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.

Tramadol Drug Properties

Brand namesUltram, ConZip, Qdolo
Type of pain it can treatPost-operative pain, non-cancer long-term pain
Short-acting or long-actingShort-acting
Drug typeOpioid
Drug scheduleSchedule IV
Side effectsCNS depression, constipation, dizziness, sedation, headache, anxiety, euphoria, depression, respiratory depression, seizures, withdrawal symptoms
How long it takes to start working60 minutes
How long it takes to have its peak effect2-3 hours
Duration of effect6-8 hours

Lortab Drug Properties

Brand namesLortab, Vicodin HP, Xodol
Type of pain it can treatLong-term pain (non-cancer and non-palliative), post-operative pain
Short-acting or long-actingShort-acting
Drug typeOpioid and nonopioid analgesic
Drug scheduleSchedule III
Side effectsConstipation, 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 working30-60 minutes
How long it takes to have its peak effect60 minutes
Duration of effect4-6 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 →

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

DEA. “National Drug Threat Assessment.” Drug Enforcement Administration, December 2019. Accessed September 14, 2021.

UCB Pharma. “Lortab Package Insert.” U.S. National Library of Medicine, October 2006. Accessed August 16, 2021.

Watson Laboratories. “Tramadol Package Insert.” U.S. National Library of Medicine, March 2007. Accessed August 16, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with 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 providers.