As opioids, tramadol and hydrocodone are similar in many ways, though they differ in their potencies, chemical compositions, and addictive potential. Hydrocodone, a semi-synthetic opioid, is usually more effective than fully synthetic tramadol, but it is also more addictive and, thus, more dangerous to consume.
Read along to learn more about the differences and similarities between tramadol and hydrocodone, their effectiveness, side effects, and potential consequences that may arise from their use.
What Is Tramadol, and How Does It Work?
Tramadol is a synthetic opioid classified as a Schedule IV drug, often used for treating moderate to moderately severe pain.
The drug comes in several forms, such as immediate and extended-release capsules and tablets, powders, injection solutions, and suspensions for oral use.
As a Schedule IV drug, tramadol is considered milder and safer than many other opioids. As a result, it is one of the more popular analgesics, sold under various brand names, including Ultram®, Ultram ER®, ConZip®, Ryzolt®, and Qdolo®. On the streets, tramadol is better known as Chill Pill, Trams, Trammies, Ultras, and Beans.
However, despite its advertised safety, tramadol works like other opioid pain medications. More specifically, it alters the perception of pain by binding to opioid receptors in the brain and blocking the transmission of pain signals.
Furthermore, tramadol has an added benefit that may make it especially addictive—a mild antidepressant property. The drug inhibits the reuptake of serotonin and norepinephrine, causing feelings of pleasure and euphoria.
As a result, tramadol is not recommended for extended use and should be taken exactly as prescribed to minimize the risk of side effects, dependence, and overdose.
What Is Hydrocodone, and How Does It Work?
Hydrocodone is a semi-synthetic opioid derived from codeine and classified as a Schedule II drug. It is particularly effective in alleviating moderate to moderately severe pain.
Hydrocodone can be found in several forms, including tablets, capsules, and liquids. However, it is most commonly prescribed as a tablet containing a co-ingredient, acetaminophen. That’s because the acetaminophen combination comes with fewer side effects while still retaining the potency of pure hydrocodone.
The hydrocodone-acetaminophen combination is available under brand names such as Lortab®, Norco®, and Vicodin®. You might also recognize hydrocodone by its many street names, including Vike, V-itamin, Hydro, Watson-387, and Narco.
As a Schedule II drug, hydrocodone carries a significant risk of abuse and addiction. Nevertheless, it is the most frequently prescribed opioid painkiller in the US, with tens of millions of prescriptions a year.
Like tramadol, hydrocodone works by disrupting the transmission of pain signals between the body and the brain. However, it also triggers dopamine release, resulting in feelings of euphoria and deep relaxation, which are the main causes of hydrocodone addiction and overdose.
Tramadol vs. Hydrocodone: 4 Key Differences
Tramadol and hydrocodone are both analgesic opioids, yet they differ in many respects. The four key areas where this is particularly noticeable include their respective effectiveness, composition, addictiveness, and cost.
In the following sections, we will examine the differences between tramadol and hydrocodone in more detail:
Tramadol vs. Hydrocodone Effectiveness
When it comes to treating pain, both tramadol and hydrocodone are effective; however, the former is usually prescribed for milder pain, while the latter is considered to be a superior option for severe pain.
In a study by Michael A. Turturro et al. of Mercy Hospital of Pittsburgh, it was discovered that the hydrocodone/acetaminophen combination is more effective than tramadol at relieving acute musculoskeletal pain after a minor traumatic injury.
Namely, the participants were given a capsule containing either 5 mg of hydrocodone with 500 mg of acetaminophen or 100 mg of tramadol. Their pain level was evaluated every 30 minutes for three hours using a pain scale.
Initially, the average pain score was the same for both groups, but as time went by, the difference became increasingly clear. Patients who took the hydrocodone/acetaminophen combination generally reported lower pain levels than those who ingested only tramadol.
However, it’s worth noting that subsequent studies didn’t always replicate those same results—in some cases, like in ligament reconstruction surgery, tramadol proved equally or more effective. In other words, the effectiveness of both opioids could also depend on the type of pain they are used to alleviate.
Tramadol vs. Hydrocodone Chemical Composition
Tramadol and hydrocodone have different chemical compositions, as the former is a synthetic opioid, while the latter is a semi-synthetic one.
