Gabapentin vs. Tramadol

  • 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's the Difference Between Gabapentin and Tramadol?

What Are Gabapentin and Tramadol?

Gabapentin is an anti-seizure (anticonvulsant) drug that is used for preventing seizures and for treating post-herpetic neuralgia, the pain that follows an episode of shingles. Other off-label uses for gabapentin include anxiety, alcohol withdrawal, cocaine withdrawal, hiccups, restless leg syndrome, hyperhidrosis, headaches, diabetic neuropathy, hot flashes, and fibromyalgia.

Tramadol is an opioid pain reliever (analgesic) used to manage moderate to moderately severe pain. The exact mechanism of action of tramadol is unknown, but it is similar to morphine. Like other narcotics used to treat pain, patients taking tramadol may abuse the drug and become addicted to it. Tramadol is not a nonsteroidal anti-inflammatory drug (NSAID) and it does not have the increased risk of stomach ulcers and internal bleeding that can occur with NSAIDs.

What Are the Side Effects of Gabapentin and Tramadol?

Gabapentin

The most common side effects of gabapentin are:

Other adverse effects and serious side effects associated with gabapentin include:

Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

Tramadol

Tramadol is generally well tolerated, and side effects are usually temporary.

Commonly reported side effects include

Less commonly reported side effects include

Some patients who received tramadol have reported seizures. It may cause serotonin syndrome when combined with other drugs that also increase serotonin (see drug interactions section).

Is tramadol a narcotic? Is it addictive?

Tramadol is a narcotic and is addictive. Tramadol is a Schedule IV controlled substance that has been associated with addiction, abuse, and misuse. Tramadol may be addictive, even at the dosage your doctor has prescribed. Abuse or misuse of tramadol can lead to overdose and death.

Like other opioids, people who take tramadol for a long time will develop withdrawal symptoms if your doctor reduces the dosage, or if you suddenly stop taking tramadol.

Withdrawal symptoms that may occur include:

Infants born to mothers who were taking tramadol during the pregnancy will develop symptoms of withdrawal and difficulty breathing.

What Is the Dosage of Gabapentin vs. Tramadol?

Gabapentin

Gabapentin is available as:

  • Capsules: 100, 300, and 400 mg.
  • Tablets: 100, 300, 400, 600, and 800 mg.
  • Solution: 250 mg/5 ml

Tramadol

  • The recommended dose of tramadol is 50-100 mg (immediate release tablets) every 4-6 hours as needed for pain.
  • The maximum dose is 400 mg/day.
  • To improve tolerance patients should be started at 25 mg/day, and doses may be increased by 25-50 mg every 3 days to reach 50-100 mg/day every 4 to 6 hours.
  • The recommended dose for extended release tablets is 100 mg daily, which may be increased by 100 mg every 5 days, but not to exceed 300 mg /day. To convert from immediate release to extended release, the total daily dose should be rounded down to the nearest 100 mg. Extended release tablets should be swallowed whole and not crushed or chewed.
  • Tramadol may be taken with or without food.

What Drugs Interact with Gabapentin and Tramadol?

Gabapentin

Antacids reduce the concentration of gabapentin in blood. Therefore, gabapentin should be administered 2 hours or more after taking antacids. Morphine significantly increases blood concentrations of gabapentin and may increase central nervous system-related adverse events associated with gabapentin.

Tramadol

  • Carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol) reduces the effect of tramadol by increasing its inactivation in the body.
  • Quinidine (Quinaglute, Quinidex) reduces the inactivation of tramadol, thereby increasing the concentration of tramadol by 50% to 60%.
  • Combining tramadol with monoamine oxidase inhibitors or MAOIs (for example, tranylcypromine [Parnate]) or selective serotonin inhibitors (SSRIs), for example, fluoxetine (Prozac), may result in severe side effects such as seizures or a condition called serotonin syndrome.
  • Tramadol may increase central nervous system and respiratory depression when combined with alcohol, anesthetics, narcotics, tranquilizers, or sedative hypnotics. This can reduce the level of consciousness or lead to respiratory insufficiency.

Are Gabapentin and Tramadol Safe to Take While Pregnant or Breastfeeding?

Gabapentin

Doctors do not know the safety of gabapentin during pregnancy. Gabapentin is secreted in human breast milk; therefore, if you are pregnant you should only use this medication if the benefits outweigh the unknown risk to the fetus.

Tramadol

Researchers have not established the safety of tramadol during pregnancy, The safety of tramadol during pregnancy has not been established. Mothers who are breastfeeding should not take tramadol because the infant may develop side effects, and will develop symptoms of withdrawal and difficulty breathing.

Quick GuideChronic Pain Syndrome: Treatment and Management for CPS

Chronic Pain Syndrome: Treatment and Management for CPS

Summary

Gabapentin and tramadol are used to treat different types of pain. Gabapentin is an anti-seizure (anticonvulsant) medication also used for nerve pain (neuralgia). Tramadol is an opioid pain reliever (analgesic) used to manage moderate to moderately severe pain.

Treatment & Diagnosis

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Medically Reviewed on 3/22/2018
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