Oxycodone and Hydrocodone – How They Differ and Side Effects

Last Updated: June 24, 2020

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

What Oxycodone and Hydrocodone Are

Presently, doctors prescribe both of these drugs as short-term painkillers for patients who had surgery or been injured. In addition, people use them to treat chronic pain, chronic cough, pain due to cancer and even arthritis.

One can take these drugs alone or a combination of both drugs. For example, acetaminophen may have a component of oxycodone to make it a specific narcotic painkilling drug. This type of combination can calm a patient’s mood. Incidentally, they may also combine hydrocodone with antihistamines to create a syrup. It can control coughs as well as relieve the pain due to excessive coughing. Furthermore, they both inhibit pain signals going to the central nervous system. As a result, this prevents the nerves from sending signals of pain to the brain. Otherwise, the only difference that one will find between these two medicines is on their side effects.

Where Is Oxycodone And Hydrocodone Used?

Oxycodone vs. HydrocodoneUsually, people use Oxycodone to treat moderate to severe level of pain. Additionally, People under this prescription may take it with the doctor’s instruction and discontinue it upon the doctor’s advice. Furthermore, one should not take it like the over-the-counter pain relievers.
Patients also use Hydrocodone to treat moderate to severe level of pain. Similarly, doctors prescribe it to patients with chronic pain, injury problem or have undergone surgery. Accordingly, one should only take this medicine with the doctor’s advice because it could lead to one’s addiction. In addition, people taking Hydrocodone will more likely develop dependency than those taking Oxycodone because it is an abused opioid.

Drug Class and How it Works

Meanwhile, during the fall of 2014, studies have categorized these drugs with different drug schedules. The drug schedule is the number they assign to a particular medicine, chemical or substance. This number shows the chances this substance will be abused as well as its acceptance for medical purposes. As a result, they classify both these medicines as schedule II drugs, because they have the possibility of abuse.

Oxycodone and Hydrocodone – Forms and Doses

Oxycodone vs. HydrocodoneFirstly, they may combine the drugs with other pain reliever medicines or chemicals. Pure Oxycodone has the brand name, Oxycontin. Additionally, this medicine is available in pill or tablet form and patients take it orally every 12 hours. These pills come in different doses, and patient‘s dose depends entirely on the level of pain felt.
Second, pure Hydrocodone comes in oral tablet, and have extended release (controlled releases) every 12 hours. The popular brand name for the drug is Zohydro ER. Furthermore, because it releases slowly to the body over a long period, it is ideal in treating chronic pain.

Oxycodone and Hydrocodone – Effectiveness

They are powerful painkillers and effective in treating pain. Additionally, they regard both medicines to treat pain equally. Consequently, patients taking these medicines have experienced pain relief of 30 to 60 minutes after intake. Incidentally, patients said that they had constipation while taking Hydrocodone and not with Oxycodone.

Oxycodone and Hydrocodone – Cost

One can get both of the drugs through their famous brand name or generic names. Of course, the generic ones are a lot cheaper. No doubt, before taking any of these medicines, consult first a doctor. In addition, there are some generic brands that differ in ratios of active and inactive components. For the FDA to consider the drug generic, it must contain the same amount of active ingredients. However, the regulations do not cover the inactive ingredients.
In any case, if a doctor prescribes the brand name, it can be expensive. For example, one can reduce its cost by getting prescription coupons or through insurance. However, if a person does not know how to make it cheaper, ask a pharmacist.

Oxycodone and Hydrocodone – Side Effects

Both of the drugs have similar common side effects and may include the following:

  • Shallow breathing
  • Drowsiness
  • Dizziness
  • Dry mouth
  • Lethargy
  • Itching
  • Impaired motor skill
  • Nausea
  • Vomiting

Incidentally, Hydrocodone will cause more constipation and stomach pain than Oxycodone.
Severe side effects of both medicines can include:

  • Seizures
  • Feeling of unconsciousness
  • Rapid heart rate that could lead to heart failure
  • Pain in urinating
  • Confusion

Oxycodone and Hydrocodone – Warnings

  • They are both powerful painkillers. Therefore, anyone wishing to take these medicines must consult first the doctor. In addition, they should report his or her medical history and other pre-existing health conditions and problems.
  • If one has asthma or difficulty in breathing, they must avoid these pain medications.
  • Patients who are constipated must not take Hydrocodone because it could worsen the problem.
  • Individuals with liver or kidney disease must not also take these medications.
  • While under these medications, do not drink alcohol because combining it could be dangerous. Furthermore, it can lead to excessive drowsiness or liver damage.
  • Pregnant women must consult the doctor because they could pass on in their milk and eventually affect the baby.
  • Misuse or abause of these medicines could lead to addiction, poisoning, overdose or death.

Which Medicine is Advisable?

In conclusion, both Oxycodone and Hydrocodone have the same effectiveness in treating acute and chronic pain. They also have the same side effects.

For example, a doctor may suggest Oxycodone first and see how it goes into the system. Consequently, from there they may recommend a change to Hydrocodone depending on the body’s initial reaction.

Page Sources

  1. Medline Plus. Oxycodone. 2019. https://medlineplus.gov/druginfo/meds/a682132.html.
  2. Medline Plus. Hydrocodone. 2019. https://medlineplus.gov/druginfo/meds/a614045.html.
  3. Marco C. A., Plewa M. C., Buderer N., Black C., Roberts A. Comparison of oxycodone and hydrocodone for the treatment of acute pain associated with fractures: a double-blind, randomized, controlled trial. Academic Emergency Medicine. 2005; 12(4): 282-8. https://www.ncbi.nlm.nih.gov/pubmed/15805317.
  4. Substance Abuse and Menatl Health services Administration. Oxycodone and Hydrocodone: Detection in Urine, Oral Fluid, and Blood. 2014. https://www.samhsa.gov/sites/default/files/meeting/documents/flegel-research-studies-dtab-june-2014_0.pdf.

Published on: January 25th, 2017

Updated on: June 24th, 2020

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.


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