In a new study, researchers found popular pain drug opioid tramadol (marketed as ConZip and Ultram) may increase the risk of developing hypoglycemia, or abnormally low blood sugar.
They found patients who take tramadol are at greater risk for developing the disease.
The research was conducted by a team from the University of California San Diego.
Since its approval in 1995, the opioid tramadol has become a widely prescribed remedy for osteoarthritis and other pain indications.
It presents a lesser risk for some side effects and has a lower abuse potential when compared to other opioids.
The drug is currently ranked among the top five prescribed opioids and top 60 prescribed medications in the country.
But as tramadol has grown in popularity, there have been cases of adverse effects among its users.
Recognized adverse drug reactions linked to tramadol include dizziness, nausea, headaches, and constipation—all common side effects of opioids.
More serious but rarer adverse drug reactions include serotonin syndrome and increased seizure risk.
The link to hypoglycemia is relatively new, though it had been previously suggested by case studies and animal model testing.
Hypoglycemia is often related to the treatment of diabetes, but can also occur in persons without diabetes.
Untreated, hypoglycemia can lead to serious complications of its own, such as neurocognitive dysfunction, vision loss, greater risk of falls and loss of quality of life.
In the new study, the research team analyzed more than 12 million reports from the FDA Adverse Effect Reporting System (FAERS) and Adverse Event Reporting System (AERS) databases, which chronicle voluntary reports of adverse effects while taking a medication.
They also looked at other widely prescribed opioids and similar acting, non-opioid medications, such as serotonin and norepinephrine reuptake inhibitors (Cymbalta, Effexor XR) and NMDA receptors (ketamine and memantine).
The researchers found that only drug tramadol produced a big risk of developing hypoglycemia in patients.
In fact, there was a 10-fold greater risk of hypoglycemia using tramadol than virtually every other opioid.
The only other drug identified with comparable effect was methadone, an opioid most commonly used to help persons reduce or quit addictions to heroin or other opiates.
The team says doctors need to pay attention to the likelihood of low blood sugar (and/or high insulin content), in particular, if the patient is predisposed to diabetes.
Future work would be needed to directly examine if opioid medicine could cause low blood sugar.
One author of the study is senior author Ruben Abagyan, Ph.D., professor of pharmacy.
The study is published in Scientific Reports.
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