Safer opioid Tramadol linked to increased risk of low blood sugar

Aug. 28 (UPI) -- Tramadol grew to popularity as a less addictive pain relief alternative to stronger opioids with higher risk for addiction. But those benefits may come with the potential for health risks, a new study says.

People who use Tramadol, which is commercially marketed as ConZip and Ultram, have 10 times the risk of developing hypoglycemia, a condition marked by a sharp drop in blood sugar, according to research published Wednesday in the journal Scientific Reports.

While hypoglycemia is common among people receiving treatment for diabetes, others can develop the condition as well. If it progresses long enough, hypoglycemia can also lead to lower brain function, a greater risk of falling and blindness.

"The impetus was the recent dramatic surge in tramadol popularity and prescriptions," Tigran Makunts, a researcher at University of California at San Diego and study first author, said in a news release. "We wanted to have an objective data-driven look at its adverse effects and bumped into a dangerous, unlisted and unexpected hypoglycemia."

For the study, the researchers examined more than 12 million reports of bad drug outcomes from two Food and Drug Administration databases: the Adverse Event Reporting System and Adverse Effect Reporting System. They focused on reports between January 2004 to March 2019.

When compared to other common opioids and opioid-alternatives like serotonin, norepinephrine reuptake inhibitors and NMDA receptors, tramadol was the only drug with a significant risk of hypoglycemia. And methadone was the only other drug that approached the same risk of a drastic blood sugar drop.

Tramadol carries other side effects common to other opioids such as constipation, dizziness, headaches and nausea. Although rare, the drug raises seizure risk and serotonin syndrome, which causes diarrhea, agitation and high body temperature.

The drug has been considered a safer opioid because it is thought to carry less risk for addiction than opioids like Vicodin and Percocet. But at least one study shown that tramadol may have a higher risk for prolonged use than other opioid drugs.

"The takeaway message is to warn physicians about the likelihood of low blood sugar (and/or high insulin content), in particular if the patient is predisposed to diabetes, and to motivate research about the unique molecular mechanism leading to that side effect." said Ruben Abagyan, a researcher at University of California at San Diego and study senior author. "It is particularly important for tramadol or methadone that are used widely and, often, chronically."