The effect of tramadol on blood glucose concentrations: a systematic review

Nakhaee, Samaneh; Brent, Jeffrey; Hoyte, Christopher; Farrokhfall, Khadijeh; Shirazi, Farshad; Askari, Masomeh; Mehrpour, Omid

doi:10.1080/17512433.2020.1756773

Cited by 14 publications

(11 citation statements)

References 58 publications

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“…A recent systematic review revealed that hypoglycemia is more likely to occur after tramadol use with both therapeutic use and in overdose. Importantly, all studies on tramadol use in diabetes reported hypoglycemia [104].…”

Section: Endocrine Systemmentioning

confidence: 99%

A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment

et al. 2021

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Aims As an analgesic that acts upon the central nervous system (CNS), tramadol has gained popularity in treating moderate to severe pain. Recently, it has been increasingly reported as a drug of misuse with intentional overdoses or intoxications. This review focuses on tramadol intoxication in humans and its effects on different systems. Subject and method This narrative review provides a comprehensive view of the pharmacokinetics, mechanism of action, and incidence of tramadol toxicity with an in-depth look at its side effects. In addition, the main approaches to the management of tramadol poisoning are described. Results Tramadol poisoning can affect multiple organ systems: gastrointestinal, central nervous system (seizure, CNS depression, low-grade coma, anxiety, and over time anoxic brain damage), cardiovascular system (palpitation, mild hypertension to life-threatening complications such as cardiopulmonary arrest), respiratory system, renal system (renal failure with higher doses of tramadol intoxication), musculoskeletal system (rhabdomyolysis), endocrine system (hypoglycemia), as well as, cause serotonin syndrome. Seizure, a serious nervous disturbance, is more common in tramadol intoxication than with other opioids. Fatal tramadol intoxications are uncommon, except in ingestion cases concurrent with other medications, particularly CNS depressants, most commonly benzodiazepines, and ethanol. Conclusion With the increasing popularity of tramadol, physicians must be aware of its adverse effects, substantial abuse potential, and drug interactions, to weigh its risk–benefit ratio for pain management. Alternative therapies might be considered in patients with a previous overdose history to reduce risks for adverse outcomes.

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Section: Endocrine Systemmentioning

confidence: 99%

A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment

et al. 2021

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“…Tramadol is widely used throughout the world. This has led to an increase in the number of cases of poisoning, side effects and deaths [1]. Several cases of toxicity and abuse caused by this drug have been reported in the medical literature [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review disclosed that hypoglycemia is more likely to occur than hyperglycemia after tramadol administration with therapeutic use and overdose. Also, all studies on tramadol use in diabetes documented hypoglycemia [1].…”

Section: Introductionmentioning

confidence: 99%

Effects of naloxone and diazepam on blood glucose levels in tramadol overdose using generalized estimating equation (GEE) model; (an experimental study)

et al. 2021

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Background Tramadol is a synthetic opioid and poisoning is increasing around the world day by day. Various treatments are applied for tramadol poisoning. Due to the unknown effects of tramadol poisoning and some of its treatments on blood glucose levels, this study was conducted to investigate the overdose of tramadol and its common treatments (naloxone, diazepam), and their combination on blood glucose levels in male rats. Methods This study was conducted in 45 male Wistar rats. The animals were randomly divided into five groups of 9. They received a 75 mg/kg dose of tramadol alone with naloxone, diazepam, and a combination of both of these two drugs. On the last day, animals’ tail vein blood glucose levels (BGL) were measured using a glucometer at different times, including before the tramadol injection (baseline) and 1 hour, 3 hours, and 6 hours after wards. The rats were anesthetized and sacrificed 24 h after the last injection. Blood samples were then taken, and the serum obtained was used to verify the fasting glucose concentration. Data were analyzed using SPSS software at a significance level of 0.05 using a one-way analysis of variance (ANOVA) and a generalized estimating equation (GEE). Results According to the GEE model results, the diazepam-tramadol and naloxone-diazepam-tramadol groups showed blood glucose levels five units higher than the tramadol group (p < 0.05). The diazepam-tramadol group had significantly higher blood glucose levels than the naloxone-tramadol group (p < 0.05). The mean blood glucose levels before the intervention, 3 hours and 6 hours after the injection of tramadol did not differ between the groups, but the blood glucose levels 1 hour after the injection of tramadol in the group of naloxone-tramadol were significantly lower than in the control group (p < 0.05). Blood glucose levels did not differ between the groups 24 h after injection of tramadol. Conclusion The results of the present study showed tramadol overdose does not affect blood glucose levels. The diazepam-tramadol combination and the diazepam-naloxone-tramadol combination caused an increase in blood glucose levels.

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“…Tramadol is widely used throughout the world. This leads to an increase in the number of poisoning cases, side effects, and deaths [1]. Several cases of toxicity and abuse caused by this drug have been reported in the medical literature [2,3].…”

Section: Introductionmentioning

confidence: 99%

Effects of Naloxone and Diazepam on Blood Glucose Levels in Tramadol Overdose using Generalized Estimating Equation (GEE) Model; (An Experimental Study)

Nakhaee

Farrokhfall

Miri‐Moghaddam

et al. 2021

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Background:Tramadol poisoning is increasing around the world day by day. Tramadol is a synthetic opioid. Also, various treatments are applied for tramadol poisoning. Due to the unknown effects of tramadol poisoning and some of its treatments on blood glucose, this study was conducted to investigate the overdose of tramadol and its common treatments (naloxone, diazepam) and their combination on blood glucose in male rats. Methods: This study was conducted in 45 male Wistar rats. The animals were randomly divided into five groups of 9 rats. They received a 75 mg/kg dose of tramadol alone with naloxone, diazepam, and a combination of these two drugs. On the last day, animals' tail vein blood glucose levels (BGL) were measured using a glucometer at different times, including before the tramadol injection (baseline), one hour, three hours, and six hours after the tramadol injection. The rats were anesthetized and sacrificed 24 hours after the last injection. Blood samples were then taken, and the serum obtained was used to verify the fasting glucose concentration. Data were analyzed using SPSS software at a significance level of 0.05 using a one-way analysis of variance (ANOVA) and a generalized estimating equation (GEE).Results: According to the GEE model results, the diazepam and naloxone-diazepam groups showed blood glucose levels five units higher than the tramadol group (p <0.05). The diazepam group had significantly higher blood glucose levels than the naloxone group (p <0.05). The mean blood glucose levels before the intervention, three hours and six hours after the injection of tramadol did not differ between the groups, but the blood glucose levels one hour after the injection of tramadol in the group of naloxone were significantly lower than in the control group (p <0.05). Blood glucose levels did not differ between the groups 24 hours after injection of tramadol.Conclusion: The results of the present study showed that tramadol overdose does not affect blood glucose levels. Diazepam alone and in combination with naloxone caused an increase in blood glucose levels in the tramadol overdose.

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The effect of tramadol on blood glucose concentrations: a systematic review

Cited by 14 publications

References 58 publications

A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment

A review on tramadol toxicity: mechanism of action, clinical presentation, and treatment

Effects of naloxone and diazepam on blood glucose levels in tramadol overdose using generalized estimating equation (GEE) model; (an experimental study)

Effects of Naloxone and Diazepam on Blood Glucose Levels in Tramadol Overdose using Generalized Estimating Equation (GEE) Model; (An Experimental Study)

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