Tramadol Vs Oxycodone: Efficacy, Side Effects, and Withdrawal

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Although oxycodone is much more potent than tramadol, there are some similarities between the two prescription opioids, along with noticeable differences. 

Tramadol is the name of a prescription opioid use to treat moderate to severe pain. It’s relatively inexpensive when compared to other opioids and common brand names in Ryzolt, Rybix, Ultram ER, and Fuse PAQ.Oxycodone is classified as a Schedule II controlled substance by the DEA, while tramadol is a Schedule IV. Oxycodone has a much higher probability of being abused and causes addiction, while tramadol is much lower. However, every person is different and addiction can never be ruled out.

What is Tramadol?

Although tramadol is considered slightly weaker than other prescription pain relievers, it can be a practical alternative to more potent drugs like oxycodone. As an opioid pain reliever, when someone uses tramadol, it will bind to opioid receptors and influence the central nervous system (CNS). The interaction of opioids like tramadol with the central nervous system will lower how someone perceives pain. Tramadol may also improve mood, which is one distinction between tramadol and oxycodone.

Despite its perception as a weaker opioid, it still works as a pain reliever. In some cases, even for severe pain. An extended-release version of the drug is also available in those requiring around-the-clock pain relief.

Some characteristics of tramadol include the following:

  • It’s Schedule IV
  • It’s considered a centrally acting synthetic analgesic
  • It treats chronic pain with an extended-release version
  • A significant difference between oxycodone and tramadol is that oxycodone is 1.5 times more phone than morphine, and tramadol is considered “negligible” for how much stronger it is than morphine
  • Tramadol begins working in the first hour and lasts anywhere from four to six hours

Unlike other opioids, tramadol’s riskiest side effect is the potential for seizures. Seizures have been reported in those who have taken minimal doses prescribed by their physician. Other than that, tramadol and oxycodone have similar side effects, including dizziness, dry mouth, constipation, sweating, and headache, which are common among all opioids. 

oxycodone-vs-tramadol

What Is Oxycodone?

Oxycodone is a potent, semi-synthetic opioid tightly regulated by the DEA due to its high risk of abuse and addiction. Similar to tramadol, oxycodone works on the central nervous system and alters how the person perceives pain. 

Unlike tramadol, oxycodone doesn’t boast the same impact of serotonin reuptake inhibition and norepinephrine, which is why it doesn’t cause seizures. However, it does not have the same mood-enhancing element as tramadol unless used in high doses to achieve a “euphoric” high.

Oxycodone is a pure opioid agonist and has a faster onset than tramadol. If you’re comparing tramadol vs. oxycodone, you’ll notice that oxycodone starts working in 20 to 30 minutes after ingestion, with peak effects around one hour. The half-life of oxycodone is 3.5 hours, whereas tramadol is 6.3 hours.

The numbers are vital because they highlight the reasoning behind the abuse potentials between tramadol vs. oxycodone. A majority of the time, it’s a fast-acting opioid that will be abused rather than a slower-acting drug. Although tramadol and be abused and lead to addiction, the risk is much lower. 

To compare tramadol vs. oxycodone further, let’s take a look at the following:

  • Oxycodone has a much higher potential for abuse and addiction than tramadol.
  • Since oxycodone is more potent, its effectiveness as a painkiller is much better and has a more rapid onset of pain relieving properties.
  • Tramadol has a much higher risk of seizures than oxycodone, especially in those who have a history of seizures.

Another vital fact when it comes to comparing tramadol vs. oxycodone is that tramadol doesn’t produce significant depression in the respiratory system. Although there are many dangers involved with opioids, among the most dangerous is respiratory depression, which can be fatal. Tramadol does not have that same risk. 

Another difference when comparing tramadol vs. oxycodone is the interaction with other drugs. For example, oxycodone should never be used in conjunction with other central nervous system depressants since it’ll depress respiration even further. With tramadol, you should never use other serotonin-based medications because of the possible risk of serotonin syndrome.

Interactions of Oxycodone and Tramadol

You’ll commonly see warning labels on prescriptions that say don’t mix this medication with other drugs. The reason is that interactions will change the way a substance works. Not only will this cause the drug not to work, but it can be harmful to your system. You should always consult with your physician about the vitamins, medications, or herbs you’re taking. It can help your doctor prevent any dangerous interactions. 

Here is an example of drugs that interact with tramadol and oxycodone:

Tramadol

  • Other pain medications such as hydrocodone, morphine, or fentanyl.
  • Phenothiazines, which are drugs used to treat severe mental disorders, such as prochlorperazine and chlorpromazine
  • Tranquilizers, such as alprazolam and diazepam
  • Sleeping pills like temazepam or zolpidem.
  • Quinidine
  • Amitriptyline
  • Erythromycin
  • Monoamine oxidase inhibitors (MAOIs)
  • SNRIs
  • SSRIs
  • Tripants, which are drugs used to treat migraines/headaches
  • Linezolid
  • Alcohol
  • Lithium
  • Carbamazepine
  • St. John’s Wort

Tramadol may increase respiratory depression when used in conjunction with sedative hypnotics, alcohol, narctors, or anesthetics. It can also reduce the level of consciousness.

Oxycodone

  • Chlorpromazine
  • Morphine, fentanyl, hydrocodone
  • Diazepam or alprazolam
  • Temazepam
  • Nalbuphine
  • Butorphanol
  • Pentazocine
  • Monoamine oxidase inhibitors (MAOIs)
  • Skeletal muscle relaxants that include methocarbamol and cyclobenzaprine
  • Alcohol
  • Barbiturates
  • Benzodiazepines

The combined use of these drugs can lead to increased respiratory depression or death. Since oxycodone causes constipation, the use of antidiarrheals can cause severe constipation.

Are Tramadol and Oxycodone Safe to Take During Pregnancy or While Breastfeeding?

The safety of using oxycodone while pregnant has not been established. However, children born to mothers who used oxycodone for an extended period might exhibit withdrawal symptoms or respiratory depression. You’re better off not using this drug while pregnant. 

Oxycodone may also be secreted into breast milk and cause side effects in the newborn. For this reason, it’s recommended that a mother either switch to formula or continue abstaining from oxycodone until they’re done breastfeeding.

Like oxycodone, the safety of using tramadol while pregnant has not been established. However, there haven’t been studies to determine if tramadol is safe during breastfeeding. With that said, it’s always better to err on the side of caution and avoid tramadol until you’ve stopped breastfeeding.

Possible Side Effects of Oxycodone

Like all medications, you can expect possible side effects from use. These include:

  • Stomach pain
  • Nausea
  • Constipation
  • Vomiting
  • Loss of appetite
  • Drowsiness
  • Tiredness
  • Sleepiness
  • Dizziness
  • Weakness
  • Inching
  • Dry mouth
  • Headache
  • Lightheadedness
  • Sweating
  • An inability to feel pain

Alert your physician immediately if you experience any of the following severe side effects of oxycodone:

  • Respiratory arrest
  • Respiratory depression
  • Apnea (when you stop breathing)
  • Hypotension (low blood pressure)
  • Circulatory depression
  • Shock
  • Death

Possible Side Effects of Tramadol

Despite being a weaker opioid, tramadol can still produce side effects, including:

  • Anxiety
  • Nervousness
  • Agitation
  • Skin rash
  • Seizures (convulsions)
  • Fever
  • Hallucination
  • Dizziness
  • Upset stomach
  • Nausea
  • Overactive reflexes
  • Spinning sensation
  • Fast heart rate
  • Diarrhea
  • Drowsiness
  • Loss of coordination
  • Headache
  • Constipation
  • Fainting

Tramadol and Oxycodone Withdrawal

Despite their differences, tramadol and oxycodone will produce similar withdrawal symptoms. If you cut back or stop altogether after heavy use after a few weeks more, you’ll likely experience several symptoms – this is known as withdrawal. 

Tramadol and oxycodone can cause physical dependence, meaning a person will rely on the drug to prevent withdrawal symptoms. How long it takes to establish a physical dependence will vary from one person to another. When someone stops using oxycodone or tramadol, their bodies need time to recover, which causes withdrawal symptoms. Opiate withdrawal can occur anytime long-term use is cut back or eliminated. 

Symptoms of Tramadol and Oxycodone Withdrawal

The symptoms someone faces are dependent upon the level of withdrawal they’re experiencing. Other factors will dictate how long you experience these symptoms. Early signs will start around 24-hours after you stop using tramadol or oxycodone, and they include:

  • Restlessness
  • Muscle aches
  • Runny nose
  • Lacrimation (teary eyes)
  • Inability to sleep
  • Constant yawning
  • Excessive sweating

Later symptoms will progress after the first day and become more intense. These include:

  • High blood pressure
  • Rapid heartbeat
  • Nausea and vomiting
  • Dilated pupils
  • Blurry vision
  • Goosebumps on the skin
  • Diarrhea
  • Abdominal cramping

Although the unpleasant symptoms will start improving after 72 hours, symptoms could last for months due to a condition called post-acute withdrawal syndrome. 

Babies born to mothers that are addicted to opioids while pregnant will experience the following symptoms:

  • Poor feeding
  • Digestive issues
  • Dehydration
  • Vomiting
  • Seizures

Sources

DEA (February 2021) Oxycodone. from https://www.dea.gov/factsheets/oxycodone

MedlinePlus (February 2021) Tramadol. from https://medlineplus.gov/druginfo/meds/a695011.html

DEA (February 2021) Drug Scheduling. from https://www.dea.gov/drug-scheduling

MedlinePlus (February 2021) Zolpidem. from https://medlineplus.gov/druginfo/meds/a693025.html

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