The opioid tramadol drug can cause blood sugar levels to drop to life-threatening levels, research suggests.
Scientists analyzed 12 million adverse event reports collected by the US Food and Drug Administration (FDA) for 15 years.
The painkiller, marketed as ConZip or Ultram, was found to have a significant risk of hypoglycaemia, which could lead to confusion, seizures, or even death.
This can be especially dangerous for diabetics, warned the scientists from the University of California, San Diego.
These patients are already at risk of hypoglycaemia because of the blood sugar lowering medication they are taking.
The legal opioid tramadol can cause blood sugar levels to fall to life-threatening levels (stock)
Since the approval of tramadol in the US in 1995, it has often been prescribed to other opioids because of the assumed superior safety and lower risk of addiction.
Compared with almost every other opioid, tramadol has a 10 times higher risk of hypoglycaemia, the study found.
Other studies have linked tramadol to low blood sugar levels, but official health authorities do not mention it as a recognized side effect.
The NHS provides a list of very common side effects of tramadol that affects more than one in 10, such as nausea and dizziness.
Common side effects that affect around one in 100 people are headache, vomiting, and dry mouth.
Serious side effects are even rarer but include superficial breathing, hallucinations, and epileptic seizures, officials say.
RxList, the online source of American medicines, also does not mention hypoglycaemia as a side effect of tramadol.
To find out more about the risks, the researchers analyzed voluntary reports of adverse drug reactions that patients sent to the FDA between January 2004 and March 2019.
& # 39; The impetus was the recent dramatic increase in the popularity and prescription of tramadol & # 39 ;, said study author Dr. Tigran Makunts.
& # 39; We wanted an objective, data-driven view of its adverse effects and encountered dangerous, unlisted, and unexpected hypoglycaemia. & # 39;
HOW AMERICA GOT ON OPIOID DRUGS
Prescription opioids and illicit drugs have become incredibly profound throughout the US and things are only getting worse.
In the early 2000s, the FDA and CDC began to notice a steady increase in cases of opioid addiction and overdose. In 2013 they issued guidelines to curb addiction.
However, the same year – now considered the year in which the epidemic occurred – a CDC report revealed an unprecedented increase in opioid addiction.
Deaths from overdoses are now the leading cause of death among young Americans – more deaths in a year than ever killed by HIV, violence by guns, or car accidents.
Provisional CDC data, published by the New York Times, Show that the number of deaths from overdoses in the US rose 19 percent to at least 59,000 in 2016.
This has risen from 52,404 in 2015 and doubles the mortality rate from ten years ago.
It means that for the first time an overdose of drugs is the leading cause of death for Americans younger than 50 years old.
The data uncover the bleak state of America & # 39; s opioid addiction crisis fueled by deadly manufactured drugs such as fentanyl.
The team also looked at other prescribed opioids, similarly acting non-opioid drugs – such as serotonin – and NMDA receptors – such as ketamine.
Only tramadol appeared to have a significant risk of hypoglycaemia. The opioid methadone was found to cause the side effect, but to a lesser extent.
Methadone is often prescribed to help people overcome heroin addiction.
Although the study found a link between tramadol and hypoglycaemia, the researchers emphasize that a larger trial is needed to make a link.
& # 39; The pickup message is to alert doctors to the likelihood of low blood sugar, especially if the patient is prone to diabetes, & # 39; said lead author Dr. Ruben Abagyan.
& # 39; And to motivate research into the unique molecular mechanism that leads to that side effect.
& # 39; It is especially important for tramadol or methadone that are used frequently and often chronically. & # 39;
Opioids are a class of drugs that contain illegal heroin, synthetic opioids such as fentanyl and pain killers that are legally available on prescription, according to the National Institute on Drug Abuse (NIDA).
Patients may be prescribed legal opioids if they suffer from chronic headache, postoperative pain or discomfort caused by cancer, reports the American Society of Anesthesiologists.
All of these drugs interact with opioid receptors on nerve cells. This blocks pain messages from being sent through the spinal cord to the brain.
Opioids are generally safe when taken in the short term and prescribed by a doctor. However, they can be addictive because of the euphoric feeling they cause.
Overdose can cause a person's breathing and heart rate to become dangerously slow.
More than two million Americans abuse opioids and more than 130 die every day from a related overdose, according to statistics from NIDA.
In 2017, the US Department of Health and Human Services declared the opioid crisis to be an emergency in public health.
Regarding legal, available opioids, the UK has less than the US or Germany, but has one of the fastest rates of growth over the three years to 2016, the BBC reported.
Some are concerned that the UK is on the brink of an opioid crisis, with drug use and abuse on the rise, especially in disadvantaged parts of northern England.
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