What's the Difference Between Oxycodone and Hydrocodone?

Hydrocodone and oxycodone are both opioid pain relievers. They’re available by prescription to treat moderate to severe pain, including that from cancer or recent surgery.

The medications have similar chemical structures, and they work by blocking certain receptors in the brain to change how the brain processes pain. While the medications are effective pain relievers, they also have the risk of tolerance, dependence, and addiction. This is why they are only used for a short period, unless prescribed for a chronic pain condition and closely monitored by a healthcare provider.

This article will compare hydrocodone vs. oxycodone. It will explain the difference between oxycodone and hydrocodone, which is stronger, their side effects, and more. 

Oxycodone vs. Hydrocodone Differences

Learn about the differences and similarities of oxycodone and hydrocodone.

Uses of Oxycodone and Hydrocodone

Oxycodone and hydrocodone are both used to treat pain. They are usually only used when other pain treatments haven’t worked. That’s because both carry a serious risk of dependence and addiction. In most cases, these medications are reserved for people who need around-the-clock pain relief.

A healthcare provider might prescribe these pain relievers if you have a severe injury like a broken bone, or if you’re recovering from surgery. People with painful, chronic conditions like cancer or sickle-cell disease may be prescribed oxycodone or hydrocodone as well.

Drug Class

Both oxycodone and hydrocodone are part of the same drug class. They are both Schedule II opioid or narcotic drugs. That means they have accepted medical uses (in this case, pain relief). However, they are also considered dangerous because they have a high potential for misuse and abuse. If you take either of these drugs for longer than a short period, you can become physically and psychologically dependent on them.

Forms and Dosage

If you’re comparing hydrocodone vs. oxycodone, it’s important to consider the forms and dosage. While your healthcare provider will help you determine the forms and dosage that are right for you, the information below may also be helpful. 

Oxycodone comes in six forms. They are:

• Liquid solution
• A concentrated liquid solution
• A tablet
• A capsule
• An extended-release tablet
• An extended-release capsule

Your healthcare provider will start you on a low dose of oxycodone to begin with—usually 5 to 10 milligrams every four to six hours. Over time, your body may become accustomed to the drug, and you’ll need a higher dose to get the same amount of pain relief. 

Hydrocodone is available as an extended-release capsule or tablet. The tablet is taken once daily, and the capsule is usually taken once every 12 hours. Most often, you’ll start on a low dose of hydrocodone, usually 5–10 milligrams per dose. 

Effectiveness

Both hydrocodone and oxycodone are considered effective pain relievers. One study of people who visited the emergency room for pain found that 50% of them had less pain when they were given hydrocodone or oxycodone.

Side Effects

Hydrocodone can have more side effects than oxycodone. However, the two medications have similar side effects overall. Because they are depressants, both medications can cause drowsiness, sedation, respiratory depression, and death if taking too much or using them too frequently. For your safety, it's important not to drive a vehicle or operate machinery until you know how the medication affects you.

It's important to avoid taking opioids with alcohol. Always ask your healthcare provider if you're unsure how alcohol may interact with any medications you may be taking.

Oxycodone Side Effects

The common side effects of oxycodone include:

• Dry mouth
• Stomach pain
• Feeling drowsy
• Flushing
• Headache 
• Changes to mood

Hydrocodone Side Effects

The common side effects of hydrocodone include:

• Stomach pain
• Dry mouth
• Feeling tired
• Headache
• Back pain
• Tight muscles
• Painful or frequent urination
• Ringing in the ears
• Sleep trouble
• Foot, ankle, and leg swelling
• Uncontrollable shaking

Risks

Both oxycodone and hydrocodone are considered to have serious risks. That is why they are classified as Schedule II drugs. It’s important to be aware of the risks and discuss them openly with your healthcare provider.

Addiction

The biggest risk of oxycodone and hydrocodone is addiction. Both drugs carry an important warning about their potential to be habit-forming. If you or any of your household members have a history of substance use disorder or addiction, have a candid conversation with your healthcare provider about whether oxycodone or hydrocodone are right for you.

People who misuse these drugs by taking them more often than prescribed are at risk for overdose. Symptoms of an overdose include:

• Shallow, slow, or difficult breathing that may progress to stopping breathing
• Sleepiness, progressing to an inability to respond or wake up
• Slow heart rate that may progress to cardiac arrest
• Muscle weakness
• Cold, clammy skin

If you have a prescription for oxycodone and hydrocodone, talk to your healthcare provider about getting Narcan. This is an emergency nasal spray that can be used to reverse opioid overdose. 

Drug Interactions

Oxycodone and hydrocodone have many drug interactions. You should tell your healthcare provider about any prescription drugs or supplements you take. You should also tell them about your alcohol use. They may recommend not drinking while you are taking oxycodone and hydrocodone.

The list of drugs that interact with oxycodone and hydrocodone is extensive. That’s why it’s important to tell your healthcare provider about all the medicines you’re taking. Here’s an overview of some common drugs that interact with oxycodone and hydrocodone:

• Antihistamines
• Cough medications 
• Selective serotonin-reuptake inhibitors (SSRIs)
• Monoamine oxidase inhibitors (MAOIs)
• Saint-John's-wort 
• Tryptophan
• Gabapentin
• Sedatives such as benzodiazepines like Xanax (alprazolam) and Valium (diazepam)
• Muscle relaxers
• Medications used to help fall or stay asleep
• Certain antibiotic, antiviral, or antifungal medications
• Certain anti-seizure medications
• Other opioid medications

Withdrawals

If you’ve been taking hydrocodone or oxycodone for a while, your body can become dependent on the medications. You should never stop taking them suddenly because if you do, you can experience withdrawal. Talk with your healthcare provider about how to safely stop taking painkillers. 

Summary

Hydrocodone and oxycodone are opioid pain relievers used to treat moderate or severe pain. Both medications carry a serious risk for dependence and addiction. Because of that, they should only be used short term.

Before taking these medications, tell your healthcare provider about any medication you take, including vitamins and supplements. Talk about your alcohol use and how to safeguard yourself against opioid overdose.