Two medicines, side by side

Diclofenac vs tramadol

Diclofenac and tramadol are both labeled for pain. Drugs@FDA records approvals of diclofenac since 1988 and of tramadol since 1995. Pharmacies paid $0.0619 per diclofenac sod DR 75 mg tablet 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. In FDA's classes, diclofenac is a nonsteroidal anti-inflammatory drug and tramadol an opioid agonist.

Check it at the source: the diclofenac FDA label on DailyMed (effective February 11, 2025); the tramadol FDA label on DailyMed (effective March 5, 2026).

Highlights of the diclofenac record

Diclofenac (Voltaren) · label of February 11, 2025

Used for

From the label: indications
• for the temporary relief of arthritis pain ONLY in the following areas: o hand, wrist, elbow (upper body areas) o foot, ankle, knee (lower body areas) • this product may take up to 7 days to work for arthritis pain; it is not for immediate relief. If no pain relief in 7 days, stop use.

On the market

Earliest approval on file: July 28, 1988
Generic labelers: 149 labelers
Pharmacy cost: $0.0619 per tablet

Supply and safety

Shortage: A presentation being discontinued
Recalls: 6

Highlights of the tramadol record

Tramadol (Ultram) · label of March 5, 2026

Boxed warning

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: indications
Tramadol 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 (Diclofenac label of February 11, 2025, Tramadol label of March 5, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do diclofenac and tramadol differ on the record?

In FDA's classes, diclofenac is a nonsteroidal anti-inflammatory drug and tramadol an opioid agonist.

Both labels carry a boxed warning; the records quote them.

Generics: diclofenac since 1995; tramadol since 2002 (Drugs@FDA).

DEA schedule: diclofenac none; tramadol CIV.

	Diclofenac	Tramadol
Labeled for	Pain, Osteoarthritis, Rheumatoid arthritis, Migraine	Pain
Pharmacologic class	Nonsteroidal Anti-inflammatory Drug	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)	July 28, 1988	March 3, 1995
First generic approved	June 29, 1995	June 19, 2002
Generic labelers (NDC)	149 labelers	39 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)	$0.0619 per tablet (Diclofenac sod DR 75 mg tablet)	$0.0248 per tablet (Tramadol HCl 50 mg tablet)
12-month price change	-25%	-1%
Boxed warning	Yes	Yes
Shortage now	A presentation being discontinued	No current entry
Recalls recorded	6	8
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)	158,675	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?

Diclofenac label, drug interactions (prescription label)
The clinical significance of this interaction is not known; however, as with other NSAIDs, concomitant administration of diclofenac and aspirin is not generally recommended because of the potential of increased adverse effects.

Tramadol label, warnings and precautions
Risks 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?

Diclofenac: the full record
Tramadol: the full record
Alternatives to diclofenac: every medicine labeled for the same conditions