Tramadol is fully synthesized in a laboratory, and no natural opiates are used in this process. Structurally, it is related to codeine and morphine and has two mechanisms of action—binding to the opioid receptors and inhibiting the reuptake of serotonin and norepinephrine.
On the other hand, hydrocodone is a derivative of codeine, a naturally occurring opiate found in the opium poppy. However, it is still made in a lab and considered more potent and addictive than codeine.
Tramadol vs. Hydrocodone Addictiveness
Tramadol and hydrocodone are both addictive and habit-forming, but hydrocodone is considered more dangerous due to its higher potency and greater risk of overdose.
For that reason, hydrocodone is classified as a Schedule II drug, whereas tramadol belongs to the Schedule IV category. More precisely, both substances are controlled and require a prescription before use, but the former comes with a much higher risk of dependence and abuse than the latter.
However, that doesn’t mean tramadol is truly a safer option—in fact, research has shown that the risk of chronic use is just as high, if not higher, among patients who were prescribed tramadol.
That’s because tramadol has had a better reputation historically and isn’t as tightly regulated as other opioids. As a result, it’s much easier to abuse the drug than it is in the case of other controlled substances.
Tramadol vs. Hydrocodone Cost
Both tramadol and hydrocodone are generally affordable options if you purchase them in their generic versions. Tramadol prices start at around $10 for a supply of 15 tablets of 50mg, while the average out-of-pocket cost for hydrocodone-acetaminophen is $7.5.
However, the final cost can vary significantly, as it can depend on insurance, coupons, or discounts that pharmaceutical companies sometimes offer.
Tramadol vs. Hydrocodone Side Effects
Tramadol and hydrocodone both belong to the opioid drug family, so they tend to cause similar side effects, including:
- Fatigue
- Nausea
- Vomiting
- Dizziness
- Heartburn
- Headache
- Dry mouth
- Drowsiness
- Constipation
- Lightheadedness
However, tramadol may also lead to insomnia, sweating, and indigestion, while hydrocodone is more likely to cause stomach pain, rash, and acid reflux. Furthermore, both opioids can come with severe side effects (hallucinations, irregular breathing, increased heart rate), which require immediate medical care.
Prolonged use of tramadol and hydrocodone may also lead to long-term effects, such as:
- Dependence
- Opioid use disorder (OUD)
- Sleep irregularities
- Chronic digestive issues
- Liver, kidney, or brain damage
- Opioid overdose
- Death
The likelihood of experiencing severe and long-term side effects increases if either opioid analgesic is taken with other substances. Therefore, it’s important to understand how tramadol and hydrocodone interact with other drugs and inform your healthcare provider of any medication you’re taking.
Tramadol and Hydrocodone Drug Interactions
Tramadol and hydrocodone may interact with the following drugs:
- Alcohol
- Other opioids
- Antipsychotics
- Muscle relaxers
- Some antibiotics
- Benzodiazepines
- Some antidepressants
- Anti-seizure medication
- Antiretroviral drugs, like ritonavir
- Antifungals, such as ketoconazole
- Sleep medication, including zolpidem
In other words, most commonly prescribed drugs don’t interact well with either tramadol or hydrocodone and shouldn’t be taken simultaneously. Usually, they can worsen the side effects, cause new ones, or decrease the analgesic effect of the two opioids.
For instance, alcohol, benzodiazepines, and other central nervous system depressants mixed with these drugs may lead to respiratory depression, hypotension, coma, and even death. That’s because opioids also act as CNS depressants, slowing down brain activity.
Furthermore, the hydrocodone/acetaminophen combination shouldn’t be mixed with other medications containing acetaminophen, as this can lead to liver damage and acetaminophen toxicity.
It’s best to let your doctor know if you’re taking anything else—even supplements and herbal medicines—before starting opioid therapy. They may seem safe to you, but you should ensure there won’t be any negative interactions leading to potentially life-threatening conditions.
Other Risk Factors of Tramadol and Hydrocodone
Risk factors that may increase the likelihood of severe side effects when using tramadol and hydrocodone include certain physical and mental conditions, such as:
- Bladder problems
- Past head injuries
- Respiratory issues
- History of depression
- Epilepsy and seizures
- Liver or kidney problems
- A history of alcohol or drug abuse
Furthermore, opioids are not recommended during pregnancy or while breastfeeding, as they may lead to neonatal abstinence syndrome (NAS). Babies with this syndrome go through withdrawal symptoms upon birth and may experience significant complications and long-term developmental delays.
