Compare Acetaminophen With Codeine vs. tramadol

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

Treats mild to moderate pain.

Tylenol #3 (Acetaminophen / Codeine) is a good option to treat pain and cough as needed when over-the-counter medicines can't control the symptoms, but must make sure you don't take too much acetaminophen (Tylenol) to avoid liver problems or death.

3.7/ 5 average rating with 581 reviewsforAcetaminophen With Codeine
Treats moderate to severe pain.

Ultram (tramadol) works well for pain. Although it's a little weaker than other opioids, it can still be addictive.

3.4/ 5 average rating with 642 reviewsfortramadol
Upsides
  • Combination pain medicine with an opioid component (codeine) and non-opioid component (acetaminophen or Tylenol) that takes advantage of different modes of pain relieve in a single pill.
  • Provides quick relieve for mild to moderate pain to improve quality of life.
  • Good for as-needed pain and control.
  • Generally well tolerated by people, especially if taken with food to lower risk of stomach upset.
  • Lower rates of misuse compared to pure opioid medicines.
  • Can help you fall asleep easier.
  • Relieves moderate to severe pain. It has been shown to work as well as other opioid pain medications.
  • Compared to typical opioids, it provides unique pain relief and effects on your mood when taken regularly.
  • Has a lower chance of causing breathing problems compared to other typical opioids.
  • Doesn't cause as much constipation as other opioid pain medicines. Staying hydrated and taking laxatives can help treat this side effect.
Downsides
  • Dizziness and drowsiness is common, but your body may adjust.
  • Everyone will get constipation - always stay hydrated and take stool softener or stimulant on days you're taking Acetaminophen with codeine if you need.
  • All opioid containing medicines have the risk of physical dependence and possibility of withdrawal when used long-term.
  • The non-opioid part of Acetaminophen with codeine, acetaminophen (Tylenol), has a high risk of liver failure and death if you take more than the maximum daily dose. Be very careful.
  • Relies on the users to be aware of how much acetaminophen (Tylenol) they are using since it is a very common ingredient in many prescription and non-prescription pain medicines.
  • Avoid alcohol.
  • Some people think it's weaker than other opioid pain medications. It can also cause more upset stomach.
  • Like other opioid pain relievers, Ultram (tramadol) has a high risk of addiction, abuse, misuse, overdose, and death.
  • The extended release version of Ultram (tramadol) should only be used for severe pain that requires daily, around-the-clock treatment once alternative treatments haven't worked.
  • It's a controlled substance regulated by the federal government. This means that your use of Ultram (tramadol) will be tracked to prevent potential prescription abuse.
  • Like all opioids, don't use when pregnant, since the baby can become dependent on it and have withdrawal symptoms after birth.
Used for
Dosage forms
  • Pill
  • Liquid
  • Pill
  • Extended release
  • Extended release capsule
  • Dissolving tablet
Price
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Reviews
581 reviews so far
69%
saidit'sworth it
41%
saiditworked well
9%
saidit'sa big hassle

Have you used Tylenol #3 (Acetaminophen / Codeine)?

Leave a review
642 reviews so far
61%
saidit'sworth it
40%
saiditworked well
16%
saidit'sa big hassle

Have you used Ultram (tramadol)?

Leave a review
Side effects
The Tylenol #3 (Acetaminophen / Codeine) FDA package insert doesn’t have numbers about how common side effects are.
13possible side effects
  • Dizziness
    26%
  • Nausea
    24%
  • Constipation
    24%
  • Headache
    18%
  • Sleepiness
    16%
  • Vomiting
    9%
  • Pruritus
    8%
  • CNS Stimulation
    7%
  • Asthenia
    6%
  • Sweating
    6%
  • Dyspepsia
    5%
  • Dry Mouth
    5%
  • Diarrhea
    5%
See more detailed side effects
Risks and risk factors
No information currently available
  • Breathing problems
    • Age 65 or greater
    • Overdose
    • Using alcohol, benzodiazepines or other medicines that slow breathing
  • Addiction, abuse, and overdose
    • Taking more than the prescribed dose
    • Taking with alcohol or benzodiazepines
    • Stopping Ultram (tramadol) suddenly
  • Interactions with other drugs
  • Withdrawal in newborns
    • Pregnancy
  • Accidental ingestion
    • Children can reach medication
See more detailed risks and warnings