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Good pain management practice dictates that the dose be individualized according to patient need using the lowest beneficial dose. Selective norepinephrine reuptake inhibitors: The primary metabolite mono -O-desmethyltramadol M1 has antinociceptive activity. You can only add a maximum of 25 drugs to MyRx. Please speak with your doctor. The results of the multiple-dose short-term trials in acute pain also provide evidence for efficacy of tramadol in the management of acute pain.

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