The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

IX.d

Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)

Renal failure may increase the risk of this complication

Publications

Caré W, Tangre A, Dufayet L, Lekens B, Laborde-Casterot H, Langrand J, French Poison Centers Research Network, Mégarbane B, Vodovar D

Exposure to immediate-release tramadol in children 6 years and under - a nationwide French poison control center study.

Clinical toxicology (Philadelphia, Pa.). 2022;60(6):750-758

Layne KA, Dargan PI, Dines AM, Leaper C, Yates C, Hovda KE, Heyerdahl F, Archer JRH, Giraudon I, Wood DM, Euro-DEN Plus Research Group

Acute toxicity related to misuse (nonmedical use) of tramadol: Experience of the European Drug Emergencies Network Plus.

British journal of clinical pharmacology. 2021;87(4):1668-1675

Stassinos GL, Gonzales L, Klein-Schwartz W

Characterizing the Toxicity and Dose-Effect Profile of Tramadol Ingestions in Children.

Pediatric emergency care. 2019;35(2):117-120

Hassanian-Moghaddam H, Farnaghi F, Rahimi M

Tramadol overdose and apnea in hospitalized children, a review of 20 cases.

Research in pharmaceutical sciences. 2015;10(6):544-52

Ryan NM, Isbister GK

Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely.

Clinical toxicology (Philadelphia, Pa.). 2015;53(6):545-50

Orliaguet G, Hamza J, Couloigner V, Denoyelle F, Loriot MA, Broly F, Garabedian EN

A case of respiratory depression in a child with ultrarapid CYP2D6 metabolism after tramadol.

Pediatrics. 2015;135(3):e753-5

Rahimi HR, Soltaninejad K, Shadnia S

Acute tramadol poisoning and its clinical and laboratory findings.

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 2014;19(9):855-9

Hassanian-Moghaddam H, Farajidana H, Sarjami S, Owliaey H

Tramadol-induced apnea.

The American journal of emergency medicine. 2013;31(1):26-31

Tantry TP, Kadam D, Shetty P, Adappa KK

Tramadol-induced respiratory depression in a morbidly obese patient with normal renal function.

Indian journal of anaesthesia. 2011;55(3):318-20

Ouro-Bang'na Maman AF, Ahouangbévi S, Chobli M

[Respiratory depression after intrathecal injection of tramadol with hyperbaric bupivacaine].

Canadian journal of anaesthesia = Journal canadien d'anesthesie. 2006;53(11):1161-2

Nieuwenhuijs D, Bruce J, Drummond GB, Warren PM, Dahan A

Influence of oral tramadol on the dynamic ventilatory response to carbon dioxide in healthy volunteers.

British journal of anaesthesia. 2001;87(6):860-5

Barnung SK, Treschow M, Borgbjerg FM

Respiratory depression following oral tramadol in a patient with impaired renal function.

Pain. 1997;71(1):111-2