Does tramadol increase hip fracture risk?

Use of the pain medication tramadol was linked with a higher risk of hip fractures compared with the use of other pain medications in an analysis of a patient database from the United Kingdom.

The analysis, which is published in the Journal of Bone and Mineral Research, compared tramadol use with codeine, naproxen, ibuprofen, celecoxib, and etoricoxib use among adults aged 50 years or older.

During one-year follow-up, 518 hip fractures occurred among 146,956 patients taking tramadol, corresponding to approximately one additional new hip fracture per 1000 person-years relative to taking codeine (3.7 vs. 2.9, respectively). Likewise, up to 1.5 additional new fractures per 1000 person-years occurred with tramadol than with naproxen, ibuprofen, celecoxib, and etoricoxib.

"Considering the significant impact of hip fracture on morbidity, mortality, and healthcare costs, our results point to the need to consider tramadol's associated risk of fracture in clinical practice and treatment guidelines," said corresponding author Guanghua Lei, MD, Ph.D., of Xiangya Hospital, Central South University.