Pediatric Prescriptions for Tramadol Frequently Contraindicated
Overweight or obesity and age <12 are both contraindications for tramadol use.
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Tramadol, although seldom prescribed in children, was found to be prescribed for almost half of children with contraindications for its use, and predominantly to girls vs boys and whites vs other race children, according to a retrospective review to be presented at the World Congress on Pain 2018, held September 12-16 in Boston, Massachusetts.
Electronic medical records of children prescribed tramadol at discharge from a tertiary pediatric institution were used to collect data on patient demographics, type of surgery, and service provider (n=642). Overweight or obesity — defined as a body mass index (BMI) ≥85th percentile and <95th percentile for children and teens of the same age and sex and a BMI ≥95th percentile for children and teens of the same age and sex — and age <12 are both contraindications for tramadol use.
Patients were found to be more likely to be prescribed tramadol if they were girls vs boys (415 vs 227, respectively; P <.001), and white vs black or another race (59%, 14%, and 20%, respectively). A total of 58 (9%) and 125 (36%) patients who received tramadol were younger than 12 and between 12 and 18. These patients were also considered overweight or obese.
“Our data demonstrate inadequate adherence to US Food and Drug Administration drug safety communication regarding the use of tramadol in our institution,” the authors noted. “This suggests the need for additional education and surveillance to promote safe tramadol use and prescribing.”
Quan H, Stake C, Hebal F, Minhas S, Barsness K, Harris Z. Tramadol prescribing patterns after FDA safety communication warning issued on tramadol. Presented at the World Congress on Pain 2018; September 12-16, 2018; Boston, MA. Poster 65785.
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