Tramadol and hydrocodone are prescription narcotic pain medications. They belong to a class of drugs called opioids.

Opioids work by attaching to special receptors in the brain that control pain and emotion. Some opioids can also help control a cough and make a person feel relaxed and euphoric.

Like all opioids, tramadol and hydrocodone carry a high risk of addiction and potential overdose. For this reason, a doctor should prescribe them at the lowest possible dose for the shortest amount of time.

In this article, learn about the risks and benefits of these medications and the differences between them.

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Tramadol and hydrocodone are opioids for pain relief.

Tramadol and hydrocodone change the way in which the brain responds to pain. As with other opioids, they reduce pain and may make a person feel better emotionally.

Each of these drugs is available under various brand names, as a generic, and as a combination drug with acetaminophen (Tylenol).

Doctors consider tramadol to be milder than hydrocodone, so they may prescribe it for pain that is not as severe.

If a person is not getting relief from tramadol or other milder opioids, a doctor may prescribe hydrocodone.

Sometimes an adult may take hydrocodone to treat a severe cough, as it helps decrease activity in the brain that causes coughing. Doctors do not typically prescribe tramadol for this purpose.

People may take tramadol or hydrocodone following surgery, after a serious accident, or for health conditions that cause severe pain.

A prescription is necessary for both drugs and, due to the risks of misuse and overdose, people should only take them for short periods at the lowest possible dose.

People with specific types of coughs, such as those resulting from lung cancer, may use hydrocodone for cough relief. However, this medication does not work for all types of cough.

As tramadol is less potent, doctors may prescribe it for slightly milder pain. They will generally only recommend hydrocodone if someone has severe pain that they cannot manage with tramadol or other weaker opioids.

Hydrocodone and tramadol usually come in the form of a pill. A person should swallow the pill whole and avoid breaking or crushing it.

Breaking or crushing pills can cause too much of the medication to enter the body at once, leading to a dangerous overdose.

Once a person has finished taking tramadol or hydrocodone, they should dispose of any leftover pills properly.

The United States Food and Drug Administration (FDA) recommend that people take these medications to an approved medication disposal site.

The National Association of Boards of Pharmacy website includes information about medication disposal sites. People should not keep tramadol and hydrocodone in the home once they have stopped taking them.

The FDA advise that children under the age of 18 years should not take hydrocodone or other opioids, such as codeine.

They also state that doctors should not prescribe tramadol for children who are younger than 12. Tramadol can cause dangerous side effects in children between the ages of 12 and 18 if they have certain existing medical conditions.

Children who take either of these medications are at risk of life-threatening breathing problems, addiction, overdose, and death.

Women who are pregnant or who plan to become pregnant should not take tramadol or hydrocodone. Taking these medications or other opioids during pregnancy can cause life-threatening health problems in the baby after birth.

Women who are breastfeeding should also avoid taking opioids, including tramadol and hydrocodone, as the baby can receive unsafe levels of these drugs through breast milk.

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Heartburn can be a side effect of both tramadol and hydrocodone.

The side effects of tramadol and hydrocodone vary from person to person but may include:

  • drowsiness
  • dizziness, lightheadedness, or fainting
  • constipation
  • sleep problems or being very sleepy
  • headaches
  • anxiety or nervousness
  • shaking
  • mood changes
  • dry mouth
  • heartburn
  • nausea
  • lack of appetite
  • changes in the menstrual cycle
  • loss of sexual desire

Occasionally, tramadol or hydrocodone can cause severe side effects that require emergency medical attention, including:

  • seizures
  • hives, a rash, or blisters
  • difficulty breathing or swallowing
  • swelling of the face, throat, tongue, lips, or other parts of the body
  • hoarse voice
  • hallucinations, or seeing or hearing things that are not there
  • confusion
  • shivering or twitching
  • agitation or severe mood changes
  • muscle stiffness or loss of coordination
  • vomiting or diarrhea

Tramadol and hydrocodone can have dangerous interactions with other medications and substances. These interactions can increase the risk of life-threatening side effects, such as breathing problems and coma. They can also be fatal.

It is crucial for a person to tell a doctor about all the medications and supplements that they are taking before using tramadol or hydrocodone.

Drinking alcohol or taking illicit drugs while taking tramadol or hydrocodone can cause dangerous or fatal side effects.

Other medications and supplements that can cause adverse interactions with tramadol and hydrocodone include:

  • antibiotics
  • antidepressants
  • antipsychotics and anti-anxiety medications
  • allergy medicines, or antihistamines
  • benzodiazepines
  • cold medicines
  • cough medicines
  • fungal infection medications
  • heart rhythm medications
  • HIV medications
  • irritable bowel medicines
  • laxatives
  • muscle relaxants
  • nausea medications
  • Parkinson’s disease medications
  • prescription and over-the-counter (OTC) pain relievers
  • sedatives or tranquilizers
  • seizure medications
  • sleeping pills
  • St. John’s wort
  • tryptophan
  • ulcer medications
  • urinary problem medications

When medicines combine tramadol or hydrocodone with acetaminophen, there are other interactions to consider. For example, taking additional acetaminophen with the medication can lead to liver damage.

Other medications, vitamins, and supplements can also cause dangerous effects when people take them with hydrocodone or tramadol, so it is essential that people make a doctor aware of everything that they are taking.

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A person should always consult a doctor before taking prescription opioids.

It is vital to never take prescription opioids, such as tramadol or hydrocodone, without a doctor’s prescription and guidance. Taking these medications at the wrong dose or for an extended period can lead to addiction and overdose.

People should see a doctor if pain is interfering with their daily life and OTC pain relievers are not providing relief. A doctor can recommend a suitable treatment to help control the pain.

If a woman takes tramadol or hydrocodone during pregnancy, the baby may experience severe withdrawal symptoms after birth. These symptoms may include extreme irritability, high-pitched crying, shaking, vomiting, diarrhea, unusual sleep patterns, and lack of weight gain.

People who think that they may be addicted to an opioid medication should seek medical help. They can also call the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP.

A range of treatments is available to help a person stop taking opioids safely and minimize withdrawal symptoms.

Seek emergency medical care if a person who has been taking opioids shows signs of overdose, such as:

  • seizures
  • unconsciousness
  • pinpoint pupils
  • a limp, lifeless body
  • skin that looks pale or blue or feels cold
  • slowed breathing or struggling to breathe
  • choking, gasping, or gurgling

If a person has overdosed on opioids, call 911 or the local emergency services number and give them naloxone, if it is available.

Naloxone is a medication that can reverse an opioid overdose. It is available at some pharmacies.

While prescription opioids, such as tramadol and hydrocodone, are useful for severe pain and some types of cough, people should take them with caution and only as a doctor advises.

It is vital to be aware of the possible side effects and risks and to seek medical attention when necessary.

People should ensure that they keep all opioid medications away from children. When they are no longer taking the medicine, they should dispose of it at an approved medication disposal site.