In older patients, That is essential to know as polypharmacy is common and will potentiate the chance of DDIs and ADRs. Consequently, concurrent consumption of CYP2D6 inhibitors or inducers could potentiate or block tramadol conversion into ODT and this could enhance or decrease efficacy/ADRs on the prescribed tramadol. Literature https://hemalchem.com/product/o-dsmt/