Hydrocodone vs. Oxycodone

What Is the Difference Between Hydrocodone and Oxycodone?

Hydrocodone and oxycodone are both pain relievers. They block your body's pain signals. They’re very similar, but there are some differences in side effects.

Both are a type of painkiller called an opioid, which can be addiction forming. Opioids come from the poppy plant, but there are human-made versions, too.

Your doctor might prescribe one of these medicines to treat severe pain that hasn't gotten better with medicines that aren’t as strong, like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs).

You might take these painkillers for a short period of time after surgery or an injury like a broken bone. Or you might take them longer term to manage chronic pain from illnesses like cancer or arthritis.

Studies show both hydrocodone and oxycodone work well for short-term pain. But when you take them for more than a couple of months, your body can become used to the drug, and it won't work as well. Because of this, you need more of it to feel the same effects.

Opioids are some of the most commonly abused prescription drugs. Talk with your doctor about how to safely take them to lower your risk for addiction and abuse.

Forms

You can take either drug on its own or with another pain reliever like acetaminophen, aspirin, or ibuprofen.

They might be in liquid, tablet, or capsule form. Both also come in extended-release (ER) capsules and tablets. They slowly release the drug into your body so it lasts longer. ER versions are not meant to treat short-term pain, like the kind you have after surgery.

Dosages

Hydrocodone and oxycodone come in many different doses. The dose your doctor prescribes depends on:

  • Your age
  • The cause of your pain and how severe it is
  • How long you'll take the drug
  • Whether you have heart, lung, liver, or kidney disease
  • Other drugs you take
  • Your risk for addiction and abuse

Experts say you should start with a low dose. Your doctor can raise it if you need more pain relief. Follow your doctor's instructions, and be sure to read the label when taking these medicines. Don't take more than the instructions say you should.

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How and When to Take Them

You take oxycodone once every 4 to 6 hours, or as needed, to manage your pain. The same is true if you take a form that includes another medicine, such as acetaminophen, aspirin, or ibuprofen. You only need to take the extended-release versions once or twice a day.

Hydrocodone extended-release capsules are usually taken once every 12 hours. The extended-release tablet is usually taken once daily.

Ask your doctor whether you should take them with or without food. Drink plenty of water to swallow the extended-release capsules or tablets.

Don't stop taking these medicines without telling your doctor. When your body expects the medication but doesn’t get it, you might go through withdrawal. That can cause headaches, irritability, and other symptoms. But this only happens when you use the medicine regularly.

How to Store

Your medicine should stay in the bottle it came in. Don’t put it in the bathroom or anywhere else with a lot of moisture. Keep it away from children. Your pharmacist can tell you what to do with expired medication.

Side Effects

Hydrocodone and oxycodone have many of the same side effects, like:

But hydrocodone can make you feel tired, while oxycodone is more likely to make you drowsy or constipated.

Taking too much can lead to an overdose, which causes these symptoms:

Drug Interactions

Your risk for serious side effects may be higher if you take other drugs with hydrocodone or oxycodone. Make sure your doctor knows about all the medications and supplements you use.

Certain drugs that depress the central nervous system are dangerous because the combination can lower your breathing and heart rate and even put you in a coma. These include:

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Some medications can change the amount of hydrocodone or oxycodone that gets released into your blood. Too much can lead to an overdose. Too little can keep you in pain and cause withdrawal symptoms. Be cautious with:

Taking hydrocodone or oxycodone with antidepressants can lead to a dangerous buildup of the brain chemical serotonin.

Other nonprescription drugs and supplements to avoid include:

Drug Warnings

Long-term use of these drugs (like for ongoing pain) can lead to addiction and misuse. That’s why it’s important to keep your doctor’s appointments. They’ll work with you to make sure you use them the right way.

There are a number of other issues to be aware of.

  • Breathing problems. Hydrocodone and oxycodone can slow your breathing and keep you from getting enough oxygen. That can be dangerous if you already have breathing problems, including asthma and COPD.
  • Constipation. Opioids can cause serious constipation. You’ll probably need to take them with a laxative or stool softener. Don't use them if you have an intestinal blockage.
  • Kidney/liver disease. You may need a lower dose if you have problems with your kidneys or liver because those conditions make it harder for your body to clear the drug.
  • Pregnancy/breastfeeding. These drugs make their way into your baby’s body through the placenta, and they’re in your breast milk. That can cause health problems for your newborn, including withdrawal symptoms. There’s also evidence they may cause birth defects, poor growth, preterm birth, or stillbirth.
  • Safety. Hydrocodone and oxycodone can be deadly for a child who gets hold of even one pill. Keep them safely out of reach.

Costs

The cost depends on the form and dosage you take, and what your insurance covers (if you have it).

Some insurance companies have stopped covering certain opioids. They’ve switched to drugs they say are less likely to be abused. Check with your insurance plan to see which opioids you can get. If they won't pay for the one your doctor prescribed, they might pay for a different type.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 21, 2020

Sources

SOURCES:

Academic Emergency Medicine: "Comparison of oxycodone and hydrocodone for the treatment of acute pain associated with fractures: a double-blind, randomized, controlled trial."

American Society of Anesthesiologists: "Opioid Abuse."

CDC: "Guide Guideline for Prescribing Opioids for Chronic Pain," “About Opioid Use During Pregnancy.”

FDA: "Oxycodone Hydrochloride oral solution prescribing information," "Oxycontin extended release prescribing information."

Kaiser Health News: "Insurer to Purdue Pharma: We Won't Pay for OxyContin Anymore."

National Institute on Drug Abuse: "Commonly Abused Prescription Drugs."

Mayo Clinic: "Chronic pain: Medication decisions," "Hydrocodone and acetaminophen (oral route)," "Hydrocodone and ibuprofen (oral route)," "Oxycodone (oral route)," "Oxycodone and acetaminophen (oral route)," "Oxycodone and aspirin (oral route)."

National Vital Statistics Reports: "Drugs most frequently involved in drug overdose deaths: United States: 2011-2016."

Pain Medicine: "Effectiveness and Safety of Once-Daily Extended-Release Hydrocodone in Individuals Previously Receiving Immediate-Release Oxycodone for Chronic Pain."

UpToDate: "Prescription of opioids for acute pain in opioid naïve patients," “Oxycodone: Drug information.”

U.S. National Library of Medicine: "Hydrocodone," "Oxycodone."

DrugFacts: "What are prescription opioids?"

Medscape: “hydrocodone/acetaminophen (Rx),” “oxycodone (Rx).”

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