Tramadol, an opioid widely prescribed for pain management, is not that effective and poses serious health risks, according to a new study.
Tramadol is commonly used to treat acute pain caused by an injury or surgery and chronic pain, including pain associated with cancer. The drug has been considered safer to prescribe than stronger opioids with a higher potential for abuse, according to research.
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It is the most commonly used opioid in the United States, according to a 2018 study that tracked opioid prescribing through insurance claims data from 1990 to 2009. Nearly 12 million daily doses of tramadol were taken during that period, according to the records.
But a new research review of 19 clinical trials involving more than 6,500 people found that the harms associated with tramadol use outweigh the limited benefits it offers for pain management. The study was published Sept. 26 in BMJ Evidence-Based Medicine.
Tramadol "may have a slight effect on reducing chronic pain levels," but it "likely" heightens the risk of "adverse cardiac events" including chest pain, coronary artery disease and congestive heart failure, the study found.
Tramadol also is associated with a higher risk of "neoplasm events," abnormal cell growth associated with prostate, breast and thyroid cancer, the researchers said.
Additionally, the study found tramadol increased the likelihood of developing less serious health issues, such as nausea, dizziness and constipation.
The pros and cons of tramadol use for pain management have been weighed by researchers in the past. A 2019 Mayo Clinic study found tramadol had a somewhat higher risk of being used for prolonged periods that other common opioids.
"Providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids," the researchers wrote.
But the new study was the "first systematic review related to the usage of tramadol for any type of chronic pain with a thorough investigation of adverse events," the researchers wrote.
Providers should consider alternatives to tramadol for treating pain, the researchers concluded.