Tramadol associated with lower risk of constipation than codeine - study

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By Olivia Bowthorpe

Hospitalised patients given tramadol for non-cancer pain relief were 20% less likely to experience severe constipation than those given codeine, results of a UK analysis have shown.

Conversely, morphine, oxycodone, fentanyl and a combination of opioids were associated with a 59%, 46%, 37% and 85% higher risk for constipation, respectively when compared to codeine, Dr Meghna Jani, senior clinical lecturer at the University of Manchester, and colleagues have reported in BMC Medicine.¹

Dr Jani told Doctors.net.uk: “Constipation is a common but often under-discussed side effect of opioid therapy. Patients can often find it difficult to talk about the impact it may have on their daily lives with health care professionals.”

While caution was necessary, "some patients do require opioids in the short-term for pain relief,” Dr Jani added, “therefore choosing the safest evidenced-based option within the class can be helpful."

The analysis used the electronic health records of 80,475 adult patients who were hospitalised in the North-West of England between 2009 and 2020, and who had been treated with opioids.