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Compare Methadone vs. Tramadol

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Methadone (Methadose, Methadone HCl Intensol) and tramadol (ConZip, Qdolo) are both opioid medications used to treat pain, but they have some key differences. Methadone is a Schedule II controlled substance, while tramadol is a Schedule IV controlled substance, indicating that methadone has a higher potential for misuse and dependency. Methadone is also used to treat opioid use disorder (OUD) and must initially be administered in a clinic under supervision, whereas tramadol is not used for OUD and can be taken at home. Methadone works solely by attaching to mu-opioid receptors in the brain, while tramadol not only attaches to these receptors but also increases serotonin and norepinephrine levels, which can help with pain. Methadone is available in various forms, including tablets and liquids, while tramadol comes in immediate-release and extended-release forms. Both medications can cause serious side effects like dangerously slow breathing and withdrawal symptoms, but tramadol is considered a weaker opioid and might have a lower risk of misuse compared to methadone.

  • Methadone
    Tramadol
  • Methadone
    Tramadol

  • Summary of Methadone vs. Tramadol

    Summary for Opioid
    Prescription only

    Methadone is an opioid medication. It's used to treat adults with long-term pain that's not relieved by non-opioid pain medications. Methadone is also used with counseling and support programs for opioid use disorder (or opioid addiction). When it's used for opioid use disorder, it's first given at a methadone clinic under the supervision of a healthcare professional (HCP). Methadone is available as tablets, liquids, and dissolvable tablets that are taken by mouth. It's common to have side effects like lightheadedness, dizziness, and sleepiness.

    Summary for Opioid
    Prescription only

    Tramadol is an opioid pain medication used when non-opioid medications aren't working well enough to control pain. Compared to other opioids, tramadol might have a lower risk of misuse and dependency. But tramadol is a controlled substance and has a lot of potentially serious risks, so it must be used with caution.

  • Indications of Methadone vs. Tramadol

    Indications for
    •Long-term pain that isn't relieved by non-opioid pain medications alone - except for Methadose brand name and its generics)
    •Treatment and maintenance of opioid use disorder (OUD) - all brand names and generics
    Indications for
    •Pain that isn't relieved by non-opioid pain medications alone

  • Pros and Cons of Methadone vs. Tramadol

    Pros and Const for Opioid
    Pros
    •Comes as a tablet and liquid that are taken by mouth
    •Available as a lower-cost generic version
    Cons
    •Can cause life-threatening slow breathing, especially if it's mixed with alcohol
    •Has potential to be habit-forming
    Pros and Const for Opioid
    Pros
    •Extended-release tablets and ConZip capsules are taken once per day and last throughout the day.
    •Immediate-release tablets are available as a lower-cost generic.
    •Possible lower risk of misuse and dependency compared to other opioids
    Cons
    •A controlled medication, so there are special requirements to get a prescription filled
    •Must slowly lower the dose to stop the medication after long-term use to avoid withdrawal symptoms
    •Can't use in some children due to higher risk of potentially severe and life-threatening side effects
    •Not recommended while breastfeeding

  • Common Side Effects of Methadone vs. Tramadol

    Common Side Effects for
    •Lightheadedness
    •Dizziness
    •Sleepiness
    •Nausea
    •Vomiting
    •Sweating
    Common Side Effects for
    •Constipation (up to 46%)
    •Nausea (up to 40%)
    •Dizziness (up to 33%)
    •Headache (up to 32%)
    •Sleepiness (up to 25%)
    •Vomiting (up to 17%)

  • Warnings of Methadone vs. Tramadol

    Common Side Effects for
    •Potential for misuse and addiction
    •Dangerously slow breathing (respiratory depression)
    •Risk for opioid overdose
    •Difficulty concentrating and extreme sleepiness
    •Life-threatening heart rhythm problems (QT prolongation)
    •Drug interactions
    •Harm to newborn babies
    •Serotonin syndrome
    •Low blood pressure
    •Low adrenal hormone levels
    •Seizures
    •Low blood sugar (hypoglycemia)
    •Withdrawal symptoms
    Common Side Effects for
    •Potential for addiction and misuse
    •Dangerously slow breathing (respiratory depression)
    •Overdose
    •Harm to newborn babies
    •Drug interactions
    •Difficulty concentrating and extreme sleepiness
    •Serotonin syndrome
    •Seizures
    •Low blood pressure
    •Low adrenal hormone levels
    •Physical dependence and withdrawal
    •Low blood sodium levels

  • Prices with our coupons for Methadone vs. Tramadol

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