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Suboxone vs. Tramadol

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

Key takeaways

Buprenorphine/naloxone (Suboxone, Zubsolv, Bunavail) and tramadol (Ultram, ConZip, Qdolo) are both opioid medications, but they are used for different purposes. Buprenorphine/naloxone is a combination medication used to treat opioid dependence, while tramadol is used to manage pain when non-opioid medications aren't effective. Buprenorphine/naloxone works by reducing opioid cravings and withdrawal symptoms, combining a partial opioid agonist (buprenorphine) and an opioid antagonist (naloxone). Tramadol, on the other hand, is an opioid receptor agonist that also increases serotonin and norepinephrine levels to help manage pain. Buprenorphine/naloxone is available in different forms like sublingual films and tablets, whereas tramadol is available in immediate-release and extended-release oral forms. Both medications have a risk of misuse and dependency, but tramadol is considered to have a lower risk compared to other opioids. Additionally, tramadol is not recommended for use in children under 12 or for breastfeeding mothers, while buprenorphine/naloxone requires careful dosing adjustments and is not interchangeable between its different brand forms.

Suboxone tablets

(buprenorphine / naloxone)

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Tramadol

 

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Summary for Suboxone

Prescription only

Suboxone tablets (buprenorphine / naloxone) are used for the maintenance treatment of opioid use disorder (OUD) in adults. This medication-assisted treatment is given along with counseling and social and emotional support. It contains two active ingredients: buprenorphine is a partial opioid agonist, and naloxone is an opioid antagonist. The tablets are taken sublingually once per day (they're placed under the tongue where they dissolve). The dosage depends on each person's situation. Side effects include headache, pain, and nausea. It's a controlled substance because it has a risk of being addictive and being misused.

Note: The Suboxone brand name for the sublingual tablets is discontinued, but there are generic versions available. Buprenorphine/naloxone sublingual tablets are also available under the brand name Zubsolv.

Indications for Suboxone

Pros and Cons for Suboxone

Pros

  • Available as a lower-cost generic
  • Comes as a tablet that's dissolved under the tongue
  • Causes milder withdrawal symptoms than other common opioids if stopped suddenly

Cons

  • Can cause bothersome side effects, such as headache, trouble sleeping, and nausea
  • Has a risk for misuse and dependency
  • Is a controlled substance, so there are special requirements for filling a prescription

Common Side Effects for Suboxone

  • Headache (36%)
  • Withdrawal symptoms, such as anxiety, goosebumps, stomach discomfort, irritability, cold sweat, joint pain, and watery eyes (25%)
  • General pain (22%)
  • Nausea (15%)
  • Sweating (14%)
  • Trouble sleeping (14%)
  • Constipation (12%)
  • Stomach pain (11%)

Warnings for Suboxone

  • Potential for addiction and misuse
  • Potentially life-threatening slowed breathing (respiratory depression)
  • Risk for opioid overdose
  • Difficulty concentrating and extreme sleepiness
  • Harm to newborn babies
  • Low adrenal hormone levels
  • Withdrawal symptoms
  • Liver damage
  • Dental problems
  • Life-threatening heart rhythm problem (QT prolongation)
  • Low blood pressure
  • Not for use for pain or for people who haven't taken opioids before

Summary for Tramadol

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 for Tramadol

  • Pain that isn't relieved by non-opioid pain medications alone

Pros and Cons for Tramadol

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 for Tramadol

  • 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 for Tramadol

  • 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 Suboxone vs. Tramadol

Price Card Drug Icon
Buprenorphine/Naloxone14 films / 8mg/2mg
$32.34$126.48
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Tramadol60 tablets / 50mg
$11.42$22.11
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