Complementary and synergistic antinociceptive interaction between the enantiomers of tramadol

J Pharmacol Exp Ther. 1993 Oct;267(1):331-40.

Abstract

The explanation for the co-existence of opioid and nonopioid components of tramadol-induced antinociception appears to be related to the different, but complementary and interactive, pharmacologies of its enantiomers. The (+) enantiomer had Ki values of only 1.33, 62.4 and 54.0 microM at mu, delta and kappa receptors, respectively. The (-) enantiomer had even lower affinity at the mu and delta sites (Ki = 24.8, 213 and 53.5 microM, respectively. The (+) enantiomer was the most potent inhibitor of serotonin uptake (Ki = 0.53 microM) and the (-) enantiomer was the most potent inhibitor of norepinephrine uptake (Ki = 0.43 microM). Basal serotonin release was preferentially enhanced by the (+) enantiomer and stimulation-evoked norepinephrine release was preferentially enhanced by the (-) enantiomer. The (+) and (-) enantiomers each independently produced centrally mediated antinociception in the acetylcholine-induced abdominal constriction test (ED50 = 14.1 and 35.0 micrograms i.t., respectively). Racemic tramadol was significantly more potent (P < .05) than the theoretical additive effect of the enantiomers (antinociceptive synergy). Synergy was also demonstrated (P < .1) in the mouse 55 degrees C hot-plate test (i.p. route) and (P < .05) the rat Randall-Selitto yeast-induced inflammatory nociception model (i.v. and i.p. routes). Critically, the enantiomers interacted less than synergistically in two side-effects of inhibition of colonic propulsive motility and impairment of rotarod performance. The racemate and the (+) enantiomer were active in a chronic (arthritic) inflammatory pain model. Taken together, these findings provide a rational explanation for the coexistence of dual components to tramadol-induced antinociception and might form the basis for understanding its clinical profile.

MeSH terms

  • Acetylcholine / pharmacology
  • Analgesics / chemistry*
  • Animals
  • Arthritis / drug therapy
  • Drug Synergism
  • Male
  • Mice
  • Mice, Inbred Strains
  • Neurotransmitter Uptake Inhibitors
  • Norepinephrine / metabolism
  • Pain Threshold / drug effects
  • Receptors, Opioid / metabolism
  • Serotonin / metabolism
  • Stereoisomerism
  • Structure-Activity Relationship
  • Tramadol / administration & dosage*
  • Tramadol / chemistry
  • Tramadol / metabolism

Substances

  • Analgesics
  • Neurotransmitter Uptake Inhibitors
  • Receptors, Opioid
  • Serotonin
  • Tramadol
  • Acetylcholine
  • Norepinephrine