Cookie policy notice

By continuing to use this site you agree to our cookies policy below:
Since 26 May 2011, the law now states that cookies on websites can ony be used with your specific consent. Cookies allow us to ensure that you enjoy the best browsing experience.

This site is intended for health professionals only

At the heart of general practice since 1960

Tramadol 'doubles risk of serious hypoglycaemia'

  • Print
  • Comment
  • Rate
  • Save

The study

A large study of around 330,000 patients between 1998 and 2012 that used case-control analysis aimed to assess the risk of hospitalisation due to hypoglycaemia in patients taking tramadol compared with patients taking codeine for non-cancer pain.

Data from the hospital episodes statistics database was used, which documents details of all hospital admissions.

The findings

1 The risk of hospitalisation due to hypoglycaemia in patients given tramadol was more than twice that of patients given codeine.

2 The highest risk was when the drug was started.

3 This was the case in patients who were receiving anti-diabetic drugs and those who were not (more than 40% of cases).

4 Several confounding factors were considered. One of the most important of these was that drug adherence levels were not known.

5 It is thought that the physiological reasons for this are related to the effects of tramadol on opioid receptions and serotonin-noradrenaline reuptake.

What does it mean for GPs?

When deciding between tramadol and codeine for pain relief, GPs should consider the risk of severe hypoglycaemia with tramadol.

In patients who may have suffered from hypoglycaemia of an unknown, GPs should consider tramadol as a potential cause.

The paper

JAMA Dec 2014

Dr Hamed Khan is a GP in the emergency department of St George’s, London, and a clinical lecturer. He tweets as @drhamedkhan.

Rate this blog  (4.5 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say

  • Print
  • Comment
  • Rate
  • Save