Research at the Lady Davis InstituteSpring 2015

Link found between pain reliever
and hypoglycemia

Tramadol, a weak opioid for treating moderate to moderately severe pain, can be linked in some cases to an increased risk of hospitalization for hypoglycemia, concludes a study by a team of epidemiologists in the Lady Davis Institute (LDI) at the JGH.

The research, published in the American Medical Association’s JAMA Internal Medicine, compared codeine to tramadol and found that tramadol was connected with an increased risk of hypoglycemia (a potentially fatal condition caused by low blood sugar) that was severe enough to send patients to the hospital. This was especially the case during the first 30 days that the pain reliever was used.

The research was conducted by a team led by Dr. Samy Suissa, Director of the LDI’s Centre for Clinical Epidemiology, and LDI epidemiologist Dr. Laurent Azoulay. They were responding to previous concerns about tramadol (full name: tramadol hydrochloride), which is increasingly prescribed for pain relief around the world.

Using information from the United Kingdom, the authors analyzed a database of all patients who had been newly treated with tramadol or codeine for non-cancer related pain between 1998 and 2012. The study used information about 334,034 patients—28,100 new users of tramadol and 305,924 new users of codeine. Of these, 1,105 were hospitalized for hypoglycemia during an average follow-up of five years (112 of the cases were fatal).

“Although rare, tramadol-induced hypoglycemia is a potentially fatal adverse event,” the study concludes. “The clinical significance of these novel findings requires additional investigation.”

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