{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:19:22Z","timestamp":1777915162550,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T00:00:00Z","timestamp":1632096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Drug interactions are common and can affect patient outcomes. Drugs that undergo emergency approval have less preapproval drug testing to identify potential interactions. Tramadol is an effective pain medication prodrug with a complex mechanism of action that requires extensive metabolism. Remdesivir is an antiviral medication given emergency approval to treat hospitalized patients with COVID-19 infections. Remdesivir is also a nucleotide analogue prodrug that undergoes intracellular metabolic conversions to its active metabolite. We discuss the case of a hospitalized patient in the United States diagnosed with COVID-19 pneumonia who developed acute pain crisis secondary to a drug\u2013drug interaction between tramadol and remdesivir, and we propose a possible mechanism of interaction.<\/jats:p>","DOI":"10.1089\/jpm.2021.0123","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T15:51:13Z","timestamp":1624290673000},"page":"1582-1584","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Acute Pain Crisis Caused by Tramadol Remdesivir Drug\u2013Drug Interaction"],"prefix":"10.1177","volume":"24","author":[{"given":"Dac","family":"Teoli","sequence":"first","affiliation":[{"name":"Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Thompson","sequence":"additional","affiliation":[{"name":"Pharmacy Services, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Wright","sequence":"additional","affiliation":[{"name":"Pharmacy Services, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivana","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany","family":"Vlaminck","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gina","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Feely","sequence":"additional","affiliation":[{"name":"Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Drug Interactions: www.merckmanuals.com\/professional\/clinical-pharmacology\/factors-affecting-response-to-drugs\/drug-interactions. (Last accessed March 20 2021)."},{"key":"e_1_3_3_3_2","unstructured":"Drug Interactions: What you should know: www.fda.gov\/drugs\/resources-you-drugs\/drug-interactions-what-you-should-know. (Last accessed March 22 2021)."},{"key":"e_1_3_3_4_2","unstructured":"Veklury (remdesivir) EUA Letter of Approval reissued October 22 2020: www.fda.gov\/media\/137564\/download. (Last accessed March 20 2021)."},{"key":"e_1_3_3_5_2","unstructured":"U.S. Food and Drug Administration (FDA): Fact sheet for health care providers Emergency Use Authorization (EUA) of remdesivir (GS-5734(TM)): https:\/\/www.fda.gov\/media\/137566\/download (Last accessed March 23 2021)."},{"key":"e_1_3_3_6_2","volume-title":"VEKLURY(R) Intravenous Injection, Remdesivir Intravenous Injection","author":"Product Information:","year":"2020","unstructured":"Product Information:. VEKLURY(R) Intravenous Injection, Remdesivir Intravenous Injection. Foster City, CA: Gilead Sciences Inc., (per FDA), 2020."},{"key":"e_1_3_3_7_2","volume-title":"ULTRAM(R) Oral Tablets, Tramadol Hydrochloride Oral Tablets","author":"Product Information:","year":"2007","unstructured":"Product Information:. ULTRAM(R) Oral Tablets, Tramadol Hydrochloride Oral Tablets. Raritan, NJ: Ortho-McNeil Pharmaceutical Inc., 2007."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_3_3_9_2","unstructured":"Product Information: Tramadol KRKA solution for injection and infusion tramadol hydrochloride solution for injection and infusion. KRKA DD Novo Mesto (per AEMPS; Spain) Smarjeska basket 8501 Slovenia 2019."},{"key":"e_1_3_3_10_2","unstructured":"Product Information: Tramadol KRKA oral drops tramadol hydrochloride oral drops. KRKA DD Novo Mesto (per AEMPS; Spain) Smarjeska basket 6 8501 Novo mesto Slovenia 2019."},{"key":"e_1_3_3_11_2","volume-title":"ULTRAM(R) Oral Tablets, Tramadol HCl Oral Tablets","author":"Product Information:","year":"2019","unstructured":"Product Information:. ULTRAM(R) Oral Tablets, Tramadol HCl Oral Tablets. Titusville, NJ: Janssen Pharmaceuticals Inc., (per FDA), 2019."},{"key":"e_1_3_3_12_2","unstructured":"Emergency Use Authorization: https:\/\/www.fda.gov\/emergency-preparedness-and-response\/mcm-legal-regulatory-and-policy-framework\/emergency-use-authorization. (Last accessed March 20 2021)."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200443130-00004"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002100000266"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001683"},{"key":"e_1_3_3_16_2","unstructured":"Tramadol Pharmacokinetics: www.pharmgkb.org\/pathway\/PA165946349. (Last accessed March 25 2021)."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.clpt.6100152"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12815"},{"key":"e_1_3_3_19_2","unstructured":"Fact sheet for healthcare providers emergency use authorization (EUA) of Veklury (remdesivir) for hospitalized pediatric patients weighing 3.5\u2009kg to less than 40\u2009kg or hospitalized pediatric patients less than 12 years of age weighing at least 3.5\u2009kg: https:\/\/www.fda.gov\/media\/137566\/download. (Last accessed May 3 2021)."},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jpm.2021.0123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2021.0123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2021.0123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:12:08Z","timestamp":1777655528000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jpm.2021.0123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,20]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1089\/jpm.2021.0123"],"URL":"https:\/\/doi.org\/10.1089\/jpm.2021.0123","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,20]]}}}