Does grapefruit juice interfere with effectiveness of tramadol?

Tramadol ALONE is NOT potentiated by grapefruit juice. Actually, quite the opposite is true. Since Tramadol is not technically an opiod and it works differently than other opiates, the way the liver processes it (and the result) is very different. Tramadol is broken down into O-desmethyltramadol by the cytochrome P450 isozyme CYP2B6, CYP2D6 and CYP3A4. O-desmethyltramadol is actually MORE POTENT than tramadol as far as Mu opiod activity, and thus, you WANT the liver to be converting Tramadol into O-desmethyltramadol. So grapefruit juice actually inhibits tramadol's effectiveness.