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Comparative study of hypoglycaemia induced by opioids. Is it a class effect?
Basile Chrétien1,2,3, Charles Dolladille1, Léa Hamel-Sénécal1,2,3
1Department of Pharmacology, Caen University Hospital , Caen , France.
Expert Opinion on Drug Safety
|July 19, 2019
Summary
Opioid-induced hypoglycemia is likely a class effect, as all nine studied opioids showed a significant association with low blood sugar. Women and diabetic patients appear to be at higher risk.
Area of Science:
- Pharmacovigilance
- Clinical Pharmacology
- Drug Safety
Background:
- Drug-induced hypoglycemia has been documented with specific opioids like tramadol and methadone.
- The potential for hypoglycemia as a class effect across all opioids requires investigation.
Purpose of the Study:
- To determine if drug-induced hypoglycemia is a class effect common to all opioids.
- To assess the association between various opioids and hypoglycemia using global safety databases.
Main Methods:
- Disproportionality analysis of nine opioids in VigiBase®, the WHO global individual case safety report database, using a standardized MedDRA query for hypoglycemia.
- Descriptive study of opioid-induced hypoglycemia in the French PharmacoVigilance DataBase (FPVDB) using the MedDRA Preferred Term 'hypoglycaemia'.
Main Results:
- A statistically significant association between all nine studied opioids and hypoglycemia was observed, with a global adjusted Reporting Odds Ratio (aROR) of 1.53.
- Individual aROR values for the opioids ranged from 1.09 to 1.97, all significant.
- In the FPVDB, 133 reports of opioid-related hypoglycemia were identified, with 55 cases involving glycemic imbalances in diabetic patients shortly after initiating opioid treatment.
Conclusions:
- Opioid-induced hypoglycemia is likely a class effect, associated with all studied opioids.
- Women and patients with diabetes mellitus appear to be at an increased risk for developing opioid-induced hypoglycemia.
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