What are the differences between oxycodone and hydrocodone?

Oxycodone and hydrocodone are both potent opioid painkillers, but oxycodone has, at times, been considered more potent. In years past, oxycodone was often prescribed for moderate to severe pain, while hydrocodone may have been used for comparatively milder pain. As time has gone on, both medications have become increasingly reserved for more severe pain. Oxycodone may have a higher risk of abuse and addiction compared to hydrocodone, although both medications carry this risk.

Key Highlights

  • Oxycodone and hydrocodone are prescription pain medications used for pain relief.
  • Both medications can treat acute and chronic pain caused by various conditions.
  • Oxycodone and hydrocodone are opioid drugs that work by interfering with pain signals in the central nervous system.
  • While there has been some disagreement on the topic, some research has suggested the two medications are roughly equally effective on a mg-for-mg basis.
  • These medications have potential side effects, including dry mouth, constipation, and drowsiness. Hydrocodone may be more likely to cause constipation.
  • Both medications carry a risk of addiction and should be used under the supervision of a healthcare professional.
  • It's important to follow the prescribed dosage and not misuse these medications to avoid potential harm.


Oxycodone and hydrocodone are two commonly prescribed pain medications that are often used for the management of moderate to severe pain. While both medications provide effective pain relief, it's important to understand the differences between them to make informed decisions about their use.

Pain relief is a crucial aspect of medical treatment, and these prescription drugs play a significant role in alleviating pain caused by various conditions, such as post-surgery recovery, chronic pain, and injuries. However, it's essential to remember that they are powerful opioid drugs and should only be used under the guidance of a healthcare professional.

This blog will delve into the key highlights, pharmacological differences, common uses, and side effects of oxycodone and hydrocodone. By gaining a deeper understanding of these medications, you will be better equipped to have informed discussions with your healthcare provider about pain management and treatment options.

Overview of Oxycodone and Hydrocodone

Oxycodone and hydrocodone belong to a class of medications known as opioid analgesics. These drugs work on the central nervous system to alleviate pain by binding to opioid receptors in the brain and spinal cord. Doing so interferes with the transmission of pain signals, resulting in pain relief for the patient.

Both oxycodone and hydrocodone are powerful pain medications that are typically prescribed for moderate to severe pain. They are available only with a prescription and require close monitoring from a healthcare professional due to their potential for misuse and addiction.

History and Development of Both Drugs

The development of opioids can be traced back to opium, a natural substance derived from the opium poppy plant. Opium has been used for centuries for its pain-relieving properties. Over time, scientists have synthesized various opioids, including oxycodone and hydrocodone, to create safer and more effective pain medications.

Oxycodone was first synthesized in 1916 as a modification of the opioid alkaloid thebaine, which is found in opium. It was developed to provide pain relief without some of the side effects associated with other opioids. Hydrocodone, on the other hand, was first synthesized in the early 20th century and is also derived from opium.

In recent years, there has been a growing concern about the misuse and addiction potential of opioids. As a result, healthcare providers have become more cautious in prescribing these medications and have implemented stricter monitoring and dosage control measures.

Current Usage in Medical Treatment

Oxycodone and hydrocodone are widely used in medical treatment for pain management. They are particularly effective in relieving acute pain, such as post-operative pain or severe injuries. These medications can also be prescribed for chronic pain conditions, such as cancer-related pain or persistent pain from conditions like arthritis.

The decision to prescribe oxycodone or hydrocodone depends on the individual patient's medical history, pain severity, and other factors. Healthcare providers carefully assess patients' needs and consider the risks and benefits before prescribing these medications. It's important to note that these medications should only be used as directed by a healthcare professional and should not be shared or used by anyone other than the intended patient.

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Pharmacological Differences Between Oxycodone and Hydrocodone

Although oxycodone and hydrocodone are similar in their mechanism of action, they do have some pharmacological differences. One significant difference is their chemical structure. Oxycodone is derived from thebaine, while hydrocodone is derived from codeine.

These medications work by binding to opioid receptors in the brain and spinal cord, blocking pain signals. By doing so, they provide pain relief for the patient. The specific differences in their chemical structure may contribute to variations in their potency, efficacy, and side effects.

Chemical Structure and Mechanism of Action

Oxycodone and hydrocodone have similar mechanisms of action due to their shared classification as opioid drugs. They both work by binding to opioid receptors in the brain and spinal cord. By binding to these receptors, they block the transmission of pain signals and provide pain relief.

The chemical structure of these medications influences their interactions with opioid receptors. Oxycodone and hydrocodone have specific affinities and binding properties that contribute to their analgesic effects. These medications are considered strong opioids due to their potent pain-relieving properties.

It's important to note that the binding of these medications to opioid receptors can also lead to side effects, including respiratory depression, sedation, and potential addiction. Therefore, they should only be used under the supervision of a healthcare professional and in accordance with the prescribed dosage.

