Comparative Pharmacology
Head-to-head clinical analysis: OXAYDO versus ULTRAM ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: OXAYDO versus ULTRAM ER.
OXAYDO vs ULTRAM ER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Oxycodone is a full opioid agonist with relative selectivity for mu-opioid receptors, although it can bind to kappa-opioid receptors at higher doses. The principal therapeutic action of oxycodone is analgesia. Like all full opioid agonists, there is no ceiling effect to analgesia for oxycodone.
Tramadol is a centrally acting synthetic opioid analgesic that binds to μ-opioid receptors and inhibits serotonin and norepinephrine reuptake.
Oral, 5-10 mg every 4-6 hours as needed for pain; maximum 60 mg per day.
100 mg orally once daily initially, titrate up to 100 mg twice daily as needed; maximum 200 mg/day.
None Documented
None Documented
Terminal elimination half-life is 3.5-5.5 hours for immediate-release oxycodone; clinically dose every 4-6 hours for sustained analgesia.
The terminal elimination half-life of tramadol is approximately 6.3 hours (range 5-9 hours), while its active metabolite M1 has a half-life of about 7.4 hours. Clinically, this supports dosing every 24 hours for the extended-release formulation.
Primarily renal as unchanged drug and metabolites; ~90% excreted in urine (approx 10% unchanged oxycodone, rest as noroxycodone and oxymorphone conjugates) and <10% in feces via biliary elimination.
Renal excretion of tramadol and its metabolites accounts for approximately 90% of total elimination. About 10% is excreted unchanged, 30% as O-desmethyltramadol (M1), and the remainder as other minor metabolites. Biliary/fecal excretion is minimal (<10%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic