Tapentadol is partly metabolized by the hepatic enzymes CYP2C9, CYP2C19, and CYP2D6 so it innately has interactions with medicines that improve or repress the action/expression of a number of of these enzymes, together with with substrates of these enzymes (as a result of competition with the enzyme); some enzyme mediators/substrates https://josephx676bmu8.birderswiki.com/user