Is Ultracet affected by genetics?
Partially. 1 of 2 ingredients has pharmacogenetic evidence.
Ultracet contains 2 active ingredients, and 1 of them has published pharmacogenetic guidelines. The relevant gene is CYP2D6. Your genotype can change how that ingredient behaves in your body, while the other ingredients aren't affected by genetics in any clinically established way. The strongest evidence level on this page is Strong, from the published guidelines shown below.
Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Ultracet, it's worth talking over with your prescriber or pharmacist. How we handle combination products.
What's in Ultracet
Tramadol Affected by CYP2D6
Affected by CYP2D6. Guidance from CPIC, FDA, strong evidence.
Read the full tramadol genetics guideAcetaminophen No known pharmacogenetics
No strong published pharmacogenetic guideline currently applies to acetaminophen.
Tramadol phenotype recommendations
Published guidance from CPIC and FDA on how tramadol should be dosed or substituted based on your CYP2D6 phenotype.
| Phenotype | What it means | Recommendation | Evidence |
|---|---|---|---|
| Ultrarapid MetabolizerCYP2D6 | Your body turns this drug into its active form too fast, which raises the risk of serious side effects. A different pain medicine is advised. | CPIC Avoid tramadol use because of potential for toxicity. If opioid use is warranted, consider a non-codeine opioid. FDA Avoid use. Use an alternative analgesic that is not metabolized by CYP2D6. Contraindicated in children under 12 and adolescents following tonsillectomy/adenoidectomy. Breastfeeding is not recommended. |
Strong |
| Normal MetabolizerCYP2D6 | Your body processes this drug normally, so the usual dose should work. | CPIC Use tramadol label recommended age- or weight-specific dosing. FDA Initiate therapy with recommended starting dose. |
Strong |
| Intermediate MetabolizerCYP2D6 | Your body processes tramadol somewhat slowly, but you can usually use standard doses. If it doesn't work well, you might need a different pain medication. | CPIC Use tramadol label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider non-codeine opioid. FDA Initiate therapy with recommended starting dose. |
Optional |
| Poor MetabolizerCYP2D6 | Your body can't turn this drug into its active form well, so it may not relieve your pain. A different pain medicine is advised. | CPIC Avoid tramadol use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-codeine opioid. FDA The FDA notes reduced efficacy but gives no dosing change. Monitor for adequate pain relief. |
Strong |
| IndeterminateCYP2D6 | The impact of your genotype on response to this drug is unknown. | CPIC + FDA Initiate therapy with recommended starting dose. |
Not rated |
| Not availableCYP2D6 | The impact of your genotype on response to this drug is unknown. | CPIC + FDA Initiate therapy with recommended starting dose. |
Not rated |
The gene behind the guidance
CYP2D6 Cytochrome P450 2D6
CYP2D6 is the most clinically important pharmacogene. It metabolizes around a quarter of all prescription drugs, including many antidepressants, opioids, and stimulants. The gene is unusually variable: roughly 7 percent of people are poor metabolizers (they barely activate CYP2D6), and another 1 to 3 percent are ultrarapid metabolizers (their enzyme is overactive).
The v4 report preserves the activity score used in its interpretation. Some medicines use a combined CYP2D6/CYP2C19 recommendation. CYP2D6 inhibitors can change functional metabolism; a genotype alone does not capture that effect.
See all drugs affected by CYP2D6Browse the full drug class: Pain medications.
Related medications
Find out how your genetics affect Ultracet
Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.