Tramadol Linked to Increased Risk of Hypoglycemic Event

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Opioid analgesic tramadol may increase the risk of having a hypoglycemic episode, which could be fatal, according to a study published in JAMA Internal Medicine.

The risk of the adverse event is especially high in the first 30 days of use of the pain therapy, Jean Pascal Fournier, MD, PhD, of Jewish General Hospital and McGill University in Montreal, and colleagues reported.

The researchers conducted a nested case-control analysis in the U.K. of the Clinical Practice Research Datalink and Hospital Episodes Statistics database of 334,043 patients newly treated with the weak painkiller tramadol or codeine for noncancer pain between 1998 and 2012. 1,105 patients were hospitalized for hypoglycemia during follow-up.

Cases of hospitalization for hypoglycemia were matched with up to 10 controls based on age, sex and duration of follow-up. Odds ratios and 95% confidence intervals were estimated by comparing use of tramadol with codeine. The researchers performed a cohort analysis that compared tramadol with codeine in the first 30 days after treatment initiation. They also performed a case-crossover analysis that compared tramadol exposure in a 30-day risk period immediately before hospitalization for hypoglycemia to 11 consecutive 30-day control periods.

Use of tramadol was linked to a higher risk of hospitalization for hypoglycemia (OR, 1.52 [95% CI, 1.09-2.10]), especially in the first 30 days of treatment, compared to codeine. The association was confirmed in the cohort and case-crossover analyses.

The researchers recommend that more studies be conducted to confirm the relationship between tramadol and hypoglycemia, which can be a fatal event. 

Diabetes
Tramadol Linked to Increased Risk of Hypoglycemic Event

Tramadol is a weak opioid analgesic whose use has increased rapidly, and it has been associated with adverse events of hypoglycemia.

Jean Pascal Fournier, MD, PhD, of Jewish General Hospital and McGill University in Montreal, and colleagues assessed whether tramadol use, when compared with codeine use, is associated with an increased risk of hospitalization for hypoglycemia.

A nested case-control analysis was conducted within the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episodes Statistics database of all patients newly treated with tramadol or codeine for noncancer pain between 1998 and 2012. Cohort and case-crossover analyses were also conducted to assess consistency of the results.

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