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These observations are consistent with a previous lower back pain study where comparable efficacy for flupirtine and tramadol was observed but the incidence of adverse effects related to raised LFTs and number of discontinuation post treatment were significantly higher in the tramadol group (1% with flupirtine vs 15% with tramadol
doi: 10.1016/S2468-1253(23)00198-X

I lost my faith in urgent care and all of humanity in about a 4 minute span in that lobby

New York, NY: McGraw-Hill (2000)
