Active Ingredient History
Desmetramadol (INN), also known as O-desmethyltramadol (O-DSMT), is an opioid analgesic and the main active metabolite of tramadol. Tramadol is demethylated by the liver enzyme CYP2D6 in the same way as codeine, and so similarly to the variation in effects seen with codeine, individuals who have a less active form of CYP2D6 will tend to get reduced analgesic effects from tramadol. This also results in a ceiling effect which limits tramadol's range of therapeutic benefits to the treatment of moderate pain. Wikipedia
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