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Concomitant use or discontinuation of CYP450 isoenzymes together with CYP450 3A4 inducers, CYP450 3A4 inhibitors, or CYP450 2D6 inhibitors are complicated; concomitant use needs very careful consideration from the effects on the parent drug, tramadol, along with the Energetic metabolite, M1.Decide on alternate pain administration approaches or reme
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