"this medication did not help me with my pain,  peroid. i took up to 400mg at once and still no relief but it did make me feel nauseated and gave me a headache. it&#039;s synthetic and really more like a weak antidepressant. i was prescribed it to alternate with my hydrocodone 10mg tabs. i stopped my norco for a 2 week period to give tramadol a chance but it never worked. this stuff is rubish! no it&#039;s not equal to codeine. i have taken codeine and tramadol is entirely different in effect. sorry i&#039;ll stick to true morphine based pain meds like codeine, hydrocodone, oxycodone, etc. even synthetic darvocet worked better than this stuff!"