When it comes to managing moderate-to-severe pain, you’ve likely run into the tramadol vs. Percocet dilemma.
Both of these prescription painkillers belong to the opioid family, however, they differ significantly in potency, side effects, and risk of addiction.
In this article, we will compare Tramadol vs. Percocet in terms of effectiveness, side effects, and other key factors to help you better understand their similarities and differences.
What Is Tramadol?
Tramadol, which is also sold under Ultram®, ConZip®, QDOLO®, and other brand names, is a prescription opioid used to relieve moderate-to-severe pain. It is typically prescribed for pain that cannot be controlled with non-opioid medications, such as acetaminophen.
It’s produced by combining synthetic opioids with monoamine reuptake inhibitors (MRI). As such, it is classified both as an opioid and a serotonin-norepinephrine reuptake inhibitor (SNRI).
Tramadol comes in capsules, tablets, suspensions, and solutions, available in both immediate- and extended-release formulations. Some street names for this drug include Ultras, Chill Pills, and Trammies.
How Does Tramadol Work?
Tramadol works by binding to the opioid receptors in the central nervous system (CNS), thereby preventing pain signals from reaching the brain. It also works similarly to antidepressants, as it disrupts serotonin and norepinephrine reuptake.
Initially, tramadol was considered a safer alternative to traditional opioids. However, it affects the brain in much the same way as other opioids and can, therefore, lead to dependence and addiction, especially when taken for a prolonged time.
What Is Percocet?
Percocet is a combination medication prescribed to alleviate moderate-to-severe pain that cannot be managed with non-opioid painkillers. It contains two active ingredients:
- Oxycodone, a potent semi-synthetic opioid
- Acetaminophen, an over-the-counter pain reliever
Percocet is sold under its generic name—oxycodone/acetaminophen—and several other brand names, including Endocet® and Roxicet®. While its brand-name version is available only as tablets, generic Percocet also comes in oral solution.
Some street names for Percocet include Percs, Blue Dynamite, Kickers, and Buttons.
How Does Percocet Work?
Like tramadol, Percocet works by attaching to opioid receptors and interrupting the transmission of pain signals between the body and the brain. Even though effective, repeated exposure to this medication alters brain chemistry. Because of this, anyone taking this medication risks developing tolerance, dependence, and Percocet addiction.
What Are the Key Differences Between Tramadol vs. Percocet?
The key difference between tramadol vs. Percocet is that tramadol is among the weakest opioids, whereas Percocet is a very potent opioid medication. However, potency is just one of the several major differences between these drugs.
On that note, let’s compare tramadol vs. Percocet in terms of effectiveness, chemical composition, potential for addiction, and cost:
#1. Effectiveness
| Aspect | Percocet | Tramadol |
| Potency | Higher potency (roughly 8 times more potent than tramadol) | Lower potency |
| Effectiveness at Same Dose | More effective | Less effective |
| Pain Relief Quality | Strong pain relief | Some studies show similar or even better pain relief despite lower potency with fewer side effects |
#2. Chemical Composition
Chemical composition is another major difference between tramadol and Percocet, even though both medications are classified as opioids.
| Aspect | Percocet | Tramadol |
| Chemical Composition | Combination drug: acetaminophen + oxycodone (C₁₈H₂₁NO₄) | Single drug: tramadol (C₁₆H₂₅NO₂) |
| Origin | Semi-synthetic opioid (oxycodone derived from thebaine alkaloid from poppy plant) | Fully synthetic opioid (4-phenyl-piperidine analog of codeine) |
| Mechanism of Action | Pure opioid receptor activity | Dual action: opioid receptor + SNRI (serotonin/norepinephrine reuptake inhibitor); Mimics the effects of opiates without actually containing them |
#3. Addictiveness
| Aspect | Percocet | Tramadol |
| Controlled Substance Schedule | Schedule II | Schedule IV |
| Addiction Potential | Higher potential for abuse, dependence, and addiction | Lower potential for abuse, dependence, and addiction |
| Misuse Statistics (2021) | 2nd most commonly misused prescription painkiller in the US | 4th most commonly misused prescription painkiller in US |
#4. Cost
The cost of tramadol and Percocet varies based on the form, prescription strength, and other factors. Generic medications, often covered by insurance, typically cost about 80–85% less than brand-name ones.
| Aspect | Percocet | Tramadol |
| Generic Cost per Tablet | Up to $0.34 (325mg/5mg) | $0.08 – $1.29 (50mg) |
| Brand-Name Cost per Tablet | Around $28 | Up to $6 (Ultram®) |
Tramadol vs. Percocet Side Effects
Tramadol and Percocet usually produce similar side effects, such as:
- Fatigue
- Nausea
- Vomiting
- Headache
- Drowsiness
- Constipation
- Lightheadedness
- Sleep disturbances
Even though nausea is a common side effect for both medications, a study found that patients on tramadol experienced nausea more, to be precise 44% compared to 28% on Percocet. However, when it comes to breathing suppression, there is a risk with both drugs.
Furthermore, tramadol users face a higher risk of seizures than those who take Percocet. On the other hand, since Percocet contains acetaminophen, it is more likely to cause liver damage, especially when abused or mixed with other substances, such as alcohol.
However, taking either one of the drugs in large doses increases the risk of opioid overdose, which can be deadly.
