What is the difference between tramadol and hydrocodone?

Tramadol vs. hydrocodone

Tramadol and hydrocodone change the way in which the brain responds to pain. As with other opioids, they reduce pain and may make a person feel better emotionally.

Each of these drugs is available under various brand names, as a generic, and as a combination drug with acetaminophen (Tylenol). Hydrocodone is only available as a combination product.

A 2023 articleTrusted Source notes that hydrocodone is classed as a schedule II drug, and Tramadol is classed as schedule IV. This means that Tramadol has a lower risk of drug misuse than hydrocodone, so doctors may prescribe it for pain that is not as severe.

If a person is not getting relief from tramadol or other milder opioids, a doctor may prescribe hydrocodone.

Sometimes an adult may takeTrusted Source hydrocodone to treat a severe cough, as it helps decrease activity in the brain that causes coughing. Doctors do not typically prescribe tramadol for this purpose.

Who should take tramadol and hydrocodone?

People may take tramadol or hydrocodone following surgery, after a serious accident, or for health conditions that cause severe pain.

A prescription is necessary for both drugs and due to the risks of misuse and overdose, people should only take them for short periods at the lowest possible dose.

As tramadol is less potent, doctors may prescribe it for slightly milder pain. They will generally only recommend hydrocodone if someone has severe pain that they cannot manage with tramadol or other weaker opioids.

Hydrocodone and tramadol usually come in the form of a pill. A person should swallow the pill whole and avoid breaking or crushing it.

Breaking or crushing pills can cause too much of the medication to enter the body at once, leading to a dangerous overdose.

Once a person has finished taking tramadol or hydrocodone, they should dispose of any leftover pills properly.

The United States Food and Drug Administration (FDA)Trusted Source recommends that people take these medications to an approved medication disposal site.

The National Association of Boards of Pharmacy website includes information about medication disposal sites. People should not keep tramadol and hydrocodone in the home once they have stopped taking them.

Who should not take tramadol and hydrocodone?

The FDA advisesTrusted Source that children under the age of 18 years should not take hydrocodone or other opioids, such as codeine.

They also state that doctors should not prescribe tramadol for children who are younger than 12Trusted Source. Tramadol can cause dangerous side effects in children between the ages of 12 and 18 if they have certain existing medical conditions.

Children who take either of these medications are at risk of life threatening breathing problems, addiction, overdose, and death.

Opioids, pregnancy, and nursing

Those who are pregnant can takeTrusted Source opioids, such as Tramadol, as prescribed. However, it is important to discuss the potential risks of taking opioids during pregnancy as these medications can cause negative health effects on the fetus and pregnant person.

Women who are chestfeeding or breastfeeding should avoid taking opioids, including tramadol and hydrocodone, as the baby can receive unsafe levels of these drugs through breast milk.

If a person must take opioids while nursing, they should work with a healthcare professional and monitor the child for symptoms such as sedation and breathing difficulties.

Side effects

The side effects of tramadol and hydrocodone vary from person to person but may include:

• drowsiness
• dizziness, lightheadedness, or fainting
• constipation
• sleep problems or being very sleepy
• headaches
• anxiety or nervousness
• shaking
• mood changes
• dry mouth
• heartburn
• nausea
• lack of appetite
• changes in the menstrual cycle
• loss of sexual desire

Occasionally, tramadol or hydrocodone can cause severe side effects that require emergency medical attention, including:

• seizures
• hives, a rash, or blisters
• difficulty breathing or swallowing
• swelling of the face, throat, tongue, lips, or other parts of the body
• hoarse voice
• hallucinations, or seeing or hearing things that are not there
• confusion
• shivering or twitching
• agitation or severe mood changes
• muscle stiffness or loss of coordination
• vomiting or diarrhea

Interactions with other drugs

Tramadol and hydrocodone can have dangerous interactions with other medications and substances. These interactions can increase the risk of life threatening side effects, such as breathing problems and coma. They can also be fatal.

It is crucial for a person to tell a doctor about all the medications and supplements that they are taking before using tramadol or hydrocodone.

Drinking alcohol or taking illegal drugs while taking tramadol or hydrocodone can cause dangerous or fatal side effects.

Other medications and supplements that can cause adverse interactions with tramadolTrusted Source and hydrocodoneTrusted Source:

• CNS depressants, such as alcohol, benzodiazepines, and other opioids
• CYP3A4 inhibitors, such as ketoconazole, azithromycin, and erythromycin
• CYP3A4 inducers, such as rifampin, phenytoin, carbamazepine
• antidepressants
• antipsychotics
• muscle relaxants
• anticholinergic drugs

When medicines combine tramadol or hydrocodone with acetaminophen, there are other interactions to consider. For example, taking additional acetaminophen with the medication can lead to liver damage.

Other medications, vitamins, and supplements can also cause dangerous effects when people take them with hydrocodone or tramadol, so it is essential that people make a doctor aware of everything that they are taking.

When to contact a doctor

It is vital to never take prescription opioids, such as tramadol or hydrocodone, without a doctor’s prescription and guidance. Taking these medications at the wrong dose or for an extended period can lead to addiction and overdose.

People should contact a doctor if they are experiencing pain that is interfering with their daily life and OTC pain relievers are not providing relief. A doctor can recommend a suitable treatment to help control the pain.

People who think that they may be addicted to an opioid medication should seek medical help. They can also call the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP.

A range of treatments is available to help a person stop taking opioids safely and minimize withdrawal symptoms.

Seek emergency medical care if a person who has been taking opioids shows signs of overdose, such as:

• seizures
• unconsciousness
• pinpoint pupils
• a limp, lifeless body
• skin that looks pale or blue or feels cold
• slowed breathing or struggling to breathe
• choking, gasping, or gurgling

If a person has overdosed on opioids, call 911 or the local emergency services number and give them naloxone, if it is available.

Naloxone is a medication that can reverse an opioid overdose. It is available to purchase over the counter as of 2023Trusted Source in the form of a nasal spray.

Summary

While prescription opioids, such as tramadol and hydrocodone, are useful for severe pain and some types of cough, people should take them with caution and only as a doctor advises.

It is vital to be aware of the possible side effects and risks and to seek medical attention when necessary.

People should ensure that they keep all opioid medications away from children. When they are no longer taking the medication, they should dispose of it at an approved medication disposal site.