Tramadol link to increased hypoglycaemia

As use of the analgesic increases worldwide, Canadian researchers drew on a UK database to probe the relationship between tramadol and hypoglycaemia which had previously been flagged in a pharmacovigilance study.

In their nested case control study of more than 330,000 patients newly treated between 1998 and 2012 with either tramadol or codeine for non-cancer pain, the researchers found a 52% increased risk of hypoglycaemia among those taking tramadol.

Of the 1105 patients hospitalised for hypoglycaemia during the follow up, around 10% died.

In secondary analyses, the researchers found the risk of hospitalisation for dangerously low blood sugar was two to three times higher than for codeine, with particularly pronounced effects in the first 30 days of treatment.

“The rarity of this outcome [hospitalisation], approximately 7 per 10,000 per year, may explain why it was not observed in randomised clinical trials, which were