Comparative Pharmacology
Head-to-head clinical analysis: ULTRAM versus ZYDONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ULTRAM versus ZYDONE.
ULTRAM vs ZYDONE
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; acetaminophen produces analgesia via central COX inhibition and activation of descending serotonergic pathways.
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).
Oral: 1 to 2 tablets every 4 to 6 hours as needed for pain. Each tablet contains hydrocodone bitartrate 5 mg and acetaminophen 500 mg (Zydone 5/500). Maximum acetaminophen dose: 4000 mg/day (8 tablets).
None Documented
None Documented
Tramadol: ~6 hours; M1 metabolite (O-desmethyltramadol): ~7 hours; prolonged in renal/hepatic impairment
Terminal elimination half-life of hydrocodone is 3.8-4.5 hours in healthy adults; prolonged in elderly or hepatic impairment (up to 6-8 hours). Clinical context: dosing interval typically every 4-6 hours, adjusted for renal/hepatic insufficiency.
Renal: ~90% (tramadol and metabolites; conjugated metabolites are major), Fecal: ~10%
Approximately 60% of hydrocodone and its metabolites are excreted renally as glucuronide conjugates; ~10% as norhydrocodone, hydromorphone, and other metabolites. Fecal excretion accounts for less than 5%. Total renal elimination: ~65-70%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic