High-dose tramadol conversion to buprenorphine-naloxone
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Updated: Jul 28, 2025

Intravascular Delivery of Biologics to the Rat Kidney
Published on: September 1, 2016
Julienne K Kirk1, Charlotte T Boyd2, Lisa Cassidy-Vu3
1Department of Family & Community Medicine, Wake Forest School of Medicine, Win-ston Salem, North Carolina. ORCID: https://orcid.org/0000-0002-5144-7780.
Abstract:
Buprenorphine-naloxone is a combination medication of an opioid partial agonist and opioid antagonist that is proven to be effective in outpatient management of opioid use disorder (OUD). Tramadol is a centrally acting analgesic. This commonly used pain medication inhibits serotonin and noradrenaline reuptake by acting as a selective agonist on opioid µ receptors. Transition and tapering high-dose tramadol to buprenorphine-naloxone is not well described in the literature. We report a case of a patient who was taking 1,000-1,250 mg of tramadol daily upon presentation to the clinic. She was originally prescribed 150 mg daily with escalation in dose and frequency over a 10-year period. The patient was converted to bupren-orphine-naloxone and has been successful in treatment of OUD for 1 year.
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