New research indicates that the painkiller tramadol offers only a slight alleviation for chronic pain, with its potential side effects possibly outweighing any perceived benefits.
The potent, prescription-only opiate, marketed under various brand names including Maxitram, Marol, Zydol, Zamadol, Tramulief, and Tramquel, is typically reserved for moderate to severe pain, such as that experienced after surgery or a significant injury.
While some people are prescribed the drug for long-term pain management when less powerful medications prove insufficient, a recent study has raised concerns.
Experts, writing in BMJ Evidence Based Medicine, indicated that tramadol – a particularly popular choice in the US – offers limited impact on chronic pain and is likely to heighten the risk of serious adverse effects, notably heart disease.
The team assessed 19 published clinical trials involving 6,506 people with chronic pain.
Five trials looked at the impact of tramadol on neuropathic pain; nine focused on osteoarthritis; four looked at chronic low back pain; and one focused on fibromyalgia.
Most people were taking the drug as tablets, and length of treatment ranged from two to 16 weeks.
Pooled data analysis showed that while tramadol eased pain, the effect was small and below what would be considered clinically effective.
Researchers also noted a doubling in the risk of harms associated with tramadol compared with placebo drugs, mainly driven by a higher proportion of things such as chest pain, heart disease and congestive heart failure.
Some patients also suffered nausea, dizziness, constipation and sleepiness.
The researchers concluded: “Approximately 60 million individuals worldwide experience the addictive effects of opioids.
“In 2019, drug use was responsible for approximately 600,000 deaths, with nearly 80 per cent of these fatalities associated with opioids and approximately 25 per cent resulting from opioid overdose.
“Given these trends and the present findings, the use of tramadol and other opioids should be minimised to the greatest extent possible.”
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