Related Experiment Video
Updated: Mar 22, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
SLC22A1/OCT1 Genotype Affects O-desmethyltramadol Exposure in Newborn Infants
Maja Matic1, Saskia N de Wildt, Laure Elens
1*Department of Clinical Chemistry, Erasmus University Medical Centre; Departments of †Intensive Care and ‡Paediatric Surgery, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, the Netherlands; §Integrated PharmacoMetrics, PharmacoGenomics and PharmacoKinetics, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels; ¶Center for Clinical Pharmacology, University Hospitals Leuven & Department of Pharmaceutical and Pharmacological Sciences, University Hospitals; ‖Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven; and **Neonatal Intensive Care Unit, University Hospitals, Leuven, Belgium.
The organic cation transporter 1 (OCT1) genotype influences tramadol metabolism in infants. Genetic variations in SLC22A1, encoding OCT1, affect O-desmethyltramadol (M1) levels, impacting drug response in neonates.
Area of Science:
- Pharmacogenomics
- Neonatal Pharmacology
- Drug Metabolism
Background:
- Tramadol pharmacokinetics in neonates exhibit significant variability.
- Factors influencing tramadol metabolism include postmenstrual age and CYP2D6 genotype.
- The role of other genetic factors, such as SLC22A1 (organic cation transporter 1, OCT1), remains to be fully elucidated.
Purpose of the Study:
- To investigate the association between SLC22A1 genotype and tramadol (M) and O-desmethyltramadol (M1) pharmacokinetics in early infancy.
- To determine if SLC22A1 genotype, in addition to postmenstrual age and CYP2D6 genotype, explains tramadol pharmacokinetic variability.
Main Methods:
- A cohort of 50 infants received intravenous tramadol.
- Blood samples were collected to measure tramadol and M1 concentrations.
- Linear mixed-model analysis was used to assess the impact of SLC22A1 and CYP2D6 genotypes and postmenstrual age.
Main Results:
- The SLC22A1 genotype was independently associated with the M1/M ratio, with fewer functional gene copies linked to higher M1/M ratios.
- Infants with fewer than 2 functional SLC22A1/OCT1 gene copies had a higher M1/M ratio compared to those with 2 functional copies.
- Combined CYP2D6 and SLC22A1 genotypes significantly influenced the M1/M ratio.
Conclusions:
- SLC22A1 genetics play a significant role in neonatal O-desmethyltramadol exposure.
- OCT1 transporter activity is present early in life, potentially affecting the disposition of other OCT1 substrates.
- These findings emphasize the importance of pharmacogenetic considerations in neonatal tramadol therapy.
Related Concept Videos
Pharmacogenetics of Drug Transporters: P-Glycoprotein and Solute Carrier Transporters
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu
Pharmacogenetics of Phase II Enzymes: N-acetyltransferase, Thiopurine S-methyltransferase, UDP-glucuronosyltransferase
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase
Pharmacogenetics of Phase I Enzymes: Cytochrome P450 Isozymes

