Tramadol: a serious risk of hypoglycemia

Prescribed as a painkiller, this opioid analgesic would significantly increase the risk of hypoglycemia, a new study reveals.

With 12 million boxes sold each year, Tramadol is the most popular painkiller in France. However, taking this analgesic derivative of opium, prescribed to relieve moderate to severe pain, must be taken precautions. In cause: the occurrence of some undesirable side effects. While some, such as nausea, vertigo or tremors, and in rare cases hallucinations or mental confusion, were already known and documented, it appears that the painkiller also significantly increases the risk of hypoglycaemia.

This is highlighted by a new study by researchers at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego. Published August 28 in Scientific Reports, these new studies show that patients taking Tramadol have an increased risk of hypoglycaemia or an abnormally low blood glucose level.

A risk for people with diabetes

To measure the known adverse effects associated with Tramadol, researchers analyzed from 2004 to 2019 more than 12 million reports from the Food and Drug Administration's Adverse Effect Reporting System (FAERS) and Adverse Event Reporting System (AERS) databases. (FDA), which chronicle voluntary reports of adverse reactions while taking the drug.

"We wanted to have an objective look at its side effects and we came across a dangerous hypoglycemia, unregistered and unexpected," says Tigran Makunts, PharmD, a researcher from Abagyan's laboratory and lead author of the study.

The researchers found that the risk of hypoglycemia was often related to the treatment of diabetes, but could also affect people without diabetes. If left untreated, hypoglycemia can itself lead to serious complications such as neurocognitive dysfunction, loss of vision, increased risk of falls, and loss of quality of life.

A risk 10 times higher than other opioids

Comparing Tramadol to other opioids and pain medications, the researchers found that it was the only one that produced a significant risk of hypoglycaemia: a risk up to 10 times higher than almost all the opioids tested. The only other painkiller identified as having an effect comparable to Tramadol is methadone, an opioid commonly used to help people reduce or stop their dependence on heroin or other opiates.

The authors of the study, however, point out that the existence of an association between Tramadol and hypoglycemia is the result of a correlation study. They therefore recall that a large randomized controlled clinical trial would be necessary to definitively establish causality.

"The message to remember is to warn doctors of the likelihood of hypoglycemia (and / or high insulin levels), especially if the patient is at risk for diabetes, and to motivate research into the mechanism. single molecule that leads to this side effect, "concludes the Abagyan laboratory, which conducted the research." This is particularly important for Tramadol or methadone that are widely and often used chronically. "

Video: Treating Low Blood Sugar. Hypoglycemia. Nucleus Health (April 2020).