Tramadol vs. Oxycodone: The Difference Between Two Drugs That Treat Severe Pain

Opioid analgesics are prescription pain relievers that work in your brain by changing how your body feels and responds to pain. They are typically only prescribed to treat moderate to severe pain levels, only after non-opioid pain relievers have proven to be ineffective or cannot be tolerated by the individual. A couple of the more popular opioid analgesics include tramadol and oxycodone.

The opioid tramadol is used for acute pain management in adults. It is known to be slightly weaker than other opioid pain medications. Although weaker, it can still be habit-forming and addictive. This drug is available in both of the following types: immediate-action and extended-release tablets for more severe symptoms that require around-the-clock dosing. This drug influences your central nervous system and your opioid receptors, changing the way that you perceive pain and decreasing the discomfort that you experience. 

Oxycodone is typically prescribed to treat more severe and long-term symptoms, sometimes due to chronic disease, it is stronger than some other opioids and is very closely regulated by the Drug Enforcement Administration. Due to the high potential risk of addiction, misuse, and overdose, this opioid is typically only prescribed if and when other non-opioid medications were not effective or tolerated. Oxycodone is also available in both immediate and extended-release forms.  

The Significant Differences Between Oxycodone & Tramadol

Tramadol and oxycodone are similar in many ways. However, drug comparisons also show that they have several differences. Their main difference is in their chemical structure. The different chemical structure is what is responsible for their other differences as well. Including potency, dose, and risk for addiction, mental and physical dependence, and overdose. 

The biggest difference is found in their strengths. Oxycodone has been found to be 1.5 times more potent than the well-known opioid, morphine, while tramadol is only 10% as strong as morphine! Another difference between these two pain medications is that tramadol inhibits the reuptake of serotonin neurotransmitters and norepinephrine. Oxycodone does not have this same effect. 

Originally, tramadol was not classified as a controlled substance, but in 2014 the DEA re-classified it as a Schedule IV controlled substance because it does have the potential for abuse and addiction, therefore it should be monitored closely by your prescribing physician. Oxycodone is a Schedule II controlled substance according to the Drug Enforcement Administration. Compared to tramadol, oxycodone has a higher potential for addiction. 

Both drugs are available in immediate-release or extended-release formulations. They are also both available in combination with other non-opioid-type medicines as well. Tramadol is available in a tablet in combination with acetaminophen (Tylenol) and Oxycodone is available in combination with a larger variety of other medicines like acetaminophen, aspirin, ibuprofen, naloxone, and naltrexone. 

Which One Will Be More Effective For You? What Studies Say About Patients After Facial Surgery

Both of these opiates are highly effective at treating moderate to severe pain. They have been proven to be even more effective when combined with a Non-Steroidal Anti-Inflammatory (NSAID) like acetaminophen. However, in general, oxycodone tends to be more effective because it is much more potent than tramadol, making it a better option for more severe cases most of the time. 

One study researched how well these drugs could control pain after facial surgery. During this study, the drugs were given intravenously through a patient-controlled device. The results of this study found that the pain control was similar between the two groups of participants, with no significant statistical difference. One positive of tramadol is that it does not cause respiratory depression to the extent that oxycodone does. However, it did appear to cause more nausea. In the end, researchers were able to review the results and conclude that after facial surgery the relief provided by tramadol was comparable to that provided by oxycodone without the dangerous risk of severe respiratory depression. 

Common Side Effects of These Medications

These two prescription pain relievers have similar side effects because they are both opioids. As is the case with most opioids, the most common adverse effects of either of these substances tend to be gastrointestinal in nature. Among the most common are the following;

  • Drowsiness
  • Nausea
  • Constipation
  • Vomiting
  • Headache
  • Dizziness
  • Dry Mouth
  • Indigestion/Heartburn
  • Increased blood pressure
  • Decreased Heart Rate

If you are affected by any of these adverse events or have any questions regarding these common symptoms, you should seek medical advice from your trusted healthcare provider. 

Opioid Abuse Risks & Interactions

Since both of these prescription medicines are controlled substances, they both carry the dangerous risk of addiction, mental and physical dependence, and abuse. Due to this, they should both be taken exactly as a medical professional prescribed them to you. It is important that you do not alter the dose or take them more frequently than instructed by your physician. Taking a higher dose or taking the drug more frequently than prescribed can result in a fatal overdose. This is even more dangerous when taken in combination with other central nervous system depressants like alcohol or benzodiazepines. 

Another risk factor is certain drug interactions that may occur when taking tramadol or oxycodone. A drug interaction is when a substance changes the way a drug works. This can cause harm and even prevent the drug you’re taking from doing what it was meant to do. Your doctor can help prevent the risk of possible interactions. But in order to do so, you must tell them about all prescriptions, over-the-counter medicines, vitamins, supplements, or herbs that you’re taking so that they can review your current medication list and ensure that no interactions exist. 

There are also other drugs that should be avoided when taking either of these substances. These drugs may include other medicines like morphine, hydrocodone, fentanyl, phenothiazines (like chlorpromazine and prochlorperazine), tranquilizers (like diazepam and alprazolam), sleeping pills (like zolpidem and temazepam), and quinidine. 

Frequently Asked Questions

Patients taking these prescription medications should avoid alcohol use. Alcohol may enhance the CNS depressive side effects. Combining these substances with alcohol puts you at potential risk of respiratory depression, coma, and even death in severe cases. 

No, it is not. It works by having an effect on the transmission of pain signals but does not directly affect the function of an individual’s muscles.
These prescription medications should only be taken while pregnant if instructed to do so by your healthcare provider. Neonatal opioid withdrawal syndrome is a risk factor for taking either of these drugs while pregnant. This can occur in any newborn whose mother took the drugs prior to delivery.
These drugs are not typically prescribed to be used together. Due to tramadol being much weaker than oxycodone, it would not provide any added benefit to the use of oxycodone.

Because they are not typically prescribed together due to their different potencies, you should not alternate between the two unless you have been specifically directed to do so by your health care professional. 

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