Skip to main content
Psychedex
Facts label

O-Desmethyltramadol Facts

Opioid; Depressant; Substituted phenethylamine; Mu-opioid receptor agonist

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 5 mgLight10 – 25 mgCommon25 – 50 mgStrong50 – 100 mgHeavy100+ mg

Starts in 20 – 40 minLasts 6 – 10 hoursAfter-effects 1 – 3 hours

Also recorded: Sublingual · Intravenous. See full page: psychedex.org/substances/o-desmethyltramadol

Body and dependence

Acute toxicity
High
Chronic toxicity
High
Physical dependence
Moderate
Psychological dependence
Moderate
Withdrawal
Moderate · medical supervision
Compulsive redosing
Moderate

Tolerance

Builds
Moderate
Fully resets after
10.5 days
Carries over to
morphine; oxycodone; fentanyl; heroin; tramadol; codeine; hydrocodone; methadone; buprenorphine

Effectslikely at a common dose

Perception
none likely · 1 possible
Body
Pain suppression; Sedation; Pupil constriction; Constipation; Body high; +15 possible, including Nausea, Dizziness, Motor control impairment
Thinking
none likely · 6 possible, including Cognitive impairment, Compulsive redosing urge, Confusion
Feeling
none likely · 3 possible
Self
none likely · 1 possible, including Craving

Who shouldn't take it

Absolute
Severe respiratory insufficiency; Concurrent MAOI use; Acute CNS depressant intoxication; Paralytic ileus
Relative
Head injury with raised intracranial pressure; Seizure disorders; Concurrent serotonergic medications; Renal impairment; CYP2D6 ultrarapid metabolizer status; Pregnancy; Pediatric patients; Elderly patients

Combinations62 recorded

Lethal (7)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Ketamine; Local anesthetics; MAOIs; Tramadol
Dangerous (39)
Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antihistamines; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Clonidine, Guanfacine; Gabapentin, Pregabalin; MDMA, Amphetamines; MDMA, MDA; Naloxone, Naltrexone; Naltrexone; NRIs; SNRIs; Stimulants; THC; 5-HTP, Tryptophan; Antipsychotics; Atypical antipsychotics; Buspirone; Caffeine; CBD; Dopamine agonists; and 15 more, see full page
Caution (12)
See full page: psychedex.org/substances/o-desmethyltramadol
Not graded (4)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

psychedex.org/substances/o-desmethyltramadol · Version r1 · Not medical adviceValues as of
On the printout