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Metabolism: Tramadol is extensively metabolized soon after oral administration by many pathways, such as CYP2D6 and CYP3A4, and by conjugation of mum or dad and metabolites. Somewhere around 30% of the dose is excreted during the urine as unchanged drug, whereas 60% of the dose is excreted as metabolites. The rest is excreted both as unidentified o