Tramadol and Vicodin are prescription painkillers. Both contain opioid medications, and the benefits, risks and side effects vary slightly with each. Knowing the similarities and differences between these drugs may help people decide which is best for them.

Doctors prescribe tramadol and Vicodin for high levels of pain that over-the-counter (OTC) drugs cannot help, such as pain from an accident or medical procedures, such as surgery.

Anyone choosing between tramadol and Vicodin should consider the differences in benefits, side effects, and risks.

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Doctors prescribe tramadol and Vicodin for moderate to severe pain.

Tramadol acts in two ways in the body.

Firstly, it acts on the pain receptors in the brain to stop the body from feeling pain.

Secondly, tramadol works similarly to an antidepressant by maintaining levels of feel-good chemicals, such as serotonin and norepinephrine, in the brain.

A doctor will prescribe the drug in dosages appropriate to a person’s level of pain.

Typically, doctors will want to prescribe the lowest possible dose.

Tramadol helps relieve moderate to severe levels of short-term or chronic pain. The drug may work better for nerve pain.

Vicodin is a combination of the drugs hydrocodone and acetaminophen. Acetaminophen is a pain relief medication found in OTC drugs and hydrocodone is a prescription pain relief medicine.

According to a study posted to the Journal of Pain Research, doctors prescribe Vicodin more often than any other opioid medicine in the United States.

Vicodin offers pain relief to many people experiencing moderate to severe pain. Vicodin may also be an option for people who cannot take drugs, such as morphine or oxycodone.

Vicodin is available in tablet and liquid form, and the dosage a doctor prescribes depends on the level of pain the person feels.

Side effects of tramadol include:

Some people may experience an altered state of consciousness, making it dangerous to drive or operate machinery.

Many side effects resolve in a few days, but others may remain.

Other risks

Some people may have a severe allergic reaction to tramadol.

Anyone who experiences a swelling or itchy tongue, throat, or face should stop taking the drug and seek immediate medical attention.

Side effects of Vicodin include:

  • drowsiness
  • feeling dizzy or lightheaded
  • altered state of consciousness that may make basic functioning difficult
  • nausea
  • vomiting
  • constipation
  • low blood pressure

Severe allergic reactions are possible with Vicodin. Anyone experiencing signs of an allergic reaction, such as swelling or itching in the throat, face, and mouth, should seek emergency medical care.

People taking Vicodin may be at risk of becoming dependant on the drug.

Taking high or prolonged doses of pain relievers that contain acetaminophen, such as Vicodin, may put a person at risk of liver damage.

Avoid taking any other drugs containing acetaminophen, as an overdose can be harmful or fatal at high doses.

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A person should avoid alcohol when taking Vicodin or tramadol.

Vicodin may interact with other drugs and cause unwanted, potentially dangerous interactions.

Drugs that may interact with Vicodin include:

  • alcohol
  • orphenadrine
  • azelastine
  • eluxadoline
  • thalidomide
  • idelalisib
  • conivaptan
  • butorphanol
  • buprenorphine

The liver breaks down both hydrocodone and acetaminophen. Taking these drugs with others that affect the liver may lead to a buildup and toxicity, which could cause severe symptoms or potential liver failure.

This list is not comprehensive, and other drugs may interact with Vicodin. People should always tell their doctor about all the drugs they are taking before using Vicodin.

Anyone taking Vicodin should take care to read their other drug labels to check for possible interactions.

Interactions for tramadol are similar to Vicodin, with some distinctions.

Drugs that may interact with tramadol include:

  • alcohol
  • orphenadrine
  • azelastine
  • eluxadoline
  • thalidomide
  • butorphanol
  • buprenorphine
  • carbamazepine
  • nalbuphine

Other drugs may interact with tramadol, and anyone considering taking tramadol for pain relief must let their doctor know about all the medications they are taking.

Vicodin carries a high risk of overdose. According to the Journal of Pain Research, hydrocodone is responsible for some of the highest rates of emergency room visits by people who have overdosed on opioids.

However, it is also possible to overdose on tramadol. The risk of overdosing on tramadol may be higher when people are using tramadol with alcohol or other central nervous system depressants. An overdose of tramadol can be fatal.

Older people may be at higher risk from opioids. The medication may make it difficult for them to urinate or have a bowel movement. Some people may experience severe mood changes or become confused while on or off the drug.

Severe complications

Using opioids may lead to severe complications in some people, including:

  • a rapid heartbeat
  • seizures
  • adrenal insufficiency

Vicodin and tramadol may also affect the parts of the brain that control essential bodily processes, such as breathing. Taking too much Vicodin or tramadol may make it difficult to breathe or cause a person to stop breathing altogether.

Anyone experiencing these symptoms should seek emergency medical care.

Potential for addiction or dependency

Opioids may lead to dependency because they act on pleasure receptors in the brain called opioid receptors.

Stimulating these receptors may lead to the body wanting more of the drug, which could lead to dependence.

These drugs may also cause withdrawal symptoms when the person stops taking them. Doctors may help the person taper off the drugs slowly to avoid withdrawal once they complete their prescription.

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Women may prefer not to take tramadol or Vicodin when pregnant or breastfeeding.

People who have the following conditions should use opioid drugs, such as tramadol or Vicodin, with caution:

  • any liver conditions
  • kidney disease or kidney failure
  • brain conditions, such as dementia
  • chronic obstructive pulmonary disorder (COPD)
  • cardiovascular diseases

Anyone pregnant or breastfeeding may also want to avoid them to reduce any risk to the baby.

The drugs may also pass through a woman’s milk to the baby. Women who are pregnant should discuss better options for pain relief with their doctor.

People with young children may want to avoid these drugs as well, as even a single accidental dose may be fatal in young children.

People with a history of addiction or who are in recovery may also want to stay away from these drugs and talk to their doctor about all their options to control pain. Opioid drugs may not be right for people who are depressed or have suicidal thoughts.

Tramadol and Vicodin are powerful prescription drugs, and a person should choose between them with care. People should always work with their doctors to find the best solution to their pain.

Working directly with a doctor, most people can use drugs like tramadol or Vicodin to successfully find relief from their pain while reducing their risk for complications.