Which drug is more harmful to the liver, tramadol or alcohol?

Tramadol is harmful when taken in large doses but it can be harmful even in normal doses if you have an unhealthy liver. Tramadol is a medication used for the therapy of mild-to-moderate pain. Tramadol overdose can result in acute liver failure. If you have liver diseases or a history of liver disease, your body may not be able to process this drug comfortably and result in more side effects.
On the other hand, Alcohol is harmful if taken in excessively amount. The small amount of alcohol with consuming balanced diet is not harmful. The liver filters the blood of toxins and impurities breaks down proteins and creates bile which helps the body absorb fats. When a person intakes alcohol heavily over the course of decades, the body starts to replace the liver's healthy tissue with scar tissue which results in liver damage.