Tramadol and oxycodone are among the most commonly prescribed opioid medications for moderate-to-severe pain that primarily differ in terms of potency. While it’s no secret that tramadol is relatively weak and oxycodone is very potent, there are several other differences between tramadol and oxycodone you should be aware of.
This tramadol vs. oxycodone comparison guide will help you learn more about the effectiveness, side effects, risks, and other key similarities and differences between these opioids.
What Is Tramadol, and How Does It Work?
Tramadol is an opioid pain medication prescribed for moderate-to-severe pain that cannot be controlled with weaker pain relievers.
Commonly sold under Ultram®, ConZip®, QDOLO, and other brand names, tramadol is available in liquid, tablet, and capsule, in both immediate- and extended-release formulations. Chill Pills, Trammies/Trams, and Ultras are its most popular street names.
Tramadol is created by combining synthetic opioids with monoamine reuptake inhibitors (MRI). Therefore, it is not only a synthetic but also an atypical opioid; it acts both as an opioid and as a serotonin and norepinephrine reuptake inhibitor (SNRI).
As such, tramadol works in two ways:
- It prevents the transmission of pain signals between the body and the brain by interacting with the opioid receptors in the central nervous system (CNS).
- Similarly to antidepressants, it hinders the reuptake of serotonin and norepinephrine.
Due to being one of the least potent opioids, tramadol was initially regarded as a safer alternative to traditional opioids. However, today, it is no longer a secret that it can be habit-forming and lead to opioid abuse and addiction. It has been treated as a Schedule IV controlled substance since 2014 and can only be obtained by prescription.
What Is Oxycodone, and How Does It Work?
Oxycodone is a prescription opioid used to treat moderate-to-severe pain. Like tramadol, it is prescribed when non-opioid painkillers fail to provide sufficient relief or cannot be used. It is marketed under the names OxyContin® and Oxaydo®, among others, and is often prescribed as a combination medication containing acetaminophen (Percocet®).
Oxycodone comes in several forms, including oral solution and immediate- and extended-release tablets and capsules. It is also a popular street drug; O.C. and Kicker are some street names for it.
As a semi-synthetic opioid, oxycodone is produced by synthesizing thebaine. It works by binding to opioid receptors, thereby preventing the brain from receiving pain signals.
Oxycodone is the second most commonly abused opioid in the United States after hydrocodone.
In 2022, nearly 31% of Americans misusing prescription painkillers—or 2.5 million people—abused oxycodone specifically. Due to its high potential for abuse, dependence, and addiction, it is classified as a Schedule II controlled substance.
Now that you’re more familiar with tramadol and oxycodone let’s explore their differences in greater detail.
Tramadol vs. Oxycodone: 4 Key Differences
Tramadol vs. oxycodone differ in their potency. While oxycodone is among the most potent opioids, tramadol is considered relatively weak.
With this in mind, let’s see how tramadol and oxycodone differ in terms of effectiveness, chemical composition, addictiveness, and cost.
Tramadol vs. Oxycodone: Effectiveness
Oxycodone is more potent than tramadol, but it doesn’t mean it is more effective in relieving pain—both opioids are equally effective. Research shows tramadol and oxycodone provide similar pain relief despite the difference in their potencies.
Researchers from Helsinki University Central Hospital found that oxycodone is roughly eight times more potent than tramadol. However, they haven’t seen any significant difference in terms of effectiveness.
Therefore, if you’re choosing between tramadol vs. oxycodone for pain management, it’s best to base your decision on other factors besides effectiveness, such as their side effect profiles and the recommendation of your healthcare provider.
Tramadol vs. Oxycodone: Chemical Composition
While both pain medications structurally resemble morphine, the chemical composition of tramadol vs. oxycodone differs quite a bit.
Tramadol (molecular formula C16H25NO2) is a fully synthetic opioid, meaning it is designed to mimic natural opioids without containing them. Oxycodone (molecular formula C18H21NO4), on the other hand, is semi-synthetic; it is derived from thebaine, an alkaloid that naturally occurs in the opium poppy plant.
Importantly, tramadol is a partial opioid agonist, whereas oxycodone is a full opioid agonist. Put simply, oxycodone activates opioid receptors fully; tramadol only does so to a certain extent. However, unlike oxycodone, it is a mixed-mechanism drug.
Tramadol vs. Oxycodone: Addictiveness
Regarding tramadol vs. oxycodone addictiveness, it’s safe to say that both opioids are addictive, but oxycodone is the more addictive of the two. This is evident from the fact that it falls under Schedule II controlled substances, whereas tramadol is treated as a Schedule IV substance.
Nonetheless, both drugs can be addictive, especially when taken for a prolonged time or abused (i.e., taken in any other way than prescribed).
Tramadol vs. Oxycodone: Cost
Whether you’re taking tramadol or oxycodone, the cost of your medication will primarily depend on the strength of your prescription, the drug’s formulation, your insurance coverage, and other similar factors. As a general rule, generic opioids are cheaper than brand-name ones. They are also more likely to be covered by insurance plans.
To give you a better picture, one generic tablet containing 5 mg of oxycodone should cost you no more than $0.64, whereas a single 5 mg tablet of Oxaydo® may cost as much as $11.
Similarly, a generic 50 mg tramadol tablet can cost up to $1.29, while the price of one Ultram® tablet is around $6.
Now, let’s compare tramadol vs. oxycodone side effects.
Tramadol vs. Oxycodone: Side Effects
Tramadol and oxycodone can cause many of the same side effects, including:
- Nausea
- Vomiting
- Itchy skin
- Dizziness
- Headache
- Dry mouth
- Drowsiness
- Constipation
- Trouble falling or staying asleep
When it comes to constipation in tramadol vs. oxycodone users, both drugs are very likely to cause this unwanted effect. However, a study by researchers from Massachusetts General Hospital demonstrates that tramadol users suffer from constipation for a shorter time than those who take oxycodone.
Although the study also suggests that oxycodone-induced nausea and dizziness last longer, researchers from the University Hospital Ghent found that nausea is significantly more prevalent among tramadol users. Not only that, but tramadol is also more likely to lead to serious adverse events, such as delirium, pulmonary edema, and seizures.
Moreover, long-term use of tramadol and oxycodone may lead to:
- Tolerance
- Opioid dependence
- Tramadol or oxycodone addiction
- Liver, kidney, and other organ damage
- Respiratory depression
- Opioid overdose
- Death
Inform your doctor about any side effects you experience while taking tramadol or oxycodone, including those not mentioned above. Importantly, mixing opioids with other drugs increases the risk of adverse effects.
Let’s discuss tramadol and oxycodone drug interactions.
Tramadol and Oxycodone Drug Interactions
Tramadol and oxycodone may interact with various drugs, including but not limited to:
- Antibiotics
- Other opioids
- Antihistamines
- Anticonvulsants
- Muscle relaxers
- Sleep medications
- Anxiety medications
- Antifungal medications
Mixing oxycodone and tramadol with alcohol or the above-mentioned medications increases the risk of opioid overdose, which can be deadly if not treated on time. Some substances, including grapefruit juice, can also impact your body’s ability to metabolize these opioids, increasing the intensity and duration of their effects.
Moreover, you should never mix tramadol with other serotonergic drugs (e.g., sertraline, citalopram, etc.), as this can lead to a potentially life-threatening serotonin syndrome. Some herbal medicines, such as St. John’s wort, can also increase this risk.
If you take any medications or supplements, consult with your doctor to ensure they can be safely taken with tramadol or oxycodone before initiating opioid therapy.
Other Risk Factors of Tramadol and Oxycodone
Some risk factors that may increase the risk of side effects, overdose, and other adverse events associated with tramadol and oxycodone include:
- Liver damage
- Heart disease
- Mental disorders
- Kidney problems
- Urinary problems
- Gastrointestinal problems
- Allergy to opioids or SNRIs
- Alcohol use disorder (AUD)
- Lung disease (e.g., asthma)
- Brain disorders (head injury, tumors, etc.)
Moreover, tramadol may not be suitable for those with seizure disorders, as it can trigger convulsions. Discuss your full medical history with your doctor to reduce the risks associated with tramadol and oxycodone.
Opioid use during pregnancy can lead to neonatal abstinence syndrome (NAS), stillbirth, birth defects, and other adverse events. Therefore, using tramadol and oxycodone during pregnancy is generally not recommended.
Physical Dependence and Addiction to Opioids
Oxycodone and tramadol can lead to physical dependence and addiction to opioids, even when taken as instructed. Since repeated opioid exposure causes the brain to stop producing endorphins and increases the production of opioid receptors, anyone taking these medications for a prolonged time will eventually become physically dependent on them.
If left untreated, opioid dependence can develop into an addiction, which is primarily psychological. People struggling with oxycodone or tramadol addiction can no longer control their opioid use; they cannot help but continue taking these drugs, even if it negatively impacts their personal or professional lives.
Let’s see how you can recognize tramadol or oxycodone dependence.
