7-OH-mitragynine
kratom metabolite
What it isThe CYP3A4 oxidation metabolite of mitragynine and the principal mu-opioid full agonist in kratom, with roughly 5x the mu-receptor affinity of the parent alkaloid.
Why it mattersIt drives most of kratom's analgesic, euphoric, and dependence-producing opioid effect, and concentrated synthetic 7-OH products have prompted FDA warnings and a 2026 DEA move to place it in Schedule I.
What it changesBecause it is generated by CYP3A4, strong 3A4 inhibitors or inducers shift its exposure, and its mu agonism carries real respiratory-depression and dependence risk, compounded by other opioids or sedatives.
NO BOXED WARNINGS