Comparative Pharmacology
Head-to-head clinical analysis: ULTRAM versus VICODIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRAM versus VICODIN.
ULTRAM vs VICODIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Tramadol is a centrally acting synthetic opioid analgesic that binds to μ-opioid receptors and inhibits norepinephrine and serotonin reuptake.
VICODIN (hydrocodone/acetaminophen) is a combination opioid agonist and analgesic. Hydrocodone acts on mu-opioid receptors in the CNS to alter pain perception and response; acetaminophen inhibits cyclooxygenase (COX) activity, likely in the CNS, reducing prostaglandin synthesis and providing antipyretic effects.
50-100 mg orally every 4-6 hours as needed for pain; maximum 400 mg/day (for extended-release: 100 mg once daily, titrated up to 300 mg once daily).
1-2 tablets (hydrocodone 5-10 mg and acetaminophen 300-325 mg) orally every 4-6 hours as needed for pain; maximum daily acetaminophen dose 4 g.
None Documented
None Documented
Tramadol: ~6 hours; M1 metabolite (O-desmethyltramadol): ~7 hours; prolonged in renal/hepatic impairment
Hydrocodone: 3.8-6.4 hours (terminal); Acetaminophen: 2-3 hours (terminal). Clinically, steady-state achieved in 1-2 days.
Renal: ~90% (tramadol and metabolites; conjugated metabolites are major), Fecal: ~10%
Hydrocodone: primarily renal (~60% as metabolites, 12% unchanged); minor biliary. Acetaminophen: renal (90-100% as metabolites, 2-4% unchanged).
Category C
Category C
Opioid Analgesic
Opioid Analgesic