Signs and Symptoms of Opioid Dependence
Opioid dependence is characterized by tolerance and opioid withdrawal symptoms that occur upon drug discontinuation.
With repeated opioid use, the brain begins to produce more and more opioid receptors, leading to tolerance. This is why your usual dose will eventually lose its effectiveness if you take tramadol or oxycodone for an extended time.
If this happens, do not increase your dosage. This constitutes opioid abuse and can lead to opioid toxicity and overdose. Instead, consult with your doctor.
Moreover, opioid-dependent people experience uncomfortable withdrawal symptoms, such as cravings, diarrhea, and fever, once the drug leaves their bodies. Unfortunately, it’s not unusual for people to keep taking opioids for months and even years to keep withdrawal symptoms at bay and maintain normal functioning.
Luckily, opioid dependence can be treated, regardless of how long you’ve been battling it.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is an innovative treatment developed by Dr. Andre Waismann. As the first and only treatment that addresses the neurochemical causes of opioid dependence, ANR has enabled close to 25,000 people worldwide to overcome opioid dependence quickly, safely, and effectively.
The ANR treatment differs from traditional opioid addiction treatments in that it re-regulates the endorphin-receptor system, fixing opioid-induced chemical changes. In doing so, it restores the brain to its pre-addiction state, eliminating withdrawal symptoms and negating the risk of relapse.
Most importantly, ANR is very safe and can be safely performed even on those with co-occurring medical conditions, as the treatment is personalized for each patient individually. For maximum safety, ANR is carried out in an ICU setting of fully accredited hospitals by highly experienced and compassionate board-certified medical professionals.
The ANR procedure takes 4–6 hours, whereas the average hospital stay for ANR patients lasts approximately 36 hours.
Contact us today for a free, 100% confidential consultation—we’ll be happy to answer your questions and help you get started with the treatment.
Key Takeaways
Let’s go over the key points we covered today:
- Tramadol and oxycodone are opioid medications prescribed to manage moderate-to-severe pain.
- Compared to oxycodone, tramadol is less potent and addictive; however, it provides a similar level of pain relief.
- Although tramadol and oxycodone cause similar side effects, tramadol is more likely to cause severe adverse events like seizures.
- ANR is a revolutionary opioid dependence treatment that can help you break the cycle of tramadol or oxycodone dependence within days by repairing the opioid-induced chemical imbalance.
Tramadol vs. Oxycodone FAQ
You should not take tramadol with oxycodone. Mixing opioids significantly increases the risk of opioid toxicity, overdose, respiratory depression, and other life-threatening adverse effects.
Tramadol is not stronger than morphine. On the contrary, it is about 10 times less potent than morphine. Nonetheless, tramadol is an opioid and thus carries similar risks to morphine.
Tramadol is slightly stronger than codeine, though both drugs are considered weak compared to other opioids. Still, they are more potent than acetaminophen and other over-the-counter medications.
Tapentadol is a painkiller similar to tramadol. Like tramadol, tapentadol is an atypical opioid with a dual mechanism of action. It is also considered relatively weak compared to most other opioids.
As a Schedule II controlled substance, oxycodone is more addictive than tramadol. Although both drugs can lead to opioid addiction, tramadol is treated as a Schedule IV controlled substance due to its lower potential for abuse and addiction.
You should never use tramadol or oxycodone with alcohol. The combination of oxycodone or tramadol and alcohol can be life-threatening, leading to respiratory depression, severe side effects, overdose, and death. Not to mention, mixing opioids with other substances without the doctor’s approval is considered opioid abuse.
No, tramadol is not a muscle relaxer. It is an opioid that works by affecting the transmission of pain signals. However, it does not directly affect muscle function.
You should not use tramadol or oxycodone while pregnant unless instructed otherwise by your healthcare provider. Taking opioids during pregnancy can be dangerous for the baby and the mother alike, increasing the risk of maternal death, miscarriage, NAS, and more.
You should not alternate between tramadol and oxycodone unless you have been specifically directed to do so by your doctor. Mixing these opioids can be very dangerous, especially since tramadol vs. oxycodone dosages differ quite drastically.
For example, tramadol comes in 25 mg, 30 mg, and 100 mg tablets, whereas oxycodone comes in 5–30 mg tablets. If you’re using tramadol, taking the same amount of oxycodone can be potentially life-threatening due to the difference in their potencies.
Also Read:
Tramadol Overdose: Signs, Symptoms & Treatment
Using Prescription Opioids for Chronic Pain: Risks & Effects
