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Popular pain medicines associated with a higher risk of hypoglycemia



  Opioids
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Following its approval in 1995, opioid tramadol (marketed as ConZip and Ultram) has become a widely prescribed medicine for osteoarthritis and other painful indications, in part because it has less risk of some side effects and has less potential for abuse compared to other opioids. He is currently ranked among the top five prescribed opioids and the top 60 prescribed drugs in the country.

But as tramadol has grown in popularity, adverse events among its users have also been documented. A new document published on August 28, 201

9 by Scientific Reports by researchers at the Skaggs School of Pharmacy and Pharmacy at the University of California, San Diego indicates that patients taking tramadol are at greater risk risk of developing hypoglycaemia or abnormally low blood sugar.

The research team, led by senior author PhD Ruben Abagyan, analyzes more than 12 million reports from the FDA Adverse Event Reporting System (AERS) and the Chronicle Adverse Event Reporting System (AERS) voluntary reports of side effects while taking the medicine. The study period varies from January 2004 to March 2019.

"The impulse was the recent dramatic jump in the popularity and recipes of tramadol," says first author Tigran Macuns, PharmD, a researcher at the Abagyan Lab. "We wanted to have an objective look at its adverse effects and we came across dangerous, unwritten and unexpected hypoglycaemia.

The recognized side effects associated with tramadol include dizziness, nausea, headache and constipation – all common side effects of opioids. The most serious but rare side effects include serotonin syndrome and an increased risk of seizures The association with hypoglycaemia is relatively new, although it has previously been suggested by case studies and animal model testing.

Emissions are often associated with the treatment of diabetes, but can also occur in people without diabetes.Un treated hypoglycemia can lead to serious serious complications such as neurocognitive dysfunction, loss of vision, increased risk of falls and loss of quality of life.

Researchers have also looked at other widely prescribed opioids and similar active, non-opioid drugs, such as serotonin and norepinephrine reuptake inhibitors (Cymbalta, Effexor XR) and NMDA receptors (ketamine and memantine). Tramadol alone poses a significant risk of hypoglycaemia in patients. In fact, there was a 10-fold greater risk of hypoglycaemia using tramadol than virtually any other opioid. The only other drug identified with a comparable effect is methadone, an opioid that is most commonly used to help people reduce or quit addiction to heroin or other opiates.

While this study highlights the link between tramadol and hypoglycaemia, a large, randomized, controlled clinic

"The withdrawal message is to alert doctors to the likelihood of low blood sugar (and / or high insulin content), especially if the patient is prone to diabetes, "says Abagyan," and to motivate research into the unique molecular mechanism leading to this side effect. It is especially important for tramadol or methadone, which is widely and often used chronic. "


Tramadol associated with increased risk of hospitalization for hypoglycaemia


More information:
Scientific reports (2019). www.nature.com/articles/s41598-019-48955-y

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University of California – San Diego

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Popular pain medicines associated with a higher risk of hypoglycemia (2019, August 28)
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