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By Kajal Jain

M. Pharm

21 January 2023
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SOMA VS TRAMADOL
Table of Contents

If you are looking for a comparison between Carisoprodol and Tramadol, chances are you're unaware of the analgesic that works best for your pain. Let me break it down for you. 

Carisoprodol and Tramadol are undoubtedly two wholly different and effective analgesics available today. However, they belong to other drug classes and work on different pain causes. 

A National Institute of Health survey estimates about 11 % of Americans experience body pain every day for about three months. It is also one of the leading reasons Americans incorporate complementary health approaches to managing pain.

Carisoprodol and Tramadol have been pre-eminent analgesics paving their way toward improving acute and chronic pain. Their impeccable potency makes it familiar for users to compare Carisoprodol and Tramadol.

This blog addresses the pharmacological similarities and dissimilarities between the two analgesics and helps you choose the best-suited pain medication. 

What Is Carisoprodol?

Soma, a trading name for the prescription drug Carisoprodol, is a non-benzodiazepine muscle relaxant prescribed to relieve pain from muscle injuries and spasms. It is used as an adjunct to rest, physical therapy, and other measures to reduce acute, painful musculoskeletal conditions.

Carisoprodol is available as a 350-milligram tablet. When it is taken in dosages exceeding those recommended by physicians, Carisoprodol causes giddiness, drowsiness, and relaxation. It is metabolized into Meprobamate, a Schedule IV controlled drug with potential abuse. It is rated C in the FDA's pregnancy Safety ranking for medications.

Doctors can only prescribe it for a maximum of 3 weeks. There is insufficient evidence that it works for more extended periods. The recommended dosage is 250-300 mg three times a day and at bedtime.

What Is Tramadol?

Tramadol is a strong painkiller from a class of medicines called narcotics or opiates. It is used to treat moderate-to-severe pain, for example, after a severe injury or operation. In 1995, it was approved for marketing as a non-controlled analgesic in the United States under the trade name Ultram. 

Tramadol is a Schedule IV controlled drug, and there have been reports of diversion and abuse soon after its approval. Adverse events and abuse of Tramadol are similar to other opioid analgesics.

Tramadol is available in tablet, extended-release tablet, injection, and patch form. When consumed incorrectly (broken or crushed), the extended-release tablet form acts in increased concentrations leading to overdosing symptoms.

The consumption of alcohol with Carisoprodol and Tramadol can result in central nervous system depression. It can also cause impairment of judgment and psychomotor skills, and thinking ability.
Carisoprodol is a prescription skeletal muscle relaxant, and Tramadol is an opioid medicine available only on a prescription from your doctor.
A narcotic is an opioid pain reliever. Tramadol belongs to a class of medications called opiate (narcotic) analgesics.

How Does Carisoprodol Work?

Carisoprodol is a centrally-acting muscle relaxant prevalent in treating short-term acute pain. When taken with rest and physical therapy, it acts against skeletal muscle conditions caused by strain, injury, and sprain.

Carisoprodol's working mechanism helps relieve the pain and affects communication between the nerve and central nervous system. It metabolizes in the liver and is further excreted by the kidneys. In the liver, the Carisoprodol is metabolized to Meprobamate, which significantly accounts for its abuse potential.

Patients with a lower level of CYP2C19 (enzyme for metabolization) lead to increased concentration of Carisoprodol in the body.

About 25 % of the Carisoprodol dosage taken is converted to Meprobamate, indicating that it is 3.25 times stronger than Carisoprodol. In simpler terms, 200mg of Meprobamate is equivalent to 650mg of Carisoprodol. 

How Does Tramadol Work?

Tramadol is a centrally-acting opioid agonist analgesic. In patients with moderate to severe intramuscular, intravenous, and postoperative pain and Fibromyalgia, the use of Tramadol can be effective. 

Tramadol's working mechanism includes blocking the body's pain sensation from traveling to the brain receptor, thus inducing a sense of pain relief. It inhibits the serotonin reuptake, i.e., blocking the pathways involved in the transmission of pain.

It undergoes hepatic metabolism to form five different metabolites. Desmetramadol (INN) is one of the most significant metabolites as it has 200 times the affinity of Tramadol. Furthermore, the elimination half-life of Desmetramadol (INN) is 9 hours compared to Tramadol, which is about 6 hours.

Precautions - Safety Measures Before Consuming

While administering Carisoprodol and Tramadol, following particular warning and prevention measures ensure a lower risk of experiencing adverse effects. 

Precautions of Carisoprodol 

Muscle relaxers such as Carisoprodol (Soma) can be habit-forming. Make sure you take your medicine exactly as your healthcare professional prescribes.

  1. Carisoprodol depresses your central nervous system (CNS), making it hard to stay awake or pay attention. While taking this muscle relaxer, avoid activities that require coordination or mental alertness, such as driving or operating heavy machinery. 
  2. Speak to your doctor about how safely you can use Carisoprodol if you are older than 65. You have a renal or hepatic disorder, mental health problem, or brain disorder.
  3. You should avoid taking muscle relaxants with the following drugs to prevent any adverse reaction: Alcohol, Sleep aids, CNS depressants, such as psychotropics or opioids, and Herbal supplements, such as St. John's wort.
  4. Muscle relaxants can cause withdrawal symptoms, such as hallucinations or seizures. Do not discontinue taking your medication suddenly, especially if you've been taking it longer.
  5. The consumption of alcoholic beverages with Carisoprodol is not advisable.
  6. In case of a missed dosage, take it once you remember; however, avoid the intake if it is already time for the next dosage.  

Precautions Of Tramadol

Tramadol is to be taken only if strictly recommended and prescribed by a medical doctor. Your doctor will have thoroughly assessed your specific condition before determining treatment with Tramadol as an option. Before prescribing this drug, they will weigh benefits against potential complications and likely side effects. If favorable, your doctor will recommend a prescription with strict instructions.

  1. The consumption of alcoholic beverages with Tramadol is not advisable. 
  2. Tramadol or its inactive constituents can cause various complications and allergic reactions. Discuss with your doctor if you have any known allergies or have experienced adverse reactions in the past.
  3. Tramadol may adversely interact with symptoms associated with conditions such history of (or current) brain and nervous system disorders, Parkinson's disease, head injuries or tumors, breathing and respiratory disorders, mental or mood disorders, addiction or substance abuse (drugs and alcohol), genetic conditions, intestinal and digestive problems.
  4. People 65 years or older are known to be more sensitive to some side effects of this medication.
  5. Tramadol is advisable for adults and children above 12 years old. However, the administration of the Carisoprodol pill is not recommended for patients below 16 years. 
  6. It is strongly advised to disclose information related to pregnancy to your doctor before taking a prescription for Tramadol, especially during the first trimester. 
  7. If you require surgery or dental procedures at any stage during treatment, you must inform your use of Tramadol to all attending professionals. 
  8. Sudden discontinuation of Tramadol is not advisable and should be done after consulting a doctor. 
  9. Tramadol can cause drowsiness and dizziness. Therefore, the operation of heavy machinery and driving should be avoided. 
  10. In case of a missed dosage, take it once you remember; however, avoid the intake if it is already time for the next dosage. 

Possible Side Effects

Every drug endures some side effects. It depends on the individual and the amount of consumption. The side effects can sometimes be common but critical. With the advancement of online pharmacies, there is an acceleration in users who buy Soma and Tramadol online. Such non-prescription users are often more vulnerable to experiencing side effects due to their lack of product information.  

Common side effects of Carisoprodol and Tramadol include-

  • Headache
  • Drowsiness
  • Dizziness

Allergic signs-

  • Fever
  • Diarrhea
  • Sweating
  • Vomiting
  • Twitching
  • Muscle stiffness
  • Hallucinations
  • Fast heart rate
  • Loss of coordination

Side Effects Of Carisoprodol 

Side Effects Of Tramadol

Drowsiness

Dilated pupils

Headache

Fast heart rate

Dizziness

Slow breathing

Irritability

Teary eyes

Tremor

Stomach cramps

Insomnia

Chills

Nervousness

Increased blood pressure

Agitation

Runny nose

Apart from the side effects listed here, these analgesics have other possible adverse effects. Each individual reacts differently to the analgesic, thus portraying different severity and impact. 

The above list doesn't consist of all the side effects. If you experience other side effects, do not delay and visit your doctor. Kindly contact your physician for further medical assistance.     

Tramadol And Carisoprodol High- Which Is More Prone To Abuse? 

Tramadol is a prescription narcotic analgesic that has been criticized as a "risky" choice. Tramadol can be very addictive and lead to death associated with overdosing.

According to a National Survey of Drug Use and Health study, about 1.8 million Americans have abused Tramadol alone or in combination with other compounds over the past three years.

Tramadol can cause a high that elevates the mood, dulls pain, relax people, and reduces Anxiety. Like most prescription drugs, if taken as advised by the doctor, the risk of abuse and addiction is significantly reduced.

The US Drug Intelligence Center classifies Carisoprodol as one of muscle relaxers' most significant threats to abuse. It can cause sedation, euphoric high, elevated mood, increased energy, hallucinations, and socialization at higher doses.

Carisoprodol abuse also causes drowsiness, confusion, loss of coordination, and slower reaction time. Both Carisoprodol and Tramadol high can have severe consequences if administered inappropriately. These analgesics should not be overdosed and must be taken as a doctor advises.

Common Between Carisoprodol And Tramadol

Carisoprodol and Tramadol have unique characteristics and properties that make them more efficient drugs than one another. Both drugs vary in pharmacology, morphology, pharmacokinetic or pharmacodynamic properties. Let us find out about the similarities and dissimilarities of these drugs.

 

Carisoprodol

Tramadol

FDA Approval

FDA-approved (In 1959)

FDA-approved (In 2008)

Pregnancy category

Category C

Category C

Legal status

Schedule IV controlled drug

Schedule IV controlled drug

Difference Between Carisoprodol And Tramadol

 

Carisoprodol

Tramadol

Brand Name

-    Carisoprodol

-    Ultram

Class of drug

-   Non-Benzodiazepine muscle relaxant

-    Opioid analgesic

Indications

-   Relieves discomfort associated with acute, painful musculoskeletal conditions

-   Relieves moderate to severe pain, including pain after surgery or Fibromyalgia

Dosage

-   Recommended daily dose is 250 - 350 mg, 3 times daily at bedtime.

-   Recommended daily dose is 50 – 100 mg orally. The maximum dose is 300 mg/day

Dosage Form

-    Available as an oral tablet

-   Available as an oral tablet, IV, IM, and rectal formulation

Metabolism

-     Metabolized via Liver (CYP2C19-mediated)

 

-   Liver-mediated demethylation 

and glucuronidation via CYP2D6 & CYP3A4

 

Elimination half-life

-      2.5 hours of 12 hours

-      5 - 6 hours

Onset of Action

-     Rapid (30 minutes)

-     Less than 1 hour (orally)

The onset and time of action play a crucial role in determining the efficacy and potency of Carisoprodol and Tramadol. A long onset time can be a deal breaker for most people, as none of us would like slow-acting pain medication.

The onset of action of Carisoprodol is 30 minutes, and the muscle-relaxing and pain-relieving effects last 5 to 6 hours.

In comparison, the effect of Tramadol begins within an hour of administration and reaches its peak in 2 to 4 hours. Tramadol's Immediate-release lasts 4 to 6 hours, and its extended-release formulation lasts 12 to 24 hours.

Pros and Cons

In this comparative study between Carisoprodol vs. Tramadol, Soma emerges as a better option for people struggling with short-term acute pain. In contrast, Tramadol is best suited for chronic pain. 

PROS

  • Tramadol is available in different dosage forms- Tablets, solutions, capsules, and suspensions.
  • Tramadol can be administered by people 12 years and older. 
  • Carisoprodol pill is cheap compared to Tramadol. 
  • It takes 30 minutes for Carisoprodol to start working.
  • The risk of addiction to the Carisoprodol pill is lower.  
  • Carisoprodol has a lower risk of experiencing side effects. 

CONS

  • Carisoprodol pill is only available as tablets.
  • Carisoprodol (Carisoprodol) is advised for people 16 years and older. 
  • Tramadol takes 30 to 60 minutes to show a result. 
  • The chances of abusing Tramadol are high.
  • Tramadol is considered a controlled substance by Drug Enforcement Administration (DEA) and the Centers for Disease Control and Prevention (CDC). 
  • The occurrence of side effects in Tramadol is comparatively higher. 

In the long run, it is essential to identify the kind of pain (acute or chronic) you are suffering from to determine which, among Carisoprodol and Tramadol, is the right choice for you. 

Which Is More Effective, Carisoprodol Or Tramadol?

To help with discomfort, Tramadol has been included as a prescription for treating premature ejaculation (a male sexual disorder). Tramadol is outstanding among other medications that can relieve agony. However, it spends more than is recommended and can trigger a reaction that puts the individual at risk of becoming addicted.

Since both drugs have similar efficacy for different types of pain, Tramadol is the more affordable choice. Tramadol can also be considered a better treatment for moderate back pain than Carisoprodol (Carisoprodol), as it is believed that the treatment of moderate back pain lies between the two medications.

Which Is Stronger, Carisoprodol Or Tramadol?

No definite evidence exists to state which analgesia is stronger than the two medicines. However, here are a few critical points of both anesthetics to consider-

  • The onset of action of the Carisoprodol pill is less than Tramadol. 
  • The effects of Tramadol may last for 3 to 6 hours, whereas that of Carisoprodol is 4 to 6 hours. 
  • Tramadol is known to cause more severe side effects than Carisoprodol.
  • The possible drug interaction of Tramadol is much greater than Carisoprodol. 
  • Carisoprodol and Tapentadol reviews indicate Carisoprodol to be a more preferred analgesic among people with a higher user rating than Tramadol.

Bottom Line From Practical Anxiety Solutions

It is a fact that painkillers are extremely beneficial medications that benefit a lot of people from mild to severe pain. Carisoprodol and Tramadol have been FDA-approved despite the associated risks. It is because their lists of pros outweigh their cons. 

It will reduce the incidence of drug-related addictions and complications. Additionally, it will encourage medicine companies to keep researching and making even better analgesic medications for the betterment of humankind.

  • Lee, C.R., McTavish, D. & Sorkin, E.M. Tramadol. Drugs 46, 313–340 (1993). From https://doi.org/10.2165/00003495-199346020-00008 Obtained on 21/01/2023
  • Grond, S., Sablotzki, A. Clinical Pharmacology of Tramadol. Clin Pharmacokinet 43, 879–923 (2004). From https://doi.org/10.2165/00003088-200443130-00004 Obtained on 21/01/2023
  • Littrell, Robert A., Therese Sage, and William Miller. "Meprobamate dependence secondary to carisoprodol (Soma) use." The American journal of drug and alcohol abuse 19.1 (1993): 133-134. From https://doi.org/10.3109/00952999309002671 Obtained on 21/01/2023
  • Fass, Jennifer A. "Carisoprodol legal status and patterns of abuse." Annals of Pharmacotherapy 44.12 (2010): 1962-1967. From https://doi.org/10.1345/aph.1P339 Obtained on 21/01/2023
  • Reeves, Roy R., and Vincent Liberto. "Abuse of combinations of carisoprodol and tramadol." Southern medical journal 94.5 (2001): 512-514. Obtained on 21/01/2023
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