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Solute carrier
family 22
member 1
Cytochrome P450
2B6
Cytochrome P450
3A4
Cytochrome P450
2B6
Cytochrome P450
3A4
Cytochrome P450
2D6
UDP-
glucuronosyltransferase
2B7
UDP-
glucuronosyltransferase
1-8
Cytochrome P450
2D6
Cytochrome P450
2D6
Canalicular
multispecific
organic anion
transporter 1
O-Desmethyltramadol
Tramadol
O
2
NADH
N-Desmethyltramadol
Formaldehyde
NAD
H
2
O
O
2
NADH
N,N-Didesmethyltramadol
Formaldehyde
NAD
H
2
O
O
2
NADH
O-Desmethyltramadol
Formaldehyde
NAD
H
2
O
Uridine
diphosphate
glucuronic acid
O-Desmethyltramadol
glucuronide
Uridine
5'-diphosphate
O
2
NADH
N,O-Didesmethyltramadol
Formaldehyde
NAD
H
2
O
NADH
O
2
Formaldehyde
H
2
O
NAD
N,N,O-Tridesmethyltramadol
H
2
O
ATP
O-Desmethyltramadol
glucuronide
H
+
ADP
Heme
Heme
Heme
Heme
Heme
Heme
Heme
Endoplasmic Reticulum
Membrane
Endoplasmic Reticulum
SLC22A1
CYP2B6
CYP3A4
CYP2B6
CYP3A4
CYP2D6
UGT2B7
UGT1A8
CYP2D6
CYP2D6
ABCC2
O-
Desmethyltramadol
Tramadol
Oxygen
NADH
N-
Desmethyltramadol
Formaldehyde
NAD
Water
Oxygen
NADH
N,N-
Didesmethyltramadol
Formaldehyde
NAD
Water
Oxygen
NADH
O-
Desmethyltramadol
Formaldehyde
NAD
Water
Uridine
diphosphate
glucuronic acid
O-
Desmethyltramadol
glucuronide
Uridine
5'-diphosphate
Oxygen
NADH
N,O-
Didesmethyltramadol
Formaldehyde
NAD
Water
NADH
Oxygen
Formaldehyde
Water
NAD
N,N,O-
Tridesmethyltramadol
Water
Adenosine
triphosphate
O-
Desmethyltramadol
glucuronide
Hydrogen Ion
Adenosine
diphosphate
SLC22A1
CYP2B6
CYP3A4
CYP2B6
CYP3A4
CYP2D6
UGT2B7
UGT1A8
CYP2D6
CYP2D6
ABCC2
ODmtdol
Trmdol