Examination of the Use Survey and the Usefulness of Tramadol in Cancer Pain Patients

Abstract

Tramadol is a weak opioid analgesic indicated for the treatment of moderate to severe cancer pain at step 2 of the WHO analgesic ladder. There is little experience of its use in Japan; there are few reported detailed surveys on the usage of tramadol and its usefulness in patients who changed from taking tramadol to taking stronger opioids. The present study included inpatients who took tramadol hydrochloride capsule for cancer pain in the Nagoya University Hospital between October 2011 and March 2014; these patients were retrospectively examined based on electronic medical records. We observed that, out of 143 patients, 101 (71%) were started on a dose of 100 mg/day tramadol. Fortyeight of these 101 patients (48%) were changed to administration of stronger opioids, of which only 4 patients had their tramadol dosages increased to 300 mg/day before being changed to stronger opioids. However, among patients whose administration was changed from tramadol to stronger opioids, the incidences of nausea/vomiting when changing drugs were significantly lower than that among patients who had not taken tramadol (tramadol used group 19.4% vs non-tramadol used group 41.5%: P < 0.05). These results indicate that the incidence of nausea/vomiting may be reduced when changing from taking tramadol to taking stronger opioids after having used tramadol.