BackgroundBesides the pathological states, diabetes mellitus may also alter the hepatic biotransformation of pharmaceutical agents. It is advantageous to understand the effect of diabetes on the pharmacokinetic of drugs. The objective of this study was to define the pharmacokinetic changes of tramadol and its main metabolites after in vivo intraperitoneal administration and ex vivo perfused liver study in diabetic rat model.Tramadol (10 mg/kg) was administered to rats (diabetic and control groups of six) intraperitoneally and blood samples were collected at different time points up to 300 min. In a parallel study, isolated liver perfusion was done (in diabetic and control rats) by Krebs-Henseleit buffer (containing 500 ng/ml tramadol). Perfusate samples were collected at 10 min intervals up to 180 min. Concentration of tramadol and its metabolites were determined by HPLC.ResultsTramadol reached higher concentrations after i.p. injection in diabetics (Cmax of 1607.5 ± 335.9 ng/ml) compared with control group (Cmax of 561.6 ± 111.4). M1 plasma concentrations were also higher in diabetic rats compared with control group. M2 showed also higher concentrations in diabetic rats. Comparing the concentration levels of M1 in diabetic and control perfused livers, showed that in contrast to intact animals, the metabolic ratios of M1 and M5 (M/T) were significantly higher in diabetic perfused liver compared to those of control group.ConclusionsThe pharmacokinetic of tramadol and its three metabolites are influenced by diabetes. As far as M1 is produced by Cyp2D6, its higher concentration in diabetic rats could be a result of induction in Cyp2D6 activity, while higher concentrations of tramadol can be explained by lower volume of distribution.

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A recirculated perfusion system was used to investigate the metabolism of tramadol, an analgesic agent, in the isolated perfused rat liver. Tramadol was added to the perfusion medium at a concentration of 300 ng/ml, and the perfusate samples were collected for 180 min. The concentration of tramadol and its three main metabolites O-desmethyltramadol (M1) and N-desmethyltramadol (M2) and N,O-didesmethyltramadol (M5) were determined in perfusate samples by a rapid HPLC method. All through the study, the phase I metabolism of tramadol led to the formation of M1 metabolite from early sampling points while M5 metabolite was detectable after 50 min in 6 out of 10 perfused livers and the M2 metabolite was not detectable in any experiment. The kinetic parameters of tramadol and two detectable metabolites (M1 and M5) were then calculated in perfusate samples. The tramadol concentration decreased from 297.8 to 159.6 ng/ml, with a mean half-life of 232.4 min and a hepatic clearance of 0.73 ml/min. After 180 min, the mean concentration of M1 reached 59.5 ng/ml, resulting in a metabolic ratio of 16%, while the formation of M5 metabolite continued to a mean concentration of 14.6 ng/ml resulting in a metabolic ratio of 2% using AUC((0-180min)).

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In vivo study demonstrated that pulmonary administration of sildenafil and sildenafil nanoparticles produced longer half-life and higher concentration of the drug in the lung tissue as compared to oral and IV administration. So, these formulations could be more effective than oral and IV administration of this drug.

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