Physical Dependence and Addiction to Opioids
Physical dependence and addiction to opioids may seem like one and the same, but these conditions actually differ significantly.
Dependence usually comes first, with the purely chemical changes in the brain, which occur with prolonged opioid use. With time, an individual can also develop addiction.
Most frequently, these two conditions go hand in hand among long-term opioid users—they can’t function normally without drugs and find it impossible to resist using them.
In the case of opioids, dependence comes first and may never develop into addiction if treated promptly enough.
Signs and Symptoms of Opioid Dependence
Signs and symptoms of opioid dependence include:
- Tolerance. Prolonged use of opioids increases the number of opioid receptors in the brain and decreases the natural production of endorphins. Consequently, the body needs a greater dosage of tramadol or hydrocodone to achieve the same analgesic effect, and the cravings for the drug may increase.
- Withdrawal. People dependent on opioids may experience highly unpleasant symptoms when attempting to quit, such as nausea, vomiting, tremors, insomnia, agitation, and muscle spasms. Aside from being uncomfortable, these symptoms can also be life-threatening, as the patient may attempt to alleviate them by taking too much of the opioid in question and overdosing.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is a cutting-edge opioid dependence treatment that can help you overcome tramadol or hydrocodone dependence safely and effectively.
Rather than simply managing the withdrawal symptoms, ANR focuses on the root cause of dependence. More specifically, it re-regulates the endorphin-receptor system and restores the brain to its pre-addiction state, fully eradicating the need and cravings for the drug in question. As a result, the risk of relapse is minimal.
Furthermore, ANR eliminates the uncomfortable withdrawal stage by putting the patient under deep sedation while the drug is flushed out and the brain is restored. This entire process is monitored by certified anesthesiologists and healthcare professionals, and the treatment is tailored to each patient’s needs.
Upon waking up, patients are effectively free of their opioid dependence and ready to go back to their normal lives in a matter of days. In other words, ANR is safe, quick, painless, and the only method that leads to full and lasting recovery.
To start your journey toward recovery, contact us for a free, confidential consultation.
Key Takeaways
Here are some key facts about tramadol vs. hydrocodone that we’ve covered today:
- Tramadol and hydrocodone are opioids prescribed for moderate to severe pain with similar effects and side effects.
- Tramadol and hydrocodone differ in strength, as tramadol is considered less potent and dangerous. However, it can be just as addictive when used over an extended period of time.
- ANR can effectively treat both hydrocodone and tramadol dependence by rebalancing your endorphin-receptor system and restoring your brain to its original state.
Tramadol vs. Hydrocodone FAQ
You can’t take tramadol with hydrocodone, as the two opioids can have dangerous interactions with each other. In fact, it’s not advisable to consume any two opioids together due to the increased risk of severe side effects, overdose, and even death.
Tramadol is not stronger than hydrocodone, so it is usually prescribed for moderate pain. On the other hand, hydrocodone is often administered for severe pain that can’t be relieved by most opioid painkillers.
Tramadol is technically a narcotic, although a preferred term for it is “opioid.” “Narcotic” comes with a negative connotation and is often used to describe any sort of illegal drug.
Tramadol hydrochloride is the same as tramadol, as the former is an active substance in the latter. It acts on the nerve cells of the brain and the spinal cord, blocking pain transmission and relieving discomfort.
Hydrocodone is stronger and, therefore, potentially more addictive than tramadol. It is classified as a Schedule II drug, which indicates a high potential for psychological and physical dependence. Compared to hydrocodone, tramadol is somewhat less addictive, though still dangerous.
Pain pills similar to tramadol include other opioid painkillers used to treat moderate-to-severe pain. Some common alternatives are methadone, oxycodone, and hydromorphone. However, non-opioids can have a similar effect to tramadol, especially ibuprofen and acetaminophen.
Additional Information:
Tramadol vs. Percocet: Differences, Risks and Treatment
How Long Does Tramadol Stay in Your System?
Tramadol vs. Oxycodone: Differences, Side Effects, and Risks
