Two medicines, side by side
Tramadol vs morphine
Tramadol and morphine are both labeled for pain. Drugs@FDA records approvals of tramadol since 1995 and of morphine since 1984. Pharmacies paid $0.0248 per tramadol HCl 50 mg tablet and $0.226 per morphine sulfate ir 15 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. 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.”; Morphine, “Morphine is a full opioid agonist is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses.”
Check it at the source: the tramadol FDA label on DailyMed (effective March 5, 2026); the morphine FDA label on DailyMed (effective July 13, 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 morphine record
Morphine (Duramorph) · label of July 13, 2026
ADDICTION, ABUSE, AND MISUSE; RISK EVALUATION AND MITIGATION STRATEGY (REMS); LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Morphine sulfate exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.
Used for
From the label: indicationsMorphine sulfate extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. […]
On the market
- Earliest approval on file
- September 18, 1984
- Generic labelers
- 22 labelers
- Pharmacy cost
- $0.226 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 66
Source: FDA drug labels via openFDA (Tramadol label of March 5, 2026, Morphine label of July 13, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do tramadol and morphine 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.”; Morphine, “Morphine is a full opioid agonist is relatively selective for the mu-opioid receptor, although it can bind to 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; morphine since 1986 (Drugs@FDA).
DEA schedule: tramadol CIV; morphine CII.
| Tramadol | Morphine | |
|---|---|---|
| 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. | Morphine is a full opioid agonist is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of morphine is analgesia. |
| Half-life (label) | n/a | Excretion The elimination of morphine occurs primarily as renal excretion of M3G and its effective half-life after intravenous administration is normally 2 to 4 hours. |
| Earliest approval on file (Drugs@FDA) | March 3, 1995 | September 18, 1984 |
| First generic approved | June 19, 2002 | October 7, 1986 |
| Generic labelers (NDC) | 39 labelers | 22 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0248 per tablet (Tramadol HCl 50 mg tablet) | $0.226 per tablet (Morphine sulfate ir 15 mg tablet) |
| 12-month price change | -1% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | In shortage |
| Recalls recorded | 8 | 66 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 37,421 | 120,591 |
| 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)
Do their labels mention each other?
Tramadol label, warnings and precautionsAt least one death was reported in a nursing infant who was exposed to high levels of morphine in breast milk because the mother was an ultra-rapid metabolizer of codeine.
Source: FDA drug labels via openFDA
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 tramadol
- every medicine labeled for the same conditions