Oxycodone acetaminophen (Endocet) alternatives: What can I take instead of oxycodone acetaminophen?

In this article:

• Oxycodone acetaminophen alternatives
• Oxycodone
• Xtampza ER
• Naprosyn
• Neurotin
• Tylenol Extra Strength
• OTC pain relievers
• How to switch
• Choosing the right treatment
• Expert takeaway

In this article

• Oxycodone acetaminophen alternatives
• Oxycodone
• Xtampza ER
• Naprosyn
• Neurotin
• Tylenol Extra Strength
• OTC pain relievers
• How to switch
• Choosing the right treatment
• Expert takeaway

Oxycodone-acetaminophen is a generic prescription pain reliever that contains an opioid (oxycodone) and acetaminophen, an over-the-counter painkiller. Along with its brand-name versions, Percocet and Endocet, it is approved by the Food and Drug Administration (FDA) to treat moderate or severe pain. Although effective, opioid drugs like oxycodone-acetaminophen are risky drugs to take. Side effects, dependency, withdrawal, abuse, overdose, and even death are serious risks. In most cases, healthcare professionals will eventually switch patients to another pain reliever because of the side effects or risks. For others, oxycodone-acetaminophen may not provide enough pain relief, so a stronger drug may be needed.

What can I take instead of oxycodone acetaminophen?

Oxycodone is a strong opioid pain reliever, about 1.5 times more powerful than morphine, another opiate. Oxycodone effectively controls pain but can cause serious problems such as sedation, tolerance, dependence, withdrawal, overdose, and even death. Acetaminophen, the active ingredient in Tylenol, is not an opioid, so it is not habit-forming or sedating. It is added so that the opioid dose can be lower than when used alone. 

Oxycodone-acetaminophen may not provide adequate pain control, so healthcare professionals may prescribe a stronger opioid alone or a long-acting opioid analgesic, such as OxyContin (extended-release oxycodone). Options for a more potent opioid therapy include buprenorphine and fentanyl.

If the risks of opioid treatment are a concern, healthcare providers can prescribe a less potent opioid, such as codeine (1/10 as potent as morphine), tramadol (1/5 as potent as morphine), Nucynta (tapentadol), or hydrocodone-acetaminophen. These, too, are sometimes combined with acetaminophen or ibuprofen to limit the opioid dose.

Other non-opioid treatment options include acetaminophen alone, prescription and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, naproxen, or celecoxib, nerve pain agents, such as gabapentin, and antidepressants, such as amitriptyline.

Prescription drug prices often change. These are the most accurate medication prices available at the time of publication in ZIP code 23666 as of November 23, 2025. The listed price, without insurance, refers to the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.

Top 5 oxycodone acetaminophen alternatives

The following are some of the most common alternatives to oxycodone-acetaminophen.

1. Oxycodone

A relatively simple switch away from hydrocodone-acetaminophen would be to take only oxycodone. Doses could be higher and taken more frequently, so pain control should improve. However, there’s also a greater risk of opioid side effects at higher doses. Switching to an opioid alone may be enough to make pain manageable. If not, the healthcare provider may switch to more powerful opioids.

2. Xtampza ER

If the duration of pain control is a problem, the prescribing healthcare provider may switch to a longer-acting opioid. Xtampza ER capsules are manufactured to release oxycodone gradually to provide pain relief for about 12 hours or more. They are made to reduce the risk of abuse compared to OxyContin. For safety reasons, these long-acting options are not initially used for pain management. 

3. Naprosyn

Prescription NSAIDs, such as Naprosyn, can provide significant pain relief. Naprosyn is a brand-name prescription form of high-dose naproxen, an NSAID commonly sold over the counter at a lower dose. Other effective prescription NSAID treatments include meloxicam, diclofenac, and celecoxib.

Prescription NSAIDs do not cause the same problems as opioids, such as drowsiness, constipation, addiction, or withdrawal. However, they are more powerful than over-the-counter NSAIDS and can cause serious or significant adverse effects, including bleeding problems, kidney damage, and serious gastrointestinal adverse effects. Because of these safety concerns, clinicians try to limit the dose and duration of prescription NSAID treatment.

4. Neurontin

The anticonvulsant Neurontin (gabapentin) is a workable alternative to the use of opioids for certain types of pain. Although gabapentin is FDA-approved only to treat seizures and shingles pain, doctors commonly use it off-label for nerve pain. That limits its usefulness as a substitute for opioids. For instance, it may be as effective as stronger medications for nerve-related back pain, but it doesn’t help with other types of back pain. Side effects include sedation and a risk of abuse. 

5. Tylenol Extra Strength

You may be interested in avoiding opioids altogether, in which case, you may want to try acetaminophen alone, either brand-name Tylenol or a generic. Limiting the daily amount to the level approved by your healthcare provider will still be important. Taking high doses of acetaminophen can poison and injure the liver.

Over-the-counter pain relievers

Over-the-counter pain relievers are plentiful and popular, but there aren’t many types. The proven medications are acetaminophen and three nonprescription NSAIDs: aspirin, Advil (ibuprofen), and Aleve (naproxen). They all provide pain relief, but are not as powerful as prescription NSAIDs. For even moderate pain, nonprescription analgesics may not provide sufficient pain control. They are safer than opioids and other prescription painkillers, but that doesn’t mean they’re completely safe. Use them cautiously. OTC NSAIDs can cause severe gastrointestinal or bleeding problems. Using more acetaminophen than recommended on the package could damage the liver. Acetaminophen poisoning is the leading cause of acute liver failure in the United States. 

Natural alternatives to oxycodone acetaminophen

Pain control involves more than drugs. Non-drug approaches are a necessary part of treatment, particularly physical therapