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Nortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.ortriptyline is an active metabolite of Amitriptyline. Therapeutic drug levels are monitored to assist the physician assessing therapeutic response and to avoid toxicity.
Tramadol is metabolized to an active desmethyl derivative (o-desmethyltramadol) and several inactive compounds ( Fig. 1). o-Desmethyltramadol shows higher affinity for the Î¼-opioid receptors and has twice the analgesic potency of the parent drug.