Tramadol and Percocet Drug Interactions
Here are some of the most popular drugs tramadol and Percocet may interact with, increasing the risk of side effects and, in some cases, overdose:
- Alcohol
- Opioids
- Marijuana
- Antibiotics
- Antihistamines
- Muscle relaxants
- Anxiety medication
- Seizure medication
- Antifungal medication
Grapefruit juice can inhibit the metabolism of both tramadol and Percocet, which could cause them to build up in your body.
Moreover, you should not mix Percocet with medications containing acetaminophen due to the increased risk of acetaminophen toxicity and liver damage.
Meanwhile, taking tramadol with serotonergic drugs, such as antidepressants, can induce serotonin syndrome, a life-threatening condition.
If you take any medications, including supplements, talk to your doctor to ensure they can be safely taken with opioids.
Other Risk Factors of Tramadol and Percocet
The main risk factors that can increase the likelihood of adverse effects and other risks associated with tramadol and Percocet include:
- Head injury
- Liver damage
- Heart disease
- Kidney disease
- Thyroid disorders
- Gallbladder disease
- Alcohol use disorder (AUD)
- Lung problems, such as asthma
- Allergy to acetaminophen or opioids
Opioids like tramadol and Percocet can cause neonatal abstinence syndrome (NAS), which is why they shouldn’t be used during pregnancy or while nursing.
Furthermore, those with seizure disorders should ideally look for alternative treatment options to tramadol, as they face a higher risk of convulsions. Combining tramadol with other substances further increases this risk.
If you have a history of substance abuse or addiction, inform your doctor about it to reduce the risk of opioid use disorder (OUD).
Physical Dependence and Addiction to Opioids
Anyone who takes tramadol or Percocet risks developing physical dependence and addiction to opioids. This is because repeated exposure to either of these drugs stimulates the production of opioid receptors, leading to tolerance, which signifies you’ve become dependent on opioids.
It is of vital importance to treat opioid dependence. Otherwise, it can develop into addiction, which is characterized by the loss of control over opioid use; people addicted to opioids can’t help but take them, even when this wreaks havoc on their lives.
Tragically, many people resort to dangerous illicit drugs, such as heroin, after becoming addicted to opioids like tramadol and Percocet once they can no longer obtain them legally.
Signs and Symptoms of Opioid Dependence
Opioid dependence is characterized by two symptoms:
- Tolerance. This means you’ll no longer feel the effects of your medication without increasing the dosage. Once this happens, quitting opioids or reducing their dosage will bring about distressing withdrawal symptoms. In other words, you will need opioids to function normally.
- Opioid withdrawal symptoms. Many people continue taking opioids like tramadol and Percocet for months, years, and even decades just to prevent withdrawal symptoms and continue with their lives as normal. However, opioid dependence and addiction are treatable. The key to overcoming them is seeking professional opioid dependence treatment.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is an opioid dependence treatment that can help you overcome tramadol or Percocet dependence within a matter of days.
Developed by Dr. Andre Waismann, ANR is the only treatment that recognizes and addresses the neurobiological causes of opioid dependence.
By re-regulating the endorphin-receptor system, the ANR treatment reverses opioid-induced chemical changes and restores normal brain function. As a result, it eradicates withdrawal symptoms, including cravings, negating the risk of relapse and facilitating long-term recovery from opioid dependence.
Moreover, ANR is scientifically proven safe and can be performed even on patients with complex health conditions, such as heart or kidney disease. Each treatment is tailored to every patient individually and carried out in an ICU setting of accredited hospitals by highly experienced and compassionate board-certified healthcare professionals.
Key Takeaways
Both tramadol and Percocet can be addictive, even when taken as prescribed. For this reason, you should only take these medications if non-opioid treatment alternatives aren’t available.
Before you go, here’s a summary of the key points we covered in our guide:
- Tramadol and Percocet are opioid-based medications that can help ease moderate-to-severe pain, but they also cause opioid dependence.
- Compared to tramadol, Percocet is more potent and effective in relieving pain, but it also has a higher potential for addiction.
- Tramadol is more likely to cause seizures than Percocet and can lead to serotonin syndrome, whereas Percocet can damage the liver, especially when misused.
Tramadol vs. Percocet FAQ
Fentanyl is the strongest painkiller—it can be anywhere between 50 and 100 times stronger than morphine. Due to its exceptional potency, even minimal amounts of fentanyl can cause an overdose.
Percocet is stronger than tramadol. This is because it contains oxycodone, a powerful opioid that is 50% more potent than morphine. Meanwhile, tramadol is only 10% more potent than morphine.
Extended-release tramadol can be used to treat chronic pain. Though it provides around-the-clock pain relief, taking tramadol for an extended time isn’t recommended due to an increased risk of tramadol tolerance, dependence, and addiction.
Opioids come in various forms, including tablets. Some other popular forms include capsules, oral solutions, and injectable suspensions. Your doctor can help you determine the type of opioid, dosage, and form that best suits your needs.
Yes, tramadol can cause seizures, especially within 24 hours of intake. Risk increases with alcohol, illicit drugs, antipsychotics, or antidepressants.
No, neither is safe during pregnancy. Both can cause life-threatening withdrawal symptoms, seizures, fetal death, and miscarriage.
Alternatives include NSAIDs (ibuprofen), acetaminophen, aspirin, antidepressants, steroids, and the new FDA-approved suzetrigine. Non-drug options include physical therapy, exercise, aquatic therapy, resistance training, and botulinum toxin injections for specific conditions.
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