What is the Difference Between Tramadol and Hydrocodone

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What is the Difference Between Tramadol and Hydrocodone

Opioids are a class of drugs that are primarily used to treat pain.[1] They are only available by prescription and are considered habit-forming and addictive. For this reason, doctors only prescribe opioids for pain relief on a short-term basis.

Some of the most commonly prescribed opioids include tramadol and hydrocodone. While both substances can lead to addiction, hydrocodone is considered more potent than tramadol. Additionally, tramadol is a fully synthetic opioid, while hydrocodone is only partially synthetic.

Tramadol and hydrocodone have many differences despite belonging to the same class of drugs. In this article, you will learn:

  • What tramadol is
  • What hydrocodone is
  • The differences between hydrocodone and tramadol

What is Tramadol?

Tramadol is a prescription opioid medication that is used as a pain reliever. It changes the way your brain responds to pain signals sent by the body. You might be prescribed tramadol under the brand names Ultram or ConZip.

This medication is available in both immediate and extended-release tablets. A liquid solution is also available for patients who cannot swallow a pill.

The side effects of tramadol include:[2]

  • Sleepiness or fatigue
  • Headaches
  • Anxiety or nervousness
  • Excessive shaking or tremors
  • Changes in mood
  • Heartburn and indigestion
  • Dry mouth

Some people might abuse tramadol to experience a drowsy and euphoric high. Unfortunately, doing so could lead to a severe substance use disorder. For this reason, tramadol is considered a controlled substance.

What is Hydrocodone?

Hydrocodone is a prescription opioid pain medication that is also used as an antitussive (cough medicine). Doctors only prescribe it to treat moderate to severe pain when other pain medications are not effective. You might find hydrocodone under the brand names Vicodin or Lortab.

Vicodin contains hydrocodone and acetaminophen. Acetaminophen is a non-opioid pain reliever that can increase the benefits of hydrocodone.

The common side effects of hydrocodone include:[3]

  • Tiredness and fatigue
  • Stomach pain
  • Dry mouth
  • Headaches
  • Back pain
  • Muscle tightening
  • Ringing in the ears
  • Trouble sleeping
  • Shaking or tremors
  • Increased sweating

Since hydrocodone is an opioid, many people misuse it. This medication is also a controlled substance, much like tramadol, however, hydrocodone is considered to be more potent, making it more dangerous and addictive.

Tramadol vs Hydrocodone: Understanding the Differences

While tramadol and hydrocodone share similarities like belonging to the opioid drug class and being addictive, there are several key differences. These include:

Type of Opioid

Tramadol is a synthetic opioid. It is created in a lab and is designed to mimic naturally occurring opiates. Instead of coming from the poppy plant, scientists synthesize this medication.

On the other hand, hydrocodone is considered a semi-synthetic opioid.[4] This means that while it is created in a lab, it is derived from the naturally occurring poppy plant. Scientists use naturally occurring compounds to manufacture it.


Both tramadol and hydrocodone are considered to be potent opioids, however, one medication is stronger than the other. Hydrocodone is thought to be much more potent than tramadol.

This means:

  1. Hydrocodone might be more effective for severe pain than tramadol
  2. Hydrocodone has a higher risk of abuse and addiction than tramadol

That said, both substances should be taken with caution. You should never take any opioids long-term or use a higher dose than you are prescribed.

Risk of Addiction

Drug scheduling was created to identify which substances had the highest risk of addiction and what restrictions should be placed on them. The drugs with the most significant risk of abuse are Schedule I drugs, while Schedule V drugs have the lowest risk.

Tramadol is considered a Schedule IV drug, which means it has medicinal uses and a low potential for abuse. On the other hand, hydrocodone is a Schedule II drug, meaning despite its medicinal uses, it has a high potential for abuse.[5]

Efficacy for Pain

While there is limited research done comparing the effectiveness of tramadol and hydrocodone for pain, there are some studies to take a look at. For example, a double-blind study had some patients taking hydrocodone to treat their pain while others took tramadol. They found that hydrocodone was more effective in treating the patient’s pain.[6]

Another study found that tramadol has a lower risk of causing side effects than hydrocodone.[7]

There are benefits and risks to taking either medication for pain. You should always remember that long-term use of tramadol or hydrocodone will lead to dependency. Additionally, taking higher doses than you are prescribed can trigger a substance use disorder.

Get Help for Opioid Abuse and Addiction Today

If you or a loved one suffers from painkiller addiction, it’s time to seek help. Both tramadol and hydrocodone can lead to the development of a substance use disorder. Unfortunately, being addicted to opioids puts you at a high risk of overdosing.

Attending opioid rehab can prevent you from experiencing the consequences of opioid abuse. Contact Archstone Behavioral Health today for more information on our opioid addiction treatment center.


  1. The American Society of Anesthesiologists: What are Opioids?
  2. Medline Plus: Tramadol
  3. The U.S. Department of Veterans Affairs (VA): Hydrocodone Bitartrate Extended-Release Tablets
  4. Sciencedirect.com: Semisynthetic opioids
  5. The Drug Enforcement Administration (DEA): Drug Scheduling
  6. American Family Physician: Efficacy of Tramadol vs. Hydrocodone-Acetaminophen
  7. The National Library of Medicine (NLM): Hydrocodone/acetaminophen and tramadol chlorhydrate combination tablets for the management of chronic cancer pain: a double-blind comparative trial