UCSD researchers find connection between popular opioid and low blood sugar

SAN DIEGO — A new study from UC San Diego researchers identified a potential relationship between the opioid tramadol and low blood sugar levels.

Tramadol, branded as ConZip and Ultram, is often prescribed for painful conditions like osteoarthritis because its potential for abuse is not as high as other opioid pain medications like oxycodone. However, as its popularity has grown as a pain reliever, self-reported instances of hypoglycemia have also increased in patients taking the drug.

The UCSD research team identified the correlation by studying more than 12 million voluntary side-effect reports, ranging from January 2004 to March 2019, in the U.S. Food and Drug Administration’s Adverse Effect Report System and Adverse Event Reporting System databases.

“The impetus was the recent dramatic surge in tramadol popularity and prescriptions,” said Dr. Tigran Makunts, the study’s first author. “We wanted to have an objective data-driven look at its adverse effects and bumped into a dangerous, unlisted and unexpected hypoglycemia.”

The study, published Wednesday in the journal Scientific Reports, included analysis of other common opioids and non-opioid pain medications like serotonin and norepinephrine reuptake inhibitors. The only opioid with a similar correlation of hypoglycemia development was methadone, which is often used to treat addictions to other opiates like heroin.

The researchers stressed that the study did not establish a causal link between tramadol and hypoglycemia, or a link between methadone and hypoglycemia. A large clinical study would be necessary to confirm either link, the research team said.

“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 UCSD pharmacy professor Ruben Abagyan, the study’s senior author.

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