Absorption and metabolism

Taken orally the onset of action begins after 30 to 60 min, peaks at between 90 and 120 min with significant effects persisting for a further 3 to 6 h followed by a gradual 'come down' over the subsequent 6 to 12 h. The drug is primarily metabolized by demethylation by the hepatic cytochrome P-450 enzyme, debrisoquine hydroxylase coded for by CYP 2D6.(3) Two phenotypes predominate in the population with 9 per cent being 'poor metabolizers'. The consequence of metabolizer status on patterns of use and toxicity is as yet unknown. The drug may also be taken intranasally (snorted), rectally, and (rarely) intravenously.

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