Tramadol complications: A new analysis has cast doubt on the effectiveness of tramadol, one of the most commonly prescribed painkillers for chronic conditions.
Published in BMJ Evidence-Based Medicine, the research found that the opioid provided minimal pain relief while carrying significant risks of adverse effects.
Researchers examined 19 randomised clinical trials involving 6,506 adults suffering from osteoarthritis, chronic low back pain, neuropathic pain and fibromyalgia. Each study compared tramadol against a placebo.
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The results showed tramadol did reduce pain, but the decrease fell short of what doctors typically consider meaningful for patients. Meanwhile, those taking the drug faced higher rates of both serious and minor side effects compared to placebo groups.
Heart-related complications drove most of the serious adverse events. These included chest pain, coronary artery disease and congestive heart failure. The authors said their findings suggest tramadol likely raises cardiovascular risks.
Dr. Marc Siegel, a senior medical analyst for Fox News, noted that tramadol has been viewed as a milder alternative to other opioids. “Often, we may use tramadol to avoid more addictive drugs like other opioids, though in fact tramadol is a synthetic opioid. It is much milder,” Siegel said.
Dr. Alopi M. Patel, a pain medicine physician at Icahn School of Medicine at Mount Sinai in New York, said the findings were striking. “It is notable how minimal the pain reduction was and how clearly the study highlighted the elevated risk of serious adverse events, even over relatively short trial durations,” said Patel, who was not involved in the research.
The study authors concluded that tramadol’s harms appear to outweigh its benefits for treating chronic pain. However, the analysis had limitations. Most trials lasted between two and 16 weeks, which prevented the assessment of long-term effects. Many outcomes also showed a high risk of bias, potentially overstating benefits and understating harms.
Siegel cautioned against concluding that cancer or heart disease rates are directly related without controlling for other factors. He also noted the study didn’t compare tramadol with stronger opioids like Percocet. Medical experts stressed that patients should not stop taking tramadol suddenly due to withdrawal risks. Anyone considering medication changes should speak with their doctor first.
Patel recommended transparent discussions between doctors and patients weighing tramadol’s modest benefits against its risks.