The People's Perspective on Medicine Tramadol and Hypoglycemia: Beware Symptoms of Low Blood Sugar! A serious side effect of the pain reliever tramadol can be low blood sugar. Most doctors don't know about tramadol and hypoglycemia. Learn about symptoms! Tramadol has become one of the most widely prescribed pain relievers in the world. That’s because many doctors have become reluctant to prescribe opioids like hydrocodone. Physicians prescribe tramadol instead because they perceive it as non-addicting and safe. But there are LOTS of side effects and potential withdrawal problems with tramadol. The latest research suggests a link between tramadol and hypoglycemia (Scientific Reports, Aug. 28, 2019). This is a potentially life-threatening but unrecognized adverse drug reaction! How Does Tramadol (Ultram, Ultracet) Work? Tramadol exerts a mild effect upon opioid receptors. It also affects neurotransmitters such as serotonin and norepinephrine. That makes it quite unique