title: Single-Dose Pharmacokinetic Study of Tramadol Extended-Release Tablets in Children and Adolescents.
abstract: Combined analyses from 2 open-label, phase-1 studies-the pharmacokinetic profile of tramadol and its metabolite (M1) following a single oral dose of tramadol extended release (ER) (25 to 100 mg) in children (7 to 11 years old; study 1: n = 37) and adolescents (12 to 17 years old; study 2: n = 38) with painful conditions-were historically compared with that of healthy adults following similar dosing. The dose-normalized area under the curve (DN AUC0-24h ) and maximum concentration (DN Cmax ) of tramadol and of M1 in children and in adolescents were lower than those in adults (children vs adults: tramadol, DN AUC0-24h 82.19%; DN Cmax 80.38%, P = .0031; M1, DN AUC0-24h 51.19%, DN Cmax 52.68%, P < .0001; adolescents vs adults: tramadol, DN AUC0-24h 89.56%, DN Cmax 84.01%; M1, DN AUC0-24h 85.28%, DN Cmax 83.03%, P = .0004). The arithmetic mean terminal elimination t1/2 of tramadol in children and adolescents was comparable to that in adults (children 8.4 hours; adolescents 8.5 hours; adults 7.9 hours). The most frequently reported (≥5% of participants) treatment-emergent adverse events in children included headache, upper abdominal pain and constipation, and in adolescents were headache, nausea, dizziness, and stomach discomfort. Multiple factors may have contributed to these observations, including a higher proportion of children (56%) who may have a lower activity of CYP2D6, resulting in reduced clearance of tramadol.
authors.affiliation: Janssen Research & Development, Beerse, Belgium. jvdbossc@its.jnj.com.
authors.forename: Joris
authors.initials: J
authors.lastname: Vandenbossche
authors.affiliation: Janssen Research & Development, Beerse, Belgium.
authors.forename: Achiel
authors.initials: A
authors.lastname: Van Peer
authors.affiliation: Janssen Research & Development, Raritan, NJ, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Richards
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D019540:Area Under Curve; D002648:Child; D019389:Cytochrome P-450 CYP2D6 / Q000378:metabolism; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D005260:Female; D006207:Half-Life; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy*; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D014147:Tramadol; D019389:Cytochrome P-450 CYP2D6
keywords: adolescents; children; pain; pharmacokinetics; tramadol extended release