UMEM Educational Pearls

Title: Avoid tramadol in the older patient

Category: Geriatrics

Keywords: Tramadol, geriatrics (PubMed Search)

Posted: 1/29/2026 by Robert Flint, MD (Updated: 1/31/2026)
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Tramadol has been viewed as a safer alternative for pain control than opioids. This study says differently. 
“Tramadol use was associated with increased risk of multiple ER utilizations, falls/fractures, CVD hospitalizations, safety event hospitalizations, and mortality (new users only) compared to nonuse.”

References

Musich S, Wang SS, Schaeffer JA, Slindee L, Kraemer S, Yeh CS. Safety Events Associated with Tramadol Use Among Older Adults with Osteoarthritis. Popul Health Manag. 2021 Feb;24(1):122-132. doi: 10.1089/pop.2019.0220. Epub 2020