Potency and Efficacy in Pain Management

When it comes to potency and efficacy in pain management, oxycodone and hydrocodone are considered to be approximately equally effective. Both medications provide significant pain relief for moderate to severe pain.

In cases of acute pain, such as post-operative pain or severe injuries, these medications are often prescribed at higher doses to ensure adequate pain relief. However, it's essential to balance pain relief and the potential for side effects. When determining the appropriate dosage, healthcare providers carefully consider the patient's pain severity and individual response to these medications.

It's important for patients to follow the prescribed dosage and communicate any changes in pain or side effects to their healthcare provider. Adjustments in dosage may be necessary to optimize pain management while minimizing the risk of side effects.

Common Uses for Oxycodone and Hydrocodone

Oxycodone and hydrocodone are commonly used as pain relievers in various medical conditions. The specific choice between these medications depends on factors such as the patient's medical history, pain severity, and individual response to the medications. Any previous or current use of opioids is also an important consideration.

Conditions Treated with Oxycodone

Oxycodone is used to treat a range of conditions that cause moderate to severe pain. It is often prescribed for chronic pain conditions like spinal stenosis, rheumatoid arthritis, or cancer-related pain. Chronic pain is persistent pain lasting more than three to six months.

Additionally, oxycodone may be prescribed for acute pain caused by injuries or post-operative recovery. Acute pain can be more intense but is often short-term.  In these cases, the medication may be recommended for use as needed, with smaller quantities provided.

It's important for patients to communicate with their healthcare provider about their pain symptoms and the effectiveness of oxycodone in managing their pain. Regular evaluation and monitoring are vital to ensure the appropriate use of this medication.

Conditions Treated with Hydrocodone

Hydrocodone is commonly prescribed to treat moderate or severe pain caused by various conditions, such as dental procedures, injuries, or chronic pain. Moderate pain is more significant than mild pain but not as severe as severe pain.

In addition to pain management, hydrocodone has also been used as a cough suppressant. It can be combined with antihistamines (i.e., homatropine) in a syrup available by prescription that helps relieve the pain associated with coughing.

As with any medication, hydrocodone should only be taken as prescribed by a healthcare professional. Patients should communicate with their healthcare provider about its effectiveness in managing their symptoms to ensure appropriate treatment.

Side Effects and Safety Concerns

Both oxycodone and hydrocodone have the potential to cause side effects and safety concerns. It's important for patients to be aware of these potential risks and to discuss them with their healthcare provider.

Common side effects of both medications include shallow or light breathing (respiratory depression), drowsiness, dizziness, nausea, vomiting, dry mouth, itching, and impaired motor skills. While the potential side effects are generally similar, some potential differences have been observed.

Adverse Effects of Oxycodone

Oxycodone can cause various adverse effects in some individuals. Common side effects include dry mouth, constipation, nausea, and drowsiness. Some side effects like nausea, constipation, or dry mouth can be offset by taking steps like staying hydrated and modifying your diet, but it’s always helpful to discuss concerns with your doctor.

Patients should be aware that constipation is a common side effect of opioid medications and may require the use of laxatives or other interventions to relieve symptoms. It's essential to communicate any changes in side effects or concerns to a healthcare provider to ensure appropriate management and adjustment of the treatment plan. This becomes more critical if you are experiencing difficulty breathing or feel like you may fall due to changes in balance.

Adverse Effects of Hydrocodone

Hydrocodone can also cause adverse effects in some individuals. Common side effects include dizziness, drowsiness, stomach pain, and constipation. Compared with oxycodone, hydrocodone appears to have a higher potential for causing constipation.

Patients should be cautious when operating machinery or engaging in activities that require alertness, as dizziness and drowsiness can affect cognitive function. If these side effects become severe or concerning, it's important to seek medical attention and discuss possible adjustments to the treatment plan.

Managing Side Effects and Risks

To manage the side effects and risks associated with oxycodone and hydrocodone, it's important to follow the prescribed dosage and communicate any concerns or changes in symptoms to a healthcare provider. They may recommend adjustments to the dosage or alternative treatment options if the side effects become severe or intolerable.

Additionally, patients should be mindful of their mental health when taking these medications. Opioid medications can affect mood and cognitive function, and individuals with a history of mental health conditions should be closely monitored when using these medications.

It's important to have open and honest communication with a healthcare provider regarding any concerns or questions about side effects and risks. By working together, patients and healthcare providers can optimize pain management while minimizing potential risks.

It’s also critical to talk with each of your healthcare providers about all of the medications and over-the-counter products you use. There are many products that can cause additional drowsiness when combined with opioids. Combining opioids with alcohol or medications like benzodiazepines can significantly increase the risk of fatal overdose due to respiratory depression.

Addiction and Dependency Issues

Oxycodone and hydrocodone are both powerful pain medications that come with the risk of addiction and dependency. Continued use of these drugs can lead to the development of a substance use disorder. When a person becomes dependent on these medications, they may experience withdrawal symptoms when they try to stop using them. These symptoms can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes, and involuntary leg movements. It is important to use these medications only as prescribed and to seek medical help if you are struggling with addiction or dependency.

Understanding the Risk of Addiction

The risk of addiction is a significant concern when it comes to using oxycodone and hydrocodone. These medications belong to a class of drugs known as opioids, which can be highly addictive. Opioids bind to opioid receptors in the brain and produce feelings of euphoria and pain relief. Over time, the body can become dependent on these drugs, leading to a higher tolerance and the need for larger doses to achieve the desired effects. The risk of dependency is considerable for both medications, although some studies have reported higher rates of oxycodone misuse compared with hydrocodone.

The need for more to sustain the effects can quickly spiral into opioid use disorder, a chronic condition characterized by compulsive opioid use despite negative consequences that impact daily life. It is crucial to use these medications only as prescribed by a healthcare professional and to be aware of the signs and symptoms of addiction. If you or someone you know is struggling with opioid addiction, seek help from a healthcare provider or addiction specialist.

Strategies for Prevention and Management

Prevention and management of opioid addiction involves several strategies. First and foremost, it is important to use these medications as prescribed and to follow the recommended dosage. Avoid using opioids for longer than necessary, and try non-opioid alternatives for pain management whenever possible. It is also crucial to be aware of the potential for abuse and misuse of these medications.

If an opioid is needed to effectively manage your symptoms, monitor your usage and be mindful of any feelings of euphoria or dependence that may arise. If you have a history of substance abuse or are at a higher risk for addiction, discuss alternative pain management options with your healthcare provider. Additionally, consider participating in substance abuse counseling or support groups to help manage any addictive tendencies or behaviors.

It’s critical to avoid stigmatizing the need or desire to address dependency. Anyone can become dependent on opioids; it’s not a character flaw. If you or a loved one are concerned about opioid use, taking the steps to address it can save lives.

Oxycodone and hydrocodone are classified as Schedule II drugs by the Drug Enforcement Administration (DEA). This classification indicates that these medications have a high potential for misuse and can lead to severe physical and psychological dependence. As such, these drugs are subject to strict regulations and prescription guidelines.

They can only be obtained with a valid prescription from a licensed healthcare provider. The prescription must include specific instructions regarding the dosage, frequency, and duration of use. It is important to adhere to these guidelines and to never share or sell these medications to others. Violating these regulations can lead to legal consequences and serious health risks.

DEA Classification and Prescription Guidelines

The DEA classifies oxycodone and hydrocodone as Schedule II controlled substances. This classification is reserved for drugs with a high potential for abuse and dependence. As a result, these medications are subject to stricter regulations compared to drugs in lower schedules. When prescribing oxycodone or hydrocodone, healthcare providers must adhere to specific guidelines to ensure safe and appropriate use.

These guidelines include assessing the patient's pain level, considering alternative treatment options, monitoring for signs of misuse or addiction, and providing education on the potential risks and side effects of these medications. It is crucial for patients to follow their healthcare provider's instructions when taking these drugs and to communicate openly about any concerns or issues that arise during their use.

Impact of Regulations on Accessibility and Use

The regulations surrounding the use of oxycodone and hydrocodone have had a significant impact on accessibility and use. The United States has seen a rise in opioid-related deaths and addiction in recent years, leading to increased scrutiny and tighter controls on these medications.

The National Center for Health Policy has implemented various measures to combat the opioid epidemic, including stricter prescription guidelines, enhanced monitoring programs, and increased education and awareness campaigns. These efforts have aimed to reduce the overprescribing and misuse of opioids while still ensuring that patients with legitimate pain management needs have access to appropriate treatment. While these regulations have made it more challenging for some individuals to obtain these drugs, they have also helped to address the public health crisis associated with opioid addiction.

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In conclusion, understanding the differences between Oxycodone and Hydrocodone is crucial for informed decision-making in medical treatment. From their history and usage to pharmacological variances and potential side effects, being well-informed about these opioids is vital. Whether it's their potency, common uses, or legal regulations, a comprehensive grasp of these medications can aid in safer and more effective pain management. Remember, always consult a healthcare professional for personalized advice regarding the use of these drugs. Stay informed, stay safe.

Frequently Asked Questions

Can Oxycodone and Hydrocodone Be Taken Together?

It is not recommended to take oxycodone and hydrocodone together without the guidance of a healthcare professional. While opioids can be combined in some treatment regimens (e.g., a long-acting medication for baseline coverage and a short-acting medication for breakthrough pain as needed), combining these medications can increase the risk of overdose and other adverse effects. It is crucial to follow the prescribed dosage and inform your doctor about all your medications to avoid any potential interactions or contraindications.









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