26 May 2010
The Department of Health (DH) today (May 26) drew the public's attention to the risk of suicide related to the use of medicines containing tramadol, as well as the risk of overdosage.
Through the DH's drug surveillance scheme, DH noted that the US Food and Drug Administration (USFDA) notified healthcare professionals on May 25 (US time) of changes to the warning section of the prescribing information for tramadol to strengthen the warning information to emphasise the risk of suicide for patients who are addiction-prone, taking tranquilizers or antidepressant drugs and also warned of the risk of overdosage.
Tramadol is a centrally acting synthetic analgesic indicated for the management of moderate to moderately severe chronic pain. Tramadol-related deaths have occurred in patients with previous histories of emotional disturbances or suicidal ideation or attempts, as well as histories of misuse of tranquilizers, alcohol, and other central nervous system active drugs. Serious potential consequences of overdosage with tramadol are central nervous system depression, respiratory depression and death.
In Hong Kong, 29 products containing tramadol are registered with the Pharmacy and Poisons Board (PPB). They can only be sold in dispensaries on a doctor's prescription and under the supervision of a pharmacist.
The surveillance finding has already been referred to the Registration Committee of the PPB which will review the registration requirements for tramadol in its next meeting.
Healthcare professionals are reminded not to prescribe tramadol for patients who are suicidal or addiction-prone. Extra caution should also be taken when prescribing tramadol for patients who are taking tranquilizers or antidepressant drugs and patients who use alcohol in excess and who suffer from emotional disturbance or depression.
Members of the public taking tramadol are warned not to exceed the dose recommended by their healthcare professionals. They should consult their healthcare professionals if in doubt.