Tramadol vs. Hydrocodone

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What is the difference between tramadol and hydrocodone?

  • Tramadol (Ultram) and hydrocodone (Zohydro ER) are both prescription opiates and narcotics for pain, though tramadol is less potent.
  • Hydrocodone is used for people with severe pain that don't experience pain relief from weaker opiates like tramadol or codeine.
  • Hydrocodone is derived from the poppy plant like other narcotics, including morphine, oxycodone, heroin, and opium. Hydrocodone is also partially synthetic. Tramadol is completely synthetic.
  • Though hydrocodone is more potent than tramadol, in their usual doses, both these drugs are less potent that other opiates like morphine or fentanyl. This means their potential for addiction and withdrawal is lower, but is still a risk.
  • Side effects for both drugs - aside from potential addiction and withdrawal - may include dizziness, confusion, sedation, constipation and others.
  • Opiates work because the central nervous system has opioid receptors in the nerve cells that, when coupled with natural opioids your body makes, govern pain sensation, reward, aspects of gastrointestinal function, and aspects of respiratory function, and aspects of urogenital function.
  • Opiate drugs mimic the natural opioids produced by the body. Their molecules fit into the same receptors and activate them. Hydrocodone, tramadol, morphine, and all other poppy derivatives target and activate opioid receptors.
  • These receptors and the naturally occurring (endogenous) opioids they pair with are responsible for the body's own efforts to deaden pain. Because of this, flooding the receptors with pharmaceutical opioids like hydrocodone, tramadol, and others can increase the painkilling (analgesic) properties of that part of the central nervous system.
  • Unfortunately, because the endogenous opioid system also governs pleasure reactions, pharmaceutical opioids are highly addictive. Euphoria and profound sense of wellbeing are potential side effects of all the opiate drugs on the market. Patients can become addicted physically and mentally as both their bodies and minds begin to crave that state of bliss.
Medically Reviewed by a Doctor on 4/24/2017

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