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Hydrocodone vs Oxycodone: What’s the Difference?

Hydrocodone Vs Oxycodone pills

Oxycodone and hydrocodone are prescription pain medications that belong to a group called opioid pain relievers. They are used to treat moderate to severe pain, for example, treatment of acute pain after surgery or cancer-related pain. Please continue reading to learn about some of the similarities and differences between hydrocodone and oxycodone.

What are the similarities between oxycodone and hydrocodone?


Both oxycodone and hydrocodone are semi-synthetic opioids which are narcotic pain relievers made from morphine that has been manufactured in a lab. These two medications are used to treat severe pain in addition to non-narcotic pain medications such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). They are prescription drugs that are typically used to provide short-term pain relief. For example, hydrocodone and oxycodone are frequently prescribed for treating pain after a major surgery or an injury such as a fracture. Opioids like oxycodone and hydrocodone are also used to treat severe pain from advanced cancer. These medications and other opiates are used to treat severe, chronic pain in people with impaired kidney function who are not candidates for NSAIDs or nerve pain medicine like gabapentin.

Dosage forms

Both hydrocodone and oxycodone are available in lower-cost generic versions as well as brand name products. They are formulated alone or in combination with non-narcotic pain medications such as acetaminophen, aspirin, and ibuprofen. Dosage forms of oxycodone and hydrocodone include immediate-release and extended-release capsules and tablets, and liquid solutions. The immediate-release forms are taken every 4-6 hours, and the extended-release forms are taken every 12 hours to treat pain.

Mechanism of action

Both oxycodone and hydrocodone have a similar mechanism of action. These two drugs provide pain relief by binding to opioid receptors in the central nervous system and blocking pain signals. Hydrocodone and oxycodone work on the brain’s reward system and change how you perceive pain. 


Studies have shown that both hydrocodone and oxycodone are equally effective in providing short-term pain relief. 

Side effects

Some side effects of hydrocodone and oxycodone are similar, such as constipation, nausea, dry mouth, drowsiness, and headache.

Withdrawal symptoms

Another similarity between oxycodone and hydrocodone is that abrupt discontinuation of these two drugs can lead to opioid withdrawal symptoms. 

Potential for opioid abuse

Oxycodone and hydrocodone are used to relieve moderate to severe pain. They are not the preferred treatment options for chronic pain management of persistent or long-lasting pain because they are short-acting and can be habit-forming and highly addictive.”

Therefore, it’s reserved for chronic pain patients who can’t tolerate other types of pain medicines. 

Hydrocodone and oxycodone are classified as Schedule II drugs due to their high potential for physical and psychological dependence leading to drug abuse and addiction. Oxycodone or hydrocodone misuse is associated with a high risk of developing drug-seeking behavior and opioid use disorder. Opioid abuse can lead to serious health complications, including overdose and even death. 


Taking hydrocodone and oxycodone can increase the risk of life-threatening breathing problems called respiratory depression, where your breath becomes extremely shallow, which can be fatal if left untreated. The risk is greater if you are also taking other medications that have the same effects or if you have an underlying lung condition. 

Other rare but severe side effects of oxycodone and hydrocodone include chest pain, confusion, hallucinations, agitation, fast or slow heartbeat, muscle stiffness, muscle twitching, shivering, nausea, vomiting, diarrhea, loss of appetite, weakness, dizziness, decreased sexual desire, erectile dysfunction, irregular menstruation, allergic reactions with swelling of the eyes, face, lips, tongue, or throat, skin rash, hives, itching, and difficulty breathing or swallowing.

Taking these two medications and other drugs from the opioid class is not safe during pregnancy and can lead to birth defects. Opioid drugs should also not be used for pain management if breastfeeding because they can pass into breast milk and harm the infant.

What are the differences between oxycodone and hydrocodone?

Here are some of the differences between oxycodone vs hydrocodone:

  • Oxycodone is stronger than hydrocodone on a milligram-to-milligram basis. However, both medications provide equally effective pain control.
  • Hydrocodone is more likely to cause tiredness, constipation, problems with urination, muscle tightening, and sleep problems as side effects. Oxycodone use is more likely to cause side effects such as flushing and mood changes. However, each person’s experience with a medication can be different. You may tolerate one medication, hydrocodone vs oxycodone, better than the other with fewer side effects.
  • The half-life of oxycodone is 2.6 hours, while the half-life of hydrocodone is 4.2 hours. Half-life is the duration of time it takes for the body to eliminate half the original amount of the drug. Because hydrocodone stays in your system longer, it may have a higher potential for abuse and addiction. However, both oxycodone and hydrocodone are Schedule II drugs and carry the risk of addiction.

Note: This drug information is not a substitute for professional medical advice. If you have further questions or want to know which is better for you, oxycodone vs hydrocodone, talk to your healthcare provider or pharmacist.

Frequently Asked Questions

What is the strongest pain medication?

Opioids such as morphine, codeine, oxycodone, hydrocodone, tramadol, and fentanyl are some of the strongest pain relievers available to treat acute pain and chronic pain. Fentanyl, which is a synthetic opioid, is 50-100 times stronger than morphine which is a natural opioid. Therefore, Fentanyl is one of the strongest pain medications. It is used to treat severe pain, such as pain associated with advanced cancer.

How much more potent is oxycodone compared to hydrocodone?

A double-blind, randomized, controlled trial found that oxycodone is approximately 1.5 times stronger than hydrocodone. However, both medications provide effective pain relief.

Is tramadol stronger than oxycodone?

No, tramadol is a class IV controlled substance. A small double-blind, randomized study has found that oxycodone is 8 times more potent than tramadol.

What's the difference between OxyContin and oxycodone?

Oxycodone is a generic medication. OxyContin is a brand name product that contains oxycodone as the active ingredient. OxyContin is a controlled-release formulation that provides continuous, around-the-clock pain relief.



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