Tramadol vs Hydrocodone

Tramadol and Hydrocodone
Tramadol and hydrocodone are two potent
pain relievers. They can be prescribed
individually or as combination drugs. These
drugs have a powerful effect on your brain.
They're both highly effective pain relievers,
but work in different ways and come with
their own side effects.
Read more to learn who they're for and why
they're categorized as controlled substances.

Side-by-Side Evaluation
Tramadol has two different actions in the
body. It is an opioid analgesic, which means
that it attaches to receptors in your brain to
change your perception of pain. It also works
like an antidepressant, prolonging the actions
of norepinephrine and serotonin in the
brain. Tramadol is available under several
brand names, including ConZip, Rybix ODT,
and Ultram. Another medication, Ultracet, is a
combination of tramadol and acetaminophen.
Hydrocodone is an extended release opioid
analgesic sold under the brand names
Zohydro ER and Hysingla ER. It's also an
ingredient in dozens of combination drugs,
including Vicodin and Vicodin ES.

Due to the potential for overdose and abuse,
in 2014 all hydrocodone products were moved
to a new category by the Food and Drug
Administration (FDA). They now require a
written prescription, which you must obtain
from your doctor and take to the pharmacy.
Tramadol is also a controlled drug, and
prescriptions can be called to pharmacies,
but many health systems are adopting more
stringent guidelines on prescribing this drug.
Both of these drugs can affect your driving,
since they make you drowsy. Do not drive or
operate machinery while taking them until
you know how you react to them.
Who They're For
These drugs are commonly used to treat pain
related to cancer or other chronic conditions.
They may also be prescribed following an
injury or surgical procedure. Tramadol and
hydrocodone are generally prescribed for
moderate to severe pain.
Zohydro ER and Hysingla ER are extended
release drugs, which are intended for severe
chronic pain when shorter acting
medications have been ineffective.
Forms and Dosages
Tramadol tablets are available in 50 and 100
mg strength and are usually taken several
times a day. Extended release versions come
in 100 mg, 150 mg, 200 mg, and 300 mg
strengths.
Hydrocodone extended release tablets are
available in strengths ranging from 20 mg up
to 120 mg. Extended release capsules come in
strengths ranging from 10 mg to 50 mg. It's
critical that extended release products are
taken whole. It's unsafe to break or chew
them.
Extended release capsules are generally
consumed once a day, or every 12 hours as
directed.
Because of their habit-forming properties,
your doctor will decide on the lowest possible
starting dose. The dosage can then be slowly
increased.
Because of the danger of abuse, these drugs
are classified as controlled substances. It's
illegal to give them to anyone else. The
dosage considered safe for one person could
be fatal to someone else.
Side Effects
Common side effects of tramadol include:
flushing
dizziness
congestion
sore throat
drowsiness
headache
itching
constipation
loss of appetite
nausea and vomiting
weakness
Most of these side effects will resolve within
a few days.
More serious side effects of tramadol can
include:
seizures
mood problems; there is an increased
risk of suicide in depressed patients
who take tramadol
hypersensitivity reaction, including
swelling of the tongue or throat,
trouble breathing, and skin rash
Get immediate medical attention (or call 911)
if you experience these symptoms.
Common side effects of hydrocodone include:
dizziness
drowsiness
itching
constipation
loss of appetite
nausea and vomiting
Most of these side effects will lessen with
time.
Serious side effects of hydrocodone can
include:
confusion or mood problems
low blood pressure
respiratory depression
gastric obstruction
hypersensitivity reaction, which could
include swelling of the tongue or
throat, trouble breathing, and skin rash
Get immediate medical attention (or call 911)
if you experience these symptoms.
Hydrocodone comes with a black box
warning about the potential for abuse and
misuse of this drug. According to the Drug
Enforcement Administration (DEA),
hydrocodone is associated with more drug
abuse than any other opioid.
Side effects of both drugs are more likely or
can be more intense, if you are a senior, if
you have kidney or liver disease, chronic
obstructive pulmonary disease, or other
chronic disease.

Warnings and Potential
Interactions
Signs of allergic reaction to these medications
include swelling of the tongue or throat,
trouble breathing, and skin rash. Get
immediate medical attention (or call 911) if
you experience these symptoms.
Your body may start to develop a tolerance to
opioids. This may require you to increase
your dosage to achieve the same effect. You
may experience symptoms of withdrawal
when you stop taking them. You're more
likely to develop a dependence on these
drugs if you have a history of drug or alcohol
abuse. If you have taken either drug for
weeks or months, you may need help from
your doctor to taper off the drug slowly to
help prevent withdrawal.
Women who take opioids during pregnancy
may give birth to babies who are dependent
on the drug, and will go through opioid
withdrawal. They may have to be given a
gradual, tapered dose of the drug to prevent
suffering. Opioids can also be passed to a
baby through breast milk.
Potential Interactions
Tramadol has several drug interactions. Tell
your doctor about all drugs and supplements
you take, before you start taking tramadol.
These drugs should not be taken with
tramadol:
carbamazepine
azelastine
orphenadrine
These are some of the drugs that interact
with tramadol, but you may still be able to
take them together. Talk to your doctor if you
are taking any of these drugs:
anticholinergic drugs (antihistamines,
drugs for urinary spasms and other
drugs)
other opioids
MAO inhibitors
St. John's wort
certain antidepressants
some antifungals
some HIV drugs
muscle relaxants
sleeping pills
triptans (used to treat migraine
headaches)
anxiety and psychiatric medications
warfarin
Hydrocodone has several drug interactions.
Tell your doctor about all drugs and
supplements you take before you start taking
hydrocodone.
These drugs should not be taken with
hydrocodone:
alcohol
azelastine
MAO inhibitors
orphenadrine
These are some of the drugs that interact
with hydrocodone, but you may still be able
to take them together. Talk to your doctor
before taking hydrocodone if you are taking
any of these drugs:
antidepressants
antihistamines
CNS depressants
CNS stimulants
magnesium sulfate
other opioids
sleeping pills and sedatives
sodium oxybate
Don't drink alcohol when taking opioids.
Other medications that cause sleepiness,
including cough or cold formulas, may
contain ingredients that interact with opioids
or increase the risk of sedation. Tell your
doctor and pharmacist about all the
medicines you're currently taking.
Deciding Which One to Take
Before your doctor can recommend an opioid,
it's important that you discuss all underlying
medical conditions. List all your over-the-
counter and prescription medications and
supplements. Tell your doctor if you've ever
had an alcohol or substance abuse problem.
Discuss the potential side effects and benefits
of these and other opioids with your doctor.
Together, you can choose the least potent
treatment necessary to alleviate your pain.
Once you start taking the medication, tell
your doctor about side effects right away so
the proper adjustments can be made.