Two medicines, side by side
Tramadol vs hydrocodone
Tramadol and hydrocodone are both labeled for pain. Drugs@FDA records approvals of tramadol since 1995 and of hydrocodone since 2013. Pharmacies paid $0.0248 per tramadol HCl 50 mg tablet and $7.95 per hydrocodone ER 15 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Hydrocodone's other strengths are brand-only: $13.31 per Hysingla ER 20 mg tablet. How each works, in its label's words: Tramadol, “Tramadol hydrochloride extended-release tablet contains tramadol, an opioid agonist and an inhibitor of reuptake of norepinephrine and serotonin.”; Hydrocodone, “Hydrocodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses.”
Check it at the source: the tramadol FDA label on DailyMed (effective March 5, 2026); the hydrocodone FDA label on DailyMed (effective May 29, 2026).
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
Highlights of the hydrocodone record
Hydrocodone (Hysingla) · label of May 29, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYSINGLA ER Addiction, Abuse, and Misuse Because the use of HYSINGLA ER 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: indicationsHYSINGLA ER 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
- October 25, 2013
- Generic labelers
- 1 labeler
- Pharmacy cost
- $7.95 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Tramadol label of March 5, 2026, Hydrocodone label of May 29, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do tramadol and hydrocodone differ on the record?
How each works, in its label's words: Tramadol, “Tramadol hydrochloride extended-release tablet contains tramadol, an opioid agonist and an inhibitor of reuptake of norepinephrine and serotonin.”; Hydrocodone, “Hydrocodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses.”
Both are in FDA's class opioid agonists.
Both labels carry a boxed warning; the records quote them.
Generics: tramadol since 2002; hydrocodone since 2020 (Drugs@FDA).
DEA schedule: tramadol CIV; hydrocodone CII.
| Tramadol | Hydrocodone | |
|---|---|---|
| Labeled for | Pain | Pain |
| Pharmacologic class | Opioid Agonist | Opioid Agonist |
| How it works (label) | Tramadol hydrochloride extended-release tablet contains tramadol, an opioid agonist and an inhibitor of reuptake of norepinephrine and serotonin. | Hydrocodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. The principal therapeutic action of hydrocodone is analgesia. |
| Half-life (label) | n/a | The mean terminal half-life (t 1/2 ) was similar for all HYSINGLA ER dose strengths ranging from 7 to 9 hours. |
| Earliest approval on file (Drugs@FDA) | March 3, 1995 | October 25, 2013 |
| First generic approved | June 19, 2002 | January 21, 2020 |
| Generic labelers (NDC) | 39 labelers | 1 labeler |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0248 per tablet (Tramadol HCl 50 mg tablet) | $7.95 per capsule (Hydrocodone ER 15 mg capsule) |
| 12-month price change | -1% | +34% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 8 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 37,421 | 43,191 |
| DEA schedule | CIV | CII |
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 …
Hydrocodone label, warnings and precautionsUse with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of HYSINGLA ER with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids [gabapentin or pregabalin], and other …
Source: FDA drug labels via openFDA
What next?
- Alternatives to tramadol
- every medicine labeled for the same conditions