Tramadol vs. Vicodin: Differences, side effects, and risks

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.

Tramadol benefits

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 benefits

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.

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

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.

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.

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