Comparative Pharmacology
Head-to-head clinical analysis: ULTRAM versus VICODIN HP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRAM versus VICODIN HP.
ULTRAM vs VICODIN HP
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.
Hydrocodone is a mu-opioid receptor agonist that inhibits ascending pain pathways; acetaminophen inhibits cyclooxygenase and has 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).
One tablet (hydrocodone bitartrate 10 mg/acetaminophen 660 mg) orally every 4-6 hours as needed for pain; maximum 6 tablets per day.
None Documented
None Documented
Tramadol: ~6 hours; M1 metabolite (O-desmethyltramadol): ~7 hours; prolonged in renal/hepatic impairment
Hydrocodone: 3.8-5.5 hours (mean 4.5 h). Acetaminophen: 2-3 hours. Clinical context: dosing interval every 4-6 hours for acute pain.
Renal: ~90% (tramadol and metabolites; conjugated metabolites are major), Fecal: ~10%
Primarily renal: hydrocodone is eliminated as conjugated metabolites (glucuronides) ~80%; unchanged drug ~5%. Biliary/fecal: minor, <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic