Compare Tramadol vs. Acetaminophen With Codeine

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

Ultram
(tramadol)

Tylenol #3
(acetaminophen / 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.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.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
4.62Tramadol
Reviews for Tramadol
61%
of people (All ages) say Tramadol is worth it
40%
say it works well
16%
say it's a big hassle
642 reviews
Have you used Ultram (tramadol)?
Worth itNot sureNot worth it
Reviews for Acetaminophen With Codeine
69%
-8% worse vs. Tramadol
41%
-1% worse vs. Tramadol
9%
-7% worse vs. Tramadol
581 reviews
Have you used Tylenol #3 (acetaminophen / codeine)?
Worth itNot sureNot worth it
Side effects
TramadolAcetaminophen With Codeine
  • Dizziness 26%
  • Constipation 24%
  • Nausea 24%
  • Headache 18%
  • Sleepiness 16%
  • Vomiting 9%
  • Itching 8%
  • Cns stimulation 7%
  • Muscle weakness 6%
  • Sweating 6%
More Tramadol side effects »

The Acetaminophen With Codeine FDA package insert doesn’t have numbers about how common side effects are.

More about Acetaminophen With Codeine side effects »
How it works
TramadolAcetaminophen With Codeine
Ultram (tramadol) is an opioid pain reliever. Researchers don't know exactly how it works, but it alters certain brain chemicals to lower pain perception and improve mood.Tylenol #3 (Acetaminophen / Codeine) is a combination pain medicine. Codeine is an opioid (similar to morphine) that works in the brain to lower pain perception. Acetaminophen is a non-opioid pain reliever and fever reducer.
Type of medication
TramadolAcetaminophen With Codeine
Prescription onlyPrescription only
Available as
TramadolAcetaminophen With Codeine
  • Pill
  • Extended release
  • Extended release capsule
  • Dissolving tablet
  • Pill
  • Liquid
Used for
TramadolAcetaminophen With Codeine
Risk factors for serious side effects
TramadolAcetaminophen With Codeine
  • Pregnancy
  • Age 65 or greater
  • Overdose
  • Using alcohol, benzodiazepines or other medicines that slow breathing
  • Taking more than the prescribed dose
Detailed Ultram (tramadol) risks & warnings »
    Coming soon.
    Pregnancy

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    Interactions
    TramadolAcetaminophen With Codeine
    • Ultram (tramadol) can interact with your other medicines, which can change how it affects your pain. Stopping these medicines while taking Ultram (tramadol) can make you more likely to have serious, life threatening side effects. Make sure your doctor and pharmacist know all the medicines you're taking, and let them know of any changes.
    No interactions related info.
    Alcohol
    TramadolAcetaminophen With Codeine
    No alcohol related info.
    • Avoid alcohol.
    Food
    TramadolAcetaminophen With Codeine
    • Take Ultram (tramadol) with food to avoid an upset stomach.
    • Take it with food to lower the chance of an upset stomach.
    Kidneys and liver
    TramadolAcetaminophen With Codeine
    • There are different doses for people who are older or who have liver or kidney disease, so work with your doctor to get the right dose.
    • Don't take more than instructed to prevent liver damage.
    Pain
    TramadolAcetaminophen With Codeine
    • Relieves moderate to severe pain. It has been shown to work as well as other opioid pain medications.
    • 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.
    • This is a combination pain medication. It contains both an opioid medicine, and acetaminophen (Tylenol).
    • Works best if you take it as soon as you start feeling pain.
    • Pain relief lasts 4-6 hours.
    • 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.
    • Good for as-needed pain and control.
    Sleep
    TramadolAcetaminophen With Codeine
    No sleep related info.
    • Can help you fall asleep easier.
    • Dizziness and drowsiness is common, but your body may adjust.
    Upsides and benefits
    TramadolAcetaminophen With Codeine
    • 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.
    • 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.
    Downsides and risks
    TramadolAcetaminophen With Codeine
    • 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.
    • 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.
    Tips from our pharmacists for people taking the medication
    TramadolAcetaminophen With Codeine
    • Starts working in one hour and works best if you take it regularly.
    • Can make you dizzy or drowsy, so avoid activities that need you to be fully alert until you know how this medicine affects you.
    • Take Ultram (tramadol) with food to avoid an upset stomach.
    • There are different doses for people who are older or who have liver or kidney disease, so work with your doctor to get the right dose.
    • Swallow the extended-release tablets whole. They're designed to release the drug slowly and breaking, crushing, or chewing them could cause a serious overdose.
    • Take the extended-release tablets exactly as your doctor and pharmacist tell you. If you forget, take it as soon as you remember. Don't take extra medicine to make up for a missed dose.
    • This is a combination pain medication. It contains both an opioid medicine, and acetaminophen (Tylenol).
    • Starts working in 30 minutes.
    • Works best if you take it as soon as you start feeling pain.
    • Pain relief lasts 4-6 hours.
    • Can make you dizzy or drowsy.
    • Avoid activities need you to be fully alert until you know how it affects you.
    • Take it with food to lower the chance of an upset stomach.
    • Constipation is common and may not go away while you're taking this medicine. Drinking lots of water and using laxatives can help.
    • Don't take more than instructed to prevent liver damage.
    • Use it for the shortest time possible, and at the lowest dose possible, to lower your chance of becoming addicted.
    • Talk to your doctor if it doesn't help enough for your pain, or if the side effects are really bad.
    Learn more
    More about TramadolSide effectsReviews & ratingsAlternativesFDA package insert
    Have you used Ultram (tramadol)?
    Worth itNot sureNot worth it
    More about Acetaminophen With CodeineSide effectsReviews & ratingsAlternativesFDA package insert
    Have you used Tylenol #3 (acetaminophen / codeine)?
    Worth itNot sureNot worth it