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Q: I used to be on Vicodin for back pain and my doctor changed it to tramadol. Will it work the same and is it ok to take Flexeril or Ativan, if needed, while on it? A: Vicodin (hydrocodone/acetaminophen) is a narcotic pain reliever used to alleviate moderate to severe pain. Tramadol is a narcotic-like pain reliever that is also used to alleviate moderate to severe pain. Unlike tramadol, Vicodin (hydrocodone/acetaminophen) is a controlled substance. The maximum daily dose for tramadol is 400mg/day so it is important not to exceed 8 tablets daily.
Tramadol’s use in pregnancy is generally avoided as it may cause some reversible withdrawal effects in the newborn.[16] A small prospective study in France found that, while there was an increased risk of miscarriages, there were no major malformations reported in the newborn.[16] Its use during lactation is also generally advised against, but a small trial found that infants breastfed by mothers taking tramadol were exposed to about 2.88% of the dose the mothers were taking. There was no evidence of this dose having a harmful effect on the newborn.[16]
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