contribute a greater percentage in the urine samples. They start to appear within two hours of the last dose. It is therefore essential to know how long does Tramadol stays in your urine. The metabolites remain detectable in the samples for about 40 hours after the administration of at least 12.5 pg dose of Tramadol.

Tramadol can sometimes produce false results on a Phencyclidine (PCP) screening test. Though it is not a common problem but a person should be aware of the incidence of false-positive results.

  • Hair Tests:

They are also the commonly employed tests for Tramadol. The hair samples from the head are collected and sent to the laboratory for hair analysis. The size should be at least 3 cm to improve the accuracy of results. The drug remains detectable for longer durations by using a technique, ‘liquid chromatography/mass spectrometry (LC/MS)’. The technique is capable of revealing N-desmethyltramadol (NDMT) and O-desmethyltramadol (ODMT) in the hair samples. An accuracy of 90 % has been reported by many laboratories performing the hair tests.

In cases of abuse, high concentrations of Tramadol and its metabolites (about 0.22-1.18ng/mg) are observed in hair samples. A person following a proper medical prescription will also exhibit drug but in a minor quantity of about 0.07-0.80ng/mg. Due to minimal invasiveness, long detection window, and high accuracy, hair analysis is a popular testing modality in cases of Tramadol consumption.

  • Saliva Tests:

This involves the collection of fluid from the oral cavity. The sample is then sent to the laboratory for analysis. The Gas chromatography/mass spectrometry (GC/MS) is used to analyze the collected fluid. The technique allows the accurate determination of levels of M1 and M2. The research data has demonstrated the presence of about 90% drug in the oral samples. Moreover, the drug remains detectable for more than 24 hours.

A new modality ‘Exhaled Breathing’ has also emerged. It is even less invasive than the oral fluid tests. A breathalyzer device is used to detect the presence of drug in the breath of a person. Tramadol and its metabolites are demonstrable in breath for up to 24 hours after the last dose.

  • Blood Tests:

The blood samples are also taken for identifying the levels of drug. The drug appears rapidly in the circulation and becomes demonstrable in the samples. One hour is taken by the drug to reach the concentration, which is readily detectable by blood tests. The drug stays up to 24 hours in the blood, and therefore it becomes important to know how long does Tramadol stays in your blood.  However, the invasiveness and shorter period of detection have reserved its use on certain occasions only. It is used in the hospital settings to measure the precise levels in cases of intoxication and overdose.

Tips to clear Tramadol from the system faster:

There are some tips that can expedite the clearance of drug from the system.

  • Completely stopping the drug is the first step. In cases of chronic users and addicted individuals, the step should be taken under a proper medical supervision.
  • Burn the body fat as the drug is lipophilic and tends to accumulate in adipose tissues.
  • Adequate hydration can ensure a fast excretion as the urinary flow increases and the drug can easily get out of the system.
  • Acidify the urine as it also boosts up the rate of drug elimination.
  • Activated charcoal acts as a very good remedy to stop the absorption and circulation of drug in the body.