Slowing the initial titration rate of tramadol improves tolerability

被引:53
作者
Ruoff, GE [1 ]
机构
[1] Westside Family Med Ctr, Kalamazoo, MI 49009 USA
来源
PHARMACOTHERAPY | 1999年 / 19卷 / 01期
关键词
D O I
10.1592/phco.19.1.88.30515
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Study Objectives. To examine the effect of three titration schedules on the tolerability of tramadol, and to determine whether slow titration would reduce the frequency of drug discontinuation due to adverse events. Design. Multicenter, outpatient, double-blind, parallel study. Setting. Twenty-eight outpatient study centers. Subjects. Four hundred sixty-five patients with chronic joint pain Interventions. Patients were randomized into one of four treatment groups for 14 days: placebo, or tramadol dosage titrated at 1, 4, or 10 days to achieve the study target dosage of 200 mg/day. They continued taking their dosage of nonsteroidal antiinflammatory drug during the study. Each group was examined to determine if slower titration resulted in a statistically significant trend toward fewer discontinuations due to nausea and/or vomiting and dizziness and/or vertigo. Discontinuation due to any adverse event was similarly analyzed. If the trend was statistically significant, pairwise comparisons were performed to determine the statistical significance among titration rates. Measurements and Main Results. A statistically significant trend was seen toward fewer discontinuations as a result of nausea/vomiting, dizziness/vertigo, and any adverse event as the titration rate decreased. Patients with 10-day titration rate required the fewest discontinuations, and this rate was statistically significantly different from both the 1- and 4-day rates for discontinuations. Conclusion. A slower rate of initiating tramadol therapy (50-mg increments every 3 days) improved tolerability with significantly fewer discontinuations due to dizziness or vertigo.
引用
收藏
页码:88 / 93
页数:6
相关论文
共 17 条
  • [1] GASTROINTESTINAL DAMAGE ASSOCIATED WITH THE USE OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS
    ALLISON, MC
    HOWATSON, AG
    TORRANCE, CJ
    LEE, FD
    RUSSELL, RI
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (11) : 749 - 754
  • [2] BARKIN RL, 1995, FORMULARY, V30, P542
  • [3] Dalgin Paul, 1997, Arthritis and Rheumatism, V40, pS86
  • [4] NONSTEROIDAL ANTIINFLAMMATORY DRUG-ASSOCIATED GASTROPATHY - INCIDENCE AND RISK FACTOR MODELS
    FRIES, JF
    WILLIAMS, CA
    BLOCH, DA
    MICHEL, BA
    [J]. AMERICAN JOURNAL OF MEDICINE, 1991, 91 (03) : 213 - 222
  • [5] NONSTEROIDAL ANTIINFLAMMATORY DRUG-USE AND INCREASED RISK FOR PEPTIC-ULCER DISEASE IN ELDERLY PERSONS
    GRIFFIN, MR
    PIPER, JM
    DAUGHERTY, JR
    SNOWDEN, M
    RAY, WA
    [J]. ANNALS OF INTERNAL MEDICINE, 1991, 114 (04) : 257 - 263
  • [6] KATZ WA, 1995, TODAYS THERAPEUTIC T, V13, P177
  • [7] Physiological factors and medications as predictors of injurious falls by elderly people: A prospective population-based study
    Koski, K
    Luukinen, H
    Laippala, P
    Kivela, SL
    [J]. AGE AND AGEING, 1996, 25 (01) : 29 - 38
  • [9] LINTZ W, 1986, ARZNEIMITTEL-FORSCH, V36-2, P1278
  • [10] MONTAMAT SC, 1989, NEW ENGL J MED, V321, P303