Tramadol Exposures Reported to Statewide Poison Control System

Marquardt, Kathy; Alsop, Judith A.; Albertson, Timothy E

doi:10.1345/aph.1e577

Cited by 130 publications

(125 citation statements)

References 13 publications

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“…In the present study, time of seizure varied from 20 min to 12 h post-ingestion; however, 95% of seizures occurred in the first 6 h after ingestion, which is in agreement with studies conducted by Mehrpour et al [28], Marquardt et al [27], Jovanović-Cupić et al [24], and Talaie et al [9].…”

Section: Discussionsupporting

confidence: 92%

“…In this study, the smallest reported dose associated with seizure was 200 mg (was seen in four patients). This is lower than previously published studies, in which the smallest dose of tramadol-associated seizure was reported to be 300 mg [5,27].…”

Section: Discussioncontrasting

confidence: 60%

“…Seizures caused by tramadol are typically of tonic-clonic type [5,9,25], despite the fact that tramadol at clinically NSAIDs nonsteroidal anti-inflammatory drugs relevant doses may slightly suppress the severity of seizures [27]. Much of the toxicity in tramadol overdose can be attributed to the monoamine uptake inhibition rather than its opioid effects [8].…”

Section: Discussionmentioning

confidence: 99%

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Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration

et al. 2011

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration

et al. 2011

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“…Some studies noted occurrence of seizure even in recommended doses [14,21]. Spiller et al studied 87 patients with tramadol poisoning and described seizures in 7 (8%) [20].…”

Section: Discussionmentioning

confidence: 99%

“…The neurotoxicity of tramadol mainly occurs within 24 hours postingestion, and 84.6% of seizures occur within 6 hours after tramadol intake. The minimum dose of tramadol that induces seizure has been reported to be 200 mg in two different studies [14,15]. The aim of this study was to evaluate the incidence of seizure among users and abusers of tramadol.…”

Section: Introductionmentioning

confidence: 99%

Dose-independent occurrence of seizure with tramadol

et al. 2009

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Introduction: Tramadol, as a centrally-acting, opioid-like analgesic with serotonin reuptake inhibition property, is one of the most prescribed analgesics in the world. We assessed the incidence of seizure, as it is one of the most important adverse effects.Methods: In a cross-sectional study, 215 cases of tramadol users or abusers who were admitted to Loghman-Hakim Hospital Poisoning Center (LHHPC) in Tehran during a 5-month period, from April 2007 to September 2007, were assessed to evaluate the occurrence of seizure. Patients with positive history of co-ingestion of other drugs, addiction, convulsive disorders, renal diseases, or head trauma with abnormal electroencephalography (EEG) or computerized tomography (CT) scan of the brain were excluded, thus 132 patients were included in the study. For patients who had seizure, CT scan of the brain and EEG were performed, and frequency and type of seizure were identified. Mean tramadol dose was compared between patients with and without seizure.Results: Among the patients, 97 (73.5%) were male. Seizure occurred in 61 patients (46.2%) within 24 hours after tramadol ingestion. The majority of patients who had seizure were male (male, 83.6% vs. female, 16.4%). Mean tramadol dose was lower among females than males (males, 2413 mg vs. females, 1706 mg), but the difference was not statistically significant. Of 35 patients with documented seizure type, all showed generalized tonic-clonic seizure and 12 patients had abnormal EEG (35.3%). No statistically significant difference was observed in mean tramadol intake between patients with or without seizure. Analysis of patients with seizure, according to tramadol intake, indicated that most patients used tramadol in the dose range of 500-1000 mg followed in occurrence by 1500-2000 mg, then 100-500 mg, 2500-3000 mg, and 3500-4000 mg.Conclusions: Mean tramadol intake does not differ between patients with and without seizure, and the most common dose range in those with seizure is 500-1000 mg. We thus conclude that the incidence of seizure with tramadol is not dose dependent.

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Maternotoxicity and fetotoxicity in Rattus norvegicus albinus exposed to tramadol during the late phase of pregnancy

Akhtar

Younas

Saleem

et al. 2021

Birth Defects Research

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Objectives: Tramadol, an atypical opioid, is clinically efficacious in treating moderate to severe pain. The aim of current study was to find out the toxicological effects of tramadol exposure to pregnant rats and fetuses during the late phase of pregnancy.Methods: Wistar pregnant rats were exposed to 1.25, 2.5, or 5 mg/kg/day tramadol from 14th to 20th day of pregnancy. The same therapy was given to nonpregnant rats for 7 days. The body weight, oral glucose and lipid tolerance tests, and effect on complete blood parameters in both pregnant and nonpregnant rats were determined. On 20th day, maternal placentas were excised and weighed while fetuses were observed for any deformity and growth retardation. Oxidative stress biomarkers were estimated in the liver and kidney tissue homogenates of the pregnant and nonpregnant rats while the whole fetus homogenate was processed for the same. Moreover, histopathology of the liver and kidney of pregnant and nonpregnant rats were carried out.Results: Tramadol administration did not significantly alter the area under curve of the blood glucose and triglyceride levels in both the pregnant and nonpregnant rats. It reduced the live fetuses, placental weights, fetal length, and fetal weights. Tramadol treated pregnant rats showed significantly (p < .05) reduced red blood cells, hematocrit, hemoglobin, and platelets with reference to control group. Similarly, structural abnormalities and malfunctioning of the liver and kidney of pregnant rats were instituted; however, it did not affect the

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Tramadol Exposures Reported to Statewide Poison Control System

Abstract: Tramadol overdoses frequently cause CNS depression, nausea/vomiting, tachycardia, and seizures. Symptoms generally resolve within 24 hours. Accidental ingestions in children were well tolerated, primarily causing sedation.

Cited by 130 publications

References 13 publications

Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration

Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration

Dose-independent occurrence of seizure with tramadol

Maternotoxicity and fetotoxicity in Rattus norvegicus albinus exposed to tramadol during the late phase of pregnancy

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