Tramadol vs Hydrocodone, Are they Similar? Which one is Better For Pain?

Tramadol vs Hydrocodone Comparison

Both tramadol and hydrocodone alter how the brain senses pain. They are sold under numerous brand names, as generics, and in combinations with acetaminophen (Tylenol).

Tramadol is regarded as less intense than hydrocodone and may be prescribed by doctors for less severe pain. If tramadol or other milder opioids do not provide relief, a doctor may prescribe hydrocodone.

Adults may use hydrocodone to relieve severe coughing because it decreases activity in the brain that causes coughing. Doctors, on the other hand, rarely prescribe tramadol for this purpose.

Who is Advised to Take Tramadol and Hydrocodone?

These medications are typically prescribed post-surgery for severe pain resulting from a significant injury or for specific health conditions causing intense pain.

Due to the risk of misuse and overdose, it’s crucial to use these drugs for brief periods and at the lowest effective dosage possible.

Hydrocodone might relieve coughs associated with certain conditions, like lung cancer. However, it’s important to note that it doesn’t effectively treat all coughs.

Tramadol, being less potent, is usually prescribed for moderate pain. In contrast, hydrocodone is recommended for severe pain unmanageable by tramadol or other weaker opioids.

Both tramadol and hydrocodone are typically in pill form and should be swallowed whole. It’s crucial to avoid breaking or crushing these pills, as it can result in dangerously high medication levels in the body, leading to an overdose.

After completing the course, it’s essential to dispose of any remaining pills appropriately. As the National Association of Boards of Pharmacy website details, the FDA advises using approved medication disposal sites. Refrain from keeping tramadol and hydrocodone in the household after treatment is completed.

Difference in Side-Effects of Tramadol and Hydrocodone

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

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Who Should Not Be Taking Tramadol and Hydrocodone?

Individuals falling under these categories should avoid tramadol and hydrocodone:

1. Children and Adolescents: The FDA strongly advises against administering hydrocodone or other opioids, like codeine, to children under 18 years old. Similarly, tramadol should not be prescribed to children under 12 years old due to potentially severe side effects in individuals between 12 and 18 years old with specific medical conditions. These medications pose risks of life-threatening breathing problems, addiction, overdose, and fatality in children.
2. Pregnant Women: Both tramadol and hydrocodone are not recommended for pregnant women or those planning pregnancy. The use of these medications, or any other opioids, during pregnancy may result in serious health complications in newborns after delivery.
3. Breastfeeding Women: Women who breastfeed should also abstain from taking opioids, including tramadol and hydrocodone. These drugs can be transferred through breast milk to infants, potentially exposing them to unsafe levels of medication.

Interactions of Tramadol and Hydrocodone With Other Drugs

Potential interactions with other drugs are a critical concern when taking tramadol or hydrocodone. These interactions could lead to severe side effects, including breathing problems, coma, or even fatality. Therefore, informing a healthcare professional about all ongoing medications and supplements is crucial before starting tramadol or hydrocodone.

Combining alcohol or illicit drugs with tramadol or hydrocodone can result in hazardous or fatal reactions.

Numerous medications and supplements might interact adversely with tramadol and hydrocodone, such as:

• Antibiotics.
• Antidepressants.
• Anti-anxiety medications.
• Antipsychotics.
• Allergy medications (antihistamines).
• Benzodiazepines.
• Cold and cough medicines.
• Fungal infection medications.
• Heart rhythm medications.
• HIV medications.
• Irritable bowel medications.
• Laxatives
• Muscle relaxants.
• Nausea medications.
• Parkinson’s disease medications.
• Prescription and over-the-counter pain relievers.
• Sedatives or tranquilizers.
• Seizure medications.
• Sleeping pills.
• St. John’s Wort.
• Tryptophan.
• Ulcer medications.
• Urinary problem medications.

When these drugs include acetaminophen along with tramadol or hydrocodone, additional concerns arise. Consuming extra acetaminophen alongside these medications could lead to liver damage.

Various medications, vitamins, and supplements might provoke dangerous effects when taken with hydrocodone or tramadol. Hence, informing a healthcare provider about all substances being taken is crucial.

Proper Dosages of Tramadol and Hydrocodone

Tramadol and hydrocodone doses are typically measured compared to morphine-equivalent doses, assessing the quantity needed to match a dose of morphine. While one 30 mg dose of hydrocodone equals a 30 mg dose of morphine, it takes 300 mg of tramadol to match a 30 mg dose of morphine or hydrocodone.

Tramadol is available in immediate-release tablet doses of 50 mg and 100 mg and extended-release capsules of 100 mg and 150 mg. For extended-release, dosages can reach up to 300 mg once a day. Immediate-release tramadol is administered up to 400 mg per day for individuals under 75 years old and up to 300 mg daily for those above 75.

In contrast, hydrocodone doses usually range from 2.5 mg to 10 mg, often in combination with 300 or 325 mg of acetaminophen. The maximum daily allowance for hydrocodone with acetaminophen should not exceed 60 mg of hydrocodone and 4,000 mg of acetaminophen.

Bioavailability

Bioavailability refers to the extent and rate at which a drug or substance is absorbed into the bloodstream or becomes available at the site of action after administration. It measures the amount of the administered dose that enters the systemic circulation and can produce an effect.

Regarding bioavailability, tramadol hydrochloride tablets boast a 75% bioavailability, whereas extended-release tramadol hydrochloride tablets range between 85% to 90%. Hydrocodone’s oral bioavailability is reported at 25%.

When shifting between extended-release hydrocodone products and hydrocodone bitartrate and acetaminophen tablets, the relative bioavailability remains unknown, necessitating close monitoring by a healthcare provider.

1.6 Million

An estimated 1.6 million people in the US were reported to have opioid use disorder in 2019, indicating a diagnosed addiction to opioids.

Source: NCBI

18%

In 2019, only about 18% of people with opioid use disorder received specialty treatment for their addiction.

Source: NSDUH