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As a result of the metabolism of Ultram in the liver, by CYP 2D6 and CYP 3A4, there are potential drug interactions. Drug interactions are possible with the concomitant administration of Ultram with medications that are CYP 2D6 and CYP 3A4 inhibitors, such as ketoconazole, erythromycin, quinidine, fluoxetine, paroxetine and amitriptyline.
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