Tramadol vs. Vicodin

  • 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.

Tramadol vs. Vicodin comparison

Tramadol (Ultram) and Vicodin (hydrocodone and acetaminophen) are both prescription opiates and narcotics for pain, though tramadol is weaker. Vicodin is used for people with severe pain that don't experience pain relief from weaker opiates like tramadol or codeine. Vicodin is combined with acetaminophen, which is an analgesic and antipyretic and the active ingredient in Tylenol. Vicodin is derived from the poppy plant like other narcotics, including morphine, oxycodone, heroin, and opium. The hydrocodone in Vicodin is also partially synthetic. Tramadol is completely synthetic.

Though Vicodin 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 are lower. That doesn't mean they're totally safe, however. Both can be physically and psychologically habit-forming.

Side effects for both drugs - aside from potential addiction and withdrawal - may include dizziness, confusion, sedation, constipation and others.

Tramadol is a pure, single-component pain medication. Vicodin is a combination of hydrocodone and acetaminophen, an adjunctive pain and fever reducer.

Neither tramadol nor Vicodin should be taken with alcohol or other sedatives or tranquilizers because they may potentially magnify the effects. Particularly dangerous is the potential for respiratory depression, which can make you stop breathing if you take too much of either Vicodin or tramadol, or mix either of them with the wrong medication.

What are tramadol and Vicodin?

Tramadol and Vicodin are both opiates, and Vicodin includes the pain reliever and fever reducer acetaminophen. The hydrocodone in Vicodin is made from the poppy plant, just like morphine, heroin, and opium. Tramadol is chemically similar to Vicodin, but it's synthesized from precursor molecules in a lab. Many doctors like it because it has a lower potential for addiction than other opioids, though that doesn't mean it's non-addictive.

Opiates work because the central nervous system has three main 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. These receptors are named after Greek letters: Mu receptors, Delta receptors, and Kappa receptors. They sit on the membrane of nerve cells and activate when an opioid, whether naturally occurring in the body or introduced in the form of a drug, fits into the molecule like a key in a lock.

Opiate drugs mimic the natural opioids produced by the body. Their molecules fit into the same receptors and activate them. Vicodin, tramadol, morphine, and all other poppy derivatives target and activate mostly the Mu receptors, meaning they are "Mu receptor agonists."

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 Mu receptors with pharmaceutical opioids like Vicodin, 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 reward pathways, pharmaceutical opioids are highly addictive. Endorphins are the main endogenous opioids your nervous system secretes in response to sex, a delicious meal, and other forms of pleasure. Because opiate drugs activate the same Mu receptors endorphins do, euphoria and a 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.

Tramadol and Vicodin are much less potent in their usual doses than other opiates like morphine, heroin, and its synthetic counterpart Fentanyl. Because of this, short-term use of tramadol for moderate pain symptoms comes with a relatively low risk of addiction or withdrawal. Vicodin has a higher risk for addiction.

Acetaminophen works by elevating the threshold to pain, that is, in order for pain to be felt, greater stimulation of the nerves responsible for the sensation of pain is necessary. It reduces fever through its action on the temperature-regulating center of the brain. Frequently, hydrocodone and acetaminophen are combined to achieve pain relief, as in Vicodin and Lortab.

Medically Reviewed by a Doctor on 5/9/2017

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