Table of ContentsView AllTable of ContentsDifferencesUses of TramadolUses of OxycodoneWhich Is More Effective?Safety WarningsInteractionsFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Differences

Uses of Tramadol

Uses of Oxycodone

Which Is More Effective?

Safety Warnings

Interactions

Frequently Asked Questions

Tramadol (available under brand names such as Conzip and Ryzolt) and oxycodone (brand names include OxyContin and Xtampza ER) areopioid medicationsused for pain relief.

The main difference between tramadol and oxycodone is the difference in potency, or the amount of drug needed to produce its effects.

Tramadol is a weak opioid with weaker opioid-like properties than a potent opioid medication, such as oxycodone.Although both are controlled substances, meaning they have a potential fordependence and addiction, oxycodone has a higher risk of addiction and abuse.

This article will cover the similarities and differences between tramadol and oxycodone, including uses, safety information, how well they work, and more.

Getty Images / Smith Collection/Gado / Contributor

Close-up of a white oxycodone hydrochloride 5 mg pill, marked as 05 52, resting on its edge

What Are the Differences Between Tramadol and Oxycodone?

The main difference between tramadol and oxycodone is the potency.

Tramadol is a weak opioid with a similar effect and structure to morphine with weaker opioid-like properties than a potent opioid medication, such as oxycodone. Oxycodone has a higher risk for addiction and abuse.

This is why the Food and Drug Administration (FDA) classified oxycodone as a Schedule II controlled substance which is a high-risk classification for abuse and dependence compared to Schedule IV for tramadol.

These medications work differently, too, which accounts for their differences in potency. Oxycodone is an active compound that directly causes pain relief, while tramadol acts as a prodrug. A prodrug is an inactive product that is processed in the body to reach an active form to ultimately relieve pain.

What Is Tramadol Used For?

Tramadol is a centrally acting pain reliever used to treat moderate to moderately severe pain in adults. It is prescribed for short-term pain relief and is only used when othernon-opioid agentsare ineffective in your pain management plan.

This medication comes as a tablet in a few strengths, including 50 milligrams (mg) and 100 mg.Tramadol also comes in extended-release formulations in 100 mg, 200 mg, and 300 mg.

Side Effects of Tramadol

Common side effects of tramadol include:

Severe side effects may include:

Long-term use of tramadol can also lead to liver and kidney damage.

What Is Oxycodone Used For?

Oxycodone is indicated for moderate to severe pain management for either short-acting pain or when a continuousanalgesicis needed.

The main difference is that the ER version relieves severe pain in individuals needing pain relief around the clock, while immediate-release oxycodone is used for short-term pain.

It is recommended that oxycodone dosage starts with the lowest effective dose for the shortest duration needed to manage your pain. Your starting dosage would also depend on whether you are opioid-tolerant, which means you would need a higher dosage to have the same effect.

Side Effects of Oxycodone

The most common side effects are:

Long-term use of oxycodone can cause mental or physical dependence. However, people with continuous pain may still use oxycodone for pain control.

How Long Does Oxycodone Take to Work?

Is Tramadol or Oxycodone More Effective for Pain?

Tramadol and oxycodone are strong pain medications that work in different ways to reduce pain.

Although tramadol is not as strong as oxycodone, it can still provide significant relief for moderate to severe pain, such as acute pain like surgery or injury, or chronic pain conditions likearthritis.

Oxycodone, on the other hand, is a much stronger medication that provides fast and powerful pain relief.

Your healthcare provider will decide which medication to prescribe based on the type and severity of the pain.

Tramadol and oxycodone are both effective pain relievers, but it is important to understand the serious safety risks associated with taking these medications, which include:

FDA Warnings for Tramadol

The FDA has issued the following boxed warnings regarding tramadol.

Seizures

Seizurerisk has been reported in treatment with tramadol at the recommended dose, and risk will increase when taken above the recommended dose.

Seizure risk can also increase when taking tramadol withselective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), other opioids,monoamine oxidase inhibitors (MAOIs), neuroleptics, and other drugs that reduce the seizure threshold. Naloxone can also increase the risk of seizures when administered for a tramadol overdose.

Convulsion risk can also increase in people with:

Suicide Risk

Tramadol can increase the risk of suicide. It should not be prescribed to people with an increased risk of suicide or addiction.

Serotonin Syndrome

Tramadol can also increase the risk of serotonin syndrome, a life-threatening condition that presents as mild diarrhea or nausea to severe symptoms of fever and seizures. Other antidepressant agents, including SSRIs, TCAs, MAOIs, andserotonin-norepinephrine reuptake inhibitors (SNRIs), should be avoided to prevent the risk of serotonin syndrome.

Respiratory Depression

Taking tramadol can lead to respiratory depression, especially when starting treatment or after increasing the dose. Respiratory depression can cause symptoms like shortness of breath, fast breathing, fast heart rate, and a bluish tone to the skin or lips.

FDA Warnings for Oxycodone

FDA warnings for oxycodone include:

Tramadol vs. Oxycodone Interactions

Interactions of tramadol and oxycodone with other substances include:

Summary

Oxycodone and tramadol are two prescription opioid medications used to help relieve pain. Even though these medications have a similar use, oxycodone is known to be more potent, with stronger pain-relieving capabilities than tramadol. The FDA classifies oxycodone as a higher risk for misuse than tramadol. However, both medications have the potential to cause dependence.

Both medications should not be taken if you have a history of respiratory depression or previously have had side effects while taking opioids. Tramadol should also be avoided during pregnancy, as it has been shown to damage the growth and development of embryos in animals.There is also little evidence that oxycodone is safe during pregnancy.

Both medications should not be taken if you have a history of respiratory depression or previously have had side effects while taking opioids. Tramadol should also be avoided during pregnancy, as it has been shown to damage the growth and development of embryos in animals.

There is also little evidence that oxycodone is safe during pregnancy.

Drinking alcohol while taking tramadol or oxycodone can cause serious interactions, including respiratory depression and CNS depression.

Both tramadol and oxycodone are strong pain medications and need a prescription from a healthcare provider. Since oxycodone is a Schedule II controlled substance, it has a higher possibility of addiction and abuse. Tramadol has a lower risk, though it is still misused and abused.

Acknowledgement:

The author would like to recognize and thank Ghassan Alyaseen and Leen Alyaseen for contributing to this article.

13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Tramadol hydrochloride tablet, coated.DailyMed.Label: Oxycodone hydrochloride tablet.Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R.Trends in tramadol: pharmacology, metabolism, and misuse.Anesth Analg. 2017;124(1):44-51. doi:10.1213/ANE.0000000000001683Silvasti M, Tarkkila P, Tuominen M, Svartling N, Rosenberg PH.Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery.Eur J Anaesthesiol. 1999;16(12):834-839. doi: 10.1046/j.1365-2346.1999.00597.xFood and Drug Administration.Tramadol extended-release label.Barbosa J, Faria J, Garcez F, et al.Repeated administration of clinical doses of tramadol and tapentadol causes hepato- and nephrotoxic effects in Wistar rats.Pharmaceuticals (Basel). 2020;13(7):149. doi:10.3390/ph13070149DailyMed.Label: OxyContin- oxycodone hydrochloride tablet, film coated, extended release.Centers for Disease Control and Prevention.Opioids Basics - Commonly Used Terms.Subedi M, Bajaj S, Kumar MS, Yc M.An overview of tramadol and its usage in pain management and future perspective.Biomed Pharmacother. 2019;111:443-451. doi:10.1016/j.biopha.2018.12.085Moradi M, Esmaeili S, Shoar S, Safari S.Use of oxycodone in pain management.Anesth Pain Med. 2012;1(4):262-264. doi:10.5812/aapm.4529Schwenk ES, Mariano ER.Designing the ideal perioperative pain management plan starts with multimodal analgesia.Korean J Anesthesiol. 2018;71(5):345-352. doi:10.4097/kja.d.18.00217Reines SA, Goldmann B, Harnett M, Lu L.Misuse of tramadol in the United States: an analysis of the national survey of drug use and health 2002-2017.Subst Abuse. 2020;14:1178221820930006. doi:10.1177/1178221820930006National Institutes of Health’s National Heart, Lung, and Blood Institute.Acute respiratory distress syndrome symptoms.

13 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Tramadol hydrochloride tablet, coated.DailyMed.Label: Oxycodone hydrochloride tablet.Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R.Trends in tramadol: pharmacology, metabolism, and misuse.Anesth Analg. 2017;124(1):44-51. doi:10.1213/ANE.0000000000001683Silvasti M, Tarkkila P, Tuominen M, Svartling N, Rosenberg PH.Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery.Eur J Anaesthesiol. 1999;16(12):834-839. doi: 10.1046/j.1365-2346.1999.00597.xFood and Drug Administration.Tramadol extended-release label.Barbosa J, Faria J, Garcez F, et al.Repeated administration of clinical doses of tramadol and tapentadol causes hepato- and nephrotoxic effects in Wistar rats.Pharmaceuticals (Basel). 2020;13(7):149. doi:10.3390/ph13070149DailyMed.Label: OxyContin- oxycodone hydrochloride tablet, film coated, extended release.Centers for Disease Control and Prevention.Opioids Basics - Commonly Used Terms.Subedi M, Bajaj S, Kumar MS, Yc M.An overview of tramadol and its usage in pain management and future perspective.Biomed Pharmacother. 2019;111:443-451. doi:10.1016/j.biopha.2018.12.085Moradi M, Esmaeili S, Shoar S, Safari S.Use of oxycodone in pain management.Anesth Pain Med. 2012;1(4):262-264. doi:10.5812/aapm.4529Schwenk ES, Mariano ER.Designing the ideal perioperative pain management plan starts with multimodal analgesia.Korean J Anesthesiol. 2018;71(5):345-352. doi:10.4097/kja.d.18.00217Reines SA, Goldmann B, Harnett M, Lu L.Misuse of tramadol in the United States: an analysis of the national survey of drug use and health 2002-2017.Subst Abuse. 2020;14:1178221820930006. doi:10.1177/1178221820930006National Institutes of Health’s National Heart, Lung, and Blood Institute.Acute respiratory distress syndrome symptoms.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

DailyMed.Label: Tramadol hydrochloride tablet, coated.DailyMed.Label: Oxycodone hydrochloride tablet.Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R.Trends in tramadol: pharmacology, metabolism, and misuse.Anesth Analg. 2017;124(1):44-51. doi:10.1213/ANE.0000000000001683Silvasti M, Tarkkila P, Tuominen M, Svartling N, Rosenberg PH.Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery.Eur J Anaesthesiol. 1999;16(12):834-839. doi: 10.1046/j.1365-2346.1999.00597.xFood and Drug Administration.Tramadol extended-release label.Barbosa J, Faria J, Garcez F, et al.Repeated administration of clinical doses of tramadol and tapentadol causes hepato- and nephrotoxic effects in Wistar rats.Pharmaceuticals (Basel). 2020;13(7):149. doi:10.3390/ph13070149DailyMed.Label: OxyContin- oxycodone hydrochloride tablet, film coated, extended release.Centers for Disease Control and Prevention.Opioids Basics - Commonly Used Terms.Subedi M, Bajaj S, Kumar MS, Yc M.An overview of tramadol and its usage in pain management and future perspective.Biomed Pharmacother. 2019;111:443-451. doi:10.1016/j.biopha.2018.12.085Moradi M, Esmaeili S, Shoar S, Safari S.Use of oxycodone in pain management.Anesth Pain Med. 2012;1(4):262-264. doi:10.5812/aapm.4529Schwenk ES, Mariano ER.Designing the ideal perioperative pain management plan starts with multimodal analgesia.Korean J Anesthesiol. 2018;71(5):345-352. doi:10.4097/kja.d.18.00217Reines SA, Goldmann B, Harnett M, Lu L.Misuse of tramadol in the United States: an analysis of the national survey of drug use and health 2002-2017.Subst Abuse. 2020;14:1178221820930006. doi:10.1177/1178221820930006National Institutes of Health’s National Heart, Lung, and Blood Institute.Acute respiratory distress syndrome symptoms.

DailyMed.Label: Tramadol hydrochloride tablet, coated.

DailyMed.Label: Oxycodone hydrochloride tablet.

Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R.Trends in tramadol: pharmacology, metabolism, and misuse.Anesth Analg. 2017;124(1):44-51. doi:10.1213/ANE.0000000000001683

Silvasti M, Tarkkila P, Tuominen M, Svartling N, Rosenberg PH.Efficacy and side effects of tramadol versus oxycodone for patient-controlled analgesia after maxillofacial surgery.Eur J Anaesthesiol. 1999;16(12):834-839. doi: 10.1046/j.1365-2346.1999.00597.x

Food and Drug Administration.Tramadol extended-release label.

Barbosa J, Faria J, Garcez F, et al.Repeated administration of clinical doses of tramadol and tapentadol causes hepato- and nephrotoxic effects in Wistar rats.Pharmaceuticals (Basel). 2020;13(7):149. doi:10.3390/ph13070149

DailyMed.Label: OxyContin- oxycodone hydrochloride tablet, film coated, extended release.

Centers for Disease Control and Prevention.Opioids Basics - Commonly Used Terms.

Subedi M, Bajaj S, Kumar MS, Yc M.An overview of tramadol and its usage in pain management and future perspective.Biomed Pharmacother. 2019;111:443-451. doi:10.1016/j.biopha.2018.12.085

Moradi M, Esmaeili S, Shoar S, Safari S.Use of oxycodone in pain management.Anesth Pain Med. 2012;1(4):262-264. doi:10.5812/aapm.4529

Schwenk ES, Mariano ER.Designing the ideal perioperative pain management plan starts with multimodal analgesia.Korean J Anesthesiol. 2018;71(5):345-352. doi:10.4097/kja.d.18.00217

Reines SA, Goldmann B, Harnett M, Lu L.Misuse of tramadol in the United States: an analysis of the national survey of drug use and health 2002-2017.Subst Abuse. 2020;14:1178221820930006. doi:10.1177/1178221820930006

National Institutes of Health’s National Heart, Lung, and Blood Institute.Acute respiratory distress syndrome symptoms.

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