Tramadol vs. Codeine

Tramadol and codeine are opiates prescribed for moderate pain. Codeine is also a cough suppressant. While codeine is derived from the poppy plant like other narcotics such as morphine, heroin, and opium, tramadol is a synthetic drug that shares similarities with codeine.

Both drugs are less potent than other opiates, resulting in a lower potential for addiction and withdrawal. However, caution should still be exercised as both drugs can be habit-forming, both physically and psychologically.

Aside from the risk of addiction, side effects for both drugs may include dizziness, confusion, sedation, constipation, and others.

It is important to avoid taking tramadol or codeine with alcohol or other sedatives, as combining them can lead to respiratory depression, a potentially dangerous condition that can cause breathing difficulties or even cessation of breathing.

What are tramadol and codeine?

Tramadol and codeine are both opiates. Codeine is made from the poppy plant, like morphine, heroin, and opium. Tramadol is chemically similar to codeine, but it is synthesized in a lab. Tramadol is commonly used to manage moderate to moderately severe pain, while codeine is used for pain relief as well as suppressing cough.

• Tramadol is used for moderate to moderately severe pain. Extended release tablets are for adults who require continuous treatment for chronic pain.
• Codeine is used for mild to moderately severe pain and to suppress cough.

How do they work?

Opiates work by interacting with opioid receptors in the central nervous system, which regulate pain sensation, gastrointestinal, respiratory, and urogenital functions. Codeine, tramadol, and other opiates target and activate the Mu receptors, which are responsible for pain relief. Activation of these receptors can also lead to feelings of euphoria and well-being, contributing to the potential for addiction.

While tramadol and codeine are less potent than other opiates, they can increase the painkilling properties in the central nervous system. Additionally, codeine can suppress cough by affecting the endogenous opioid system, although the exact mechanism is not fully understood.

QUESTION

What are the side effects of tramadol and codeine?

The most common side effects of tramadol and codeine include lightheadedness, dizziness, nausea, vomiting, shortness of breath, sedation, allergic reactions, constipation, abdominal pain, rash, itching, and addiction.

Some patients who received tramadol have reported seizures. It may also cause serotonin syndrome when combined with other drugs that increase serotonin.

If you have been prescribed tramadol or codeine, it is important to discuss potential side effects with your doctor.

For more information, please visit the MedicineNet drug monographs for these medications.

Can I get addicted to tramadol and codeine?

Tramadol and codeine have the potential to be habit-forming. While short-term use for pain relief is less likely to lead to addiction or withdrawal, prolonged use can result in dependence, both physically and psychologically. Tramadol is categorized as a Schedule IV medication, while codeine has a more serious Schedule II classification due to its higher potential for abuse.

What are the withdrawal symptoms of tramadol and codeine?

Abrupt withdrawal from tramadol and codeine may cause withdrawal symptoms similar to other opiates. Gradually reducing the doses of these drugs can help avoid these symptoms.

How should tramadol and codeine be taken (dosage)?

Tramadol dosage

• The recommended dose of tramadol is 50-100 mg (immediate release tablets) every 4-6 hours as needed for pain.
• The maximum dose is 400 mg/day.
• To improve tolerance, patients should start at 25 mg/day and gradually increase the dose.
• Extended release tablets should be swallowed whole and not crushed or chewed.

Codeine dosage

• The usual adult dose of codeine for pain is 15-60 mg every 4-6 hours as needed.
• The dose for cough is 10 to 20 mg every 4-6 hours as needed.
• The maximum dose for treating cough is 120 mg every 24 hours.

Before taking tramadol or codeine, it is important to consult your doctor for the appropriate dosage and instructions.

Which drugs interact with tramadol and codeine?

Combining tramadol or codeine with alcohol or other central nervous system depressants can lead to respiratory depression. Additionally, combining tramadol with certain drugs can cause serotonin syndrome.

Drugs that stimulate and block opioid receptors can reduce the effectiveness of codeine and should not be combined with it. Similarly, drugs that block the action of acetylcholine can increase the occurrence of urinary retention and constipation when combined with codeine.

Monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs) can cause severe side effects when combined with tramadol or codeine. It is important to provide a full list of medications to your doctor to avoid potential interactions.

Pregnancy and breastfeeding

• Both tramadol and codeine should be avoided during pregnancy due to the risk of dependence in the developing fetus.
• While small amounts of these drugs may be present in breast milk, they are typically not harmful to the baby.
• If you are breastfeeding and prescribed tramadol or codeine, discuss the potential risks with your doctor before making a decision.