Prescribed as a painkiller, this opioid analgesic would significantly increase the risk of hypoglycemia, reveals a new study.
With 12 million boxes sold each year, Tramadol is the best-selling painkiller in France. However, taking this opium-derived analgesic, prescribed to relieve moderate to severe pain, must take precautions. The cause: the occurrence of certain undesirable side effects. If some, such as nausea, dizziness or tremors, and in rarer cases hallucinations or mental confusion, were already known and documented, it would seem that painkillers also significantly increase the risk of hypoglycemia.
This is highlighted by a new study conducted by researchers from the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego. Published August 28 in Scientific Reportsthis new work shows that patients taking Tramadol have an increased risk of hypoglycaemia or an abnormally low blood sugar 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 FAERS (Adverse Effect Reporting System) and AERS (Adverse Event Reporting System) databases. (FDA), which chronicle voluntary reports of adverse effects while taking the drug.
“We wanted to have an objective look at its adverse effects and we came across a dangerous, unlisted and unexpected hypoglycemia”, explains Tigran Makunts, PharmD, researcher from Abagyan’s laboratory and lead author of the study.
The researchers found that the risk of hypoglycaemia was often linked 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 greater than other opioids
When comparing Tramadol to other opioids and painkillers, the researchers noticed that it was the only one to produce a significant risk of hypoglycemia: a risk up to 10 times higher than almost all the opioids analyzed. The only other painkiller identified as having an effect comparable to Tramadol was methadone, an opioid commonly used to help people reduce or quit addiction to heroin or other opiates.
The authors of the study point out, however, that the existence of an association between Tramadol and hypoglycemia is the result of a correlation study. They therefore recall that a large controlled and randomized clinical trial would be necessary to definitively establish causality.
“The take-home message is to alert physicians to the likelihood of hypoglycemia (and/or elevated insulin), particularly if the patient is predisposed to diabetes, and to motivate research into the mechanism unique molecule that leads to this side effect”, concludes the Abagyan laboratory, which conducted the research. “This is particularly important for Tramadol or methadone which are widely and often used chronically.”
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