Abstract
Objective: The objective of the study was to assess and compare the efficacy and tolerability of flupirtine versus tramadol in patients with chronic moderate low back pain (LBP).
 Materials and Methods: A prospective study was conducted in the outpatient department of orthopaedics at tertiary care hospital, Rajamahendravarm. After meeting the inclusion criteria, a total of 60 patients were randomly allocated to tablet flupirtine 100 mg in Group A and tablet tramadol 50 mg in Group B. The efficacy of the study drugs was assessed at baseline and the end of treatment by numerical rating scale11, visual analog scale-100 mm, physician’s, and patient’s global assessment. Statistical analysis was done using paired and unpaired t-test and data were presented as mean±standard deviation. Adverse drug reactions were monitored during the treatment.
 Results: The study results showed that 90% of the patients in Group A and 78% of the patients in Group B had shown a good response to their respective drugs. 30% of flupirtine group patients reported adverse drug reactions which were mild.
 Conclusion: Both the drugs are effective in the treatment of moderate chronic LBP, but the advantage of flupirtine was, the incidence of adverse drug reactions was less when compared to tramadol group.
Highlights
Low back pain (LBP) is the major health problem worldwide and it is the fifth most common reason for a physician visit, in which nearly 60–80 % of people are affected throughout their lifetime, and the prevalence of chronic LBP is 23% [1,2]
The study results showed that 90% of the patients in Group A and 78% of the patients in Group B had shown a good response to their respective drugs. 30% of flupirtine group patients reported adverse drug reactions which were mild
Both the drugs are effective in the treatment of moderate chronic LBP, but the advantage of flupirtine was, the incidence of adverse drug reactions was less when compared to tramadol group
Summary
Low back pain (LBP) is the major health problem worldwide and it is the fifth most common reason for a physician visit, in which nearly 60–80 % of people are affected throughout their lifetime, and the prevalence of chronic LBP is 23% [1,2]. Standard drug, tramadol is an atypical centrally acting opioid analgesic, most commonly used for pain relief, its analgesic effect is exerted by a dual mechanism, by weak μ opioid agonist and acts by inhibiting reuptake of serotonin and norepinephrine (NE) [8,9]. Both flupirtine and tramadol individually have proven their efficacy in the treatment of moderate chronic LBP; there is a paucity of studies comparing both the drugs. The present study was carried out to assess the efficacy and tolerability of flupirtine and tramadol in chronic LBP of moderate intensity
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