title: [Severe hypoglycemia induced by tramadol: two new cases of an unlisted side effect].
abstract: BACKGROUND
  Tramadol is a weak opioid analgesic used as a step two analgesic, approved in France for the treatment of moderate to severe pain in adult patients. The most common side effects are gastrointestinal and neurologic. Hypoglycaemia is an almost unknown side effect.
  
  
  METHODS
  We report two patients who presented with severe hypoglycaemia related to oral administration of tramadol in non diabetic patients. The underlying mechanisms of hypoglycaemia induced by tramadol are unclear. The only weak opioid analgesic drug reported to cause hypoglycaemia is propoxyphene, which has been widely used in France. The recent withdrawal of dextropropoxyphene in France might increase the prescriptions of tramadol and healthcare professionals should be aware of the risk of hypoglycaemia.
  
  
  CONCLUSIONS
  The risk of hypoglycaemia should be added to the summary of product characteristics of tramadol.
authors.affiliation: Centre régional de pharmacovigilance Marseille-Provence-Corse, hôpital Salvator, Assistance publique des Hôpitaux de Marseille, France. Solene.taugourdeau@ap-hm.fr
authors.forename: S
authors.initials: S
authors.lastname: Taugourdeau
authors.forename: L
authors.initials: L
authors.lastname: Chiche
authors.forename: F
authors.initials: F
authors.lastname: Rouby
authors.forename: A
authors.initials: A
authors.lastname: Default
authors.forename: M
authors.initials: M
authors.lastname: Boyer
authors.forename: D
authors.initials: D
authors.lastname: Castellan
authors.forename: M-A
authors.initials: MA
authors.lastname: Lanfranchi
authors.forename: C
authors.initials: C
authors.lastname: Bornet
authors.forename: R
authors.initials: R
authors.lastname: Jean
authors.forename: J-R
authors.initials: JR
authors.lastname: Harlé
authors.forename: J-M
authors.initials: JM
authors.lastname: Durand
authors.forename: M-J
authors.initials: MJ
authors.lastname: Jean-Pastor
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D010146:Pain / Q000188:drug therapy; D060735:Pharmacovigilance; D012720:Severity of Illness Index; D014147:Tramadol / Q000009:adverse effects*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol