Two medicines, side by side
Acetaminophen vs tramadol
Acetaminophen and tramadol are both labeled for pain. Drugs@FDA records approvals of acetaminophen since 1968 and of tramadol since 1995. Pharmacies paid $0.0339 per unit (Acetaminophen 500 mg caplet) and $0.0248 per tramadol HCl 50 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the acetaminophen FDA label on DailyMed (effective November 13, 2024); the tramadol FDA label on DailyMed (effective March 5, 2026).
Highlights of the acetaminophen record
Acetaminophen (Tylenol) · label of November 13, 2024
Used for
From the label: indicationstemporarily relieves minor aches and pains due to: minor pain of arthritis muscular aches backache premenstrual and menstrual cramps the common cold headache toothache temporarily reduces fever
On the market
- Earliest approval on file
- November 7, 1968
- Generic labelers
- 89 labelers
- Pharmacy cost
- $0.0339 per unit
Supply and safety
- Shortage
- No current entry
- Recalls
- 19
Highlights of the tramadol record
Tramadol (Ultram) · label of March 5, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF TRAMADOL HYDROCHLORIDE EXTENDED-RELEASE TABLETS Addiction, Abuse, and Misuse Because the use of Tramadol hydrochloride extended-release tablet exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient's risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see Warnings and Precautions ( 5.1 )].
Used for
From the label: indicationsTramadol hydrochloride extended-release tablet is indicated for the management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. […]
On the market
- Earliest approval on file
- March 3, 1995
- Generic labelers
- 39 labelers
- Pharmacy cost
- $0.0248 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 8
Source: FDA drug labels via openFDA (Acetaminophen label of November 13, 2024, Tramadol label of March 5, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do acetaminophen and tramadol differ on the record?
Both labels carry a boxed warning; the records quote them.
Generics: acetaminophen since 1986; tramadol since 2002 (Drugs@FDA).
DEA schedule: acetaminophen none; tramadol CIV.
| Acetaminophen | Tramadol | |
|---|---|---|
| Labeled for | Fever, Cough and cold, Pain | Pain |
| Pharmacologic class | n/a | Opioid Agonist |
| How it works (label) | n/a | Tramadol hydrochloride extended-release tablet contains tramadol, an opioid agonist and an inhibitor of reuptake of norepinephrine and serotonin. |
| Half-life (label) | n/a | n/a |
| Earliest approval on file (Drugs@FDA) | November 7, 1968 | March 3, 1995 |
| First generic approved | December 1, 1986 | June 19, 2002 |
| Generic labelers (NDC) | 89 labelers | 39 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0339 per unit (Acetaminophen 500 mg caplet) | $0.0248 per tablet (Tramadol HCl 50 mg tablet) |
| 12-month price change | +5% | -1% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 19 | 8 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 445,075 | 37,421 |
| DEA schedule | none | CIV |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Tramadol label, warnings and precautionsRisks from Concomitant Use with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of tramadol hydrochloride extended-release tablets with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics …
Source: FDA drug labels via openFDA
What next?
- Alternatives to acetaminophen
- every medicine labeled for the same conditions