Overview

• Pooled results from 6,506 patients show tramadol’s pain reduction falls below commonly accepted thresholds for clinical effectiveness.
• Researchers report about a twofold increase in overall harms versus placebo, driven by more chest pain, heart disease and congestive heart failure.
• The analysis spans neuropathic pain, osteoarthritis, chronic low back pain and fibromyalgia, with treatment periods of two to 16 weeks.
• Non-cardiovascular adverse effects reported include nausea, dizziness, constipation and sleepiness.
• The authors recommend minimising use of tramadol and other opioids for chronic pain, and UK GP leaders say prescribing for chronic pain has been curtailed.