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Ann Pharmacother. 2015 Dec;49(12):1311-6. doi: 10.1177/1060028015604631. Epub 2015 Sep 14.

Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System.

Author information

1
California Poison Control System, University of California San Francisco, San Francisco, CA, USA btsutaoka@calpoison.org.
2
California Poison Control System, University of California San Francisco, San Francisco, CA, USA.
3
Medical Communications Genentech, A Member of the Roche Group, South San Francisco, CA, USA.

Abstract

BACKGROUND:

Tapentadol (TAP) and tramadol (TRA) provide pain relief through similar monoaminergic and opioid agonist properties.

OBJECTIVE:

To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison Control Centers.

METHODS:

A retrospective cohort study was conducted analyzing national data for single medication TAP or TRA cases reported from June 2009 through December 2011. Case outcomes, dichotomized as severe versus mild; clinical effects; and use of naloxone were compared.

RESULTS:

There were 217 TAP and 8566 TRA cases. Significantly more severe outcomes were associated with TAP exposures for an all-age comparison (relative risk [RR] = 1.24; 95% CI = 1.04-1.48), and for the <6-year-old age group (RR = 5.76; 95% CI = 2.20-15.11). Patients with TAP exposures had significantly greater risk of respiratory depression (RR = 5.56; 95% CI = 3.50-8.81), coma (RR = 4.16; 95% CI = 2.33-7.42), drowsiness/lethargy (RR = 1.38; 95% CI = 1.15-1.66), slurred speech (RR = 3.51; 95% CI = 1.98-6.23), hallucination/delusion (RR = 7.25; 95% CI = 3.61-14.57), confusion (RR = 2.54; 95% CI = 1.56-4.13) and use of naloxone (RR = 3.80; 95% CI = 2.96-4.88). TRA exposures had significantly greater risk of seizures (RR = 7.94; 95% CI = 2.99-20.91) and vomiting (RR = 1.96; 95% CI = 1.07-3.60).

CONCLUSION:

TAP was associated with significantly more toxic clinical effects and severe outcomes consistent with an opioid agonist. TRA was associated with significantly higher rates of seizures and vomiting.

KEYWORDS:

adverse effects; tapentadol; toxicity; tramadol

PMID:
26369569
DOI:
10.1177/1060028015604631
[Indexed for MEDLINE]
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