Must-read: another adverse effect associated with tramadol

4 out of 5 stars Tramadol and Hypoglycemia: One More Thing to Worry About. Nelson LS, Juurlink DN. JAMA Intern Med 2015 Feb 1;175(2):194-5 Reference Hypoglycemia associated with use of tramadol has been noted previously in scattered case reports, after both overdose and therapeutic ingestion, involving patients with and without diabetes. In this month’s issue of JAMA Internal Medicine, Fournier et al. presented a large case-control study comparing patients started on tramadol for pain with similar patients started on codeine. They found that the tramadol patients had a significantly increased risk of hospitalization for hypoglycemia, especially in the first month after the drug was started. True, the hypoglycemia cases were rare, with an incidence of 7 per 10,000 per year. However, as Lewis Nelson (@LNelsonMD) and David Juurlink (@DavidJuurlink) point out in this superb editorial accompanying the article, there are a number of other significant adverse effects associated with this problematic drug. The editorial is a must-read short summary of tramadol pharmacology and toxicology. They start by noting: ” . . . the expectation that analgesics can significantly reduce or abolish pain is often overly optimistic and can lead to the progressive use of higher doses of stronger analgesics without a reasonable benchmark for success or failure. . . . Nonpharmacologic approaches such as physical therapy, meditation, exercise, and weight loss are harder to implement than...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical adverse effect hypoglycemia tramadol ultram Source Type: news