Two commonly prescribed prescription painkillers are tramadol and Lortab. How do tramadol and Lortab compare to one another? There are similarities and differences between these two drugs.

Article at a Glance:

  • Tramadol and Lortab both contain opioids for the active ingredient.
  • Both medications are used to treat short- and long-term pain.
  • They have similar side effects including drowsiness, dizziness and a high potential for abuse.
  • Tramadol is generally safer for older adults or people with a low opioid tolerance.
  • Tramadol carries a risk of seizures while Lortab does not.
  • The acetaminophen in Lortab can increase the risk of liver damage if used in high doses or combined with other medications that contain acetaminophen.

Comparing Tramadol and Lortab

Tramadol and Lortab are both fairly well-known pain medications. Tramadol is usually used for mild to moderate pain, while Lortab is used for moderate to severe pain since it is more potent.

Other names for Lortab include Vicodin and Norco. It contains two different active ingredients (hydrocodone and acetaminophen), where tramadol only contains one. The inclusion of acetaminophen means that Lortab has a higher risk of liver damage than Tramadol.

If these medications both treat pain, why would one be used over the other?

Similarities Between Tramadol and Lortab

Both medications can be prescribed to treat pain and conditions where pain is a symptom. Lortab contains the active ingredient hydrocodone, which is an opioid medication. Tramadol is also an opioid.

Since both are opioids, they have similar side effects including drowsiness, dizziness, nausea, vomiting, constipation and slowed breathing.

Like other opioids, there is a potential for fatal overdose if you take too much of these medications. Symptoms of an overdose include very slow breathing, bluish skin, and unconsciousness. An opioid overdose is a medical emergency.

Both medications have a high potential for addiction and abuse and both are controlled substances.

Differences Between Tramadol and Lortab


  • Tramadol has similar effects as an antidepressant but is not prescribed to treat depression or other mental health conditions. These effects may contribute to the potential for abuse.
  • Since tramadol is less potent, it is usually safer for people at risk of opioid side effects, like older adults.
  • Tramadol can increase the risk of seizures.


  • Lortab can help with a cough and with reducing fever. The hydrocodone in Lortab helps coughs, while the acetaminophen is good for reducing fever.
  • Lortab contains acetaminophen (generic Tylenol), so taking too much can cause liver damage.
  • Lortab is more potent than Tramadol and should be taken in smaller doses to reduce the risk of overdose.

Tramadol and Lortab also have different dosages and potencies.

Tramadol 50 mg vs Lortab 10 mg

The standard dosage of Tramadol is 25-100 mg every 4-6 hours as needed. The effective dose will vary from person to person based on different factors. The standard dosage of Lortab is 5-325 mg is 1-2 tabs every 4-6 hours as needed.

Tramadol 50 mg and Lortab 10 mg are moderate dosages, but the Lortab dose is more potent than tramadol.

Side Effects

Tramadol and Lortab share many potential side effects, including dizziness, sore throat, itching, drowsiness, headache, constipation, nausea and vomiting, and weakness. Potentially serious side effects of both medications include confusion, low blood pressure, respiratory depression and gastric obstruction.

Since tramadol works slightly differently than Lortab, it has unique side effects, including seizures, serotonin syndrome and mood changes.

Another potential side effect is the risk of abuse. According to the DEA, hydrocodone is currently one of the most abused opioids in the U.S., but this could be because it is prescribed more often than tramadol. Both have a high potential for abuse.


  • Can You Take Tramadol and Lortab Together?

    Tramadol and Lortab should not be used together. Both are prescribed for short-term pain, but taking them together will not give an extra benefit. Instead, combining these medications can increase the risk of fatal overdose.

  • What is Tramadol?

    Tramadol is a prescription drug sold under the brand name Ultram and it is commonly used for people who may be more sensitive to opioids, like older adults and patients at risk for drug abuse.

    Tramadol is an opioid analgesic, which means it impacts the central nervous system (CNS) and relieves pain by changing how your brain and body perceive it. When you take tramadol, as with other opioids, it binds to opioid receptors, but it also increases certain neurotransmitters, including norepinephrine and serotonin. Tramadol is also available in combination with acetaminophen, sold under the brand name Ultracet.

    Because of the opioid effects of tramadol, it is a controlled substance with a high potential for abuse.

  • What is Lortab?

    Lortab contains the active medications hydrocodone and acetaminophen. Hydrocodone is an opioid with a high potential for addiction and abuse. It is also very effective at treating pain. Acetaminophen is combined with hydrocodone to reduce the amount of opioids needed to treat pain symptoms.

    Hydrocodone works by binding to opioid receptors and reducing the sensation of pain transmitted through the nervous system. Acetaminophen works by activating nerve cells that suppress feelings of pain.

Tramadol Drug Properties

Brand names Ultram, ConZip, Qdolo
Type of pain it can treat Post-operative pain, non-cancer long-term pain
Short-acting or long-acting Short-acting
Drug type Opioid
Drug schedule Schedule IV
Side effects CNS depression, constipation, dizziness, sedation, headache, anxiety, euphoria, depression, respiratory depression, seizures, withdrawal symptoms
How long it takes to start working 60 minutes
How long it takes to have its peak effect 2-3 hours
Duration of effect 6-8 hours

Lortab Drug Properties

Brand names Lortab, Vicodin HP, Xodol
Type of pain it can treat Long-term pain (non-cancer and non-palliative), post-operative pain
Short-acting or long-acting Short-acting
Drug type Opioid and nonopioid analgesic
Drug schedule Schedule III
Side effects Constipation, liver toxicity, CNS depression, low blood pressure, respiratory depression, drowsiness, nausea and vomiting, dizziness, slow heart rate, withdrawal symptoms
How long it takes to start working 30-60 minutes
How long it takes to have its peak effect 60 minutes
Duration of effect 4-6 hours

Abuse Potential

Research has found that many people are introduced to opioids through a legitimate prescription, but go on to develop dependence or addiction. If you or someone you know is struggling with opioids, The Recovery Village can help. Contact us today to learn more about treatment options for opioid addiction.

Learn more about tramadol abuse → or Learn more about Lortab abuse

  • Sources

  • Medical Disclaimer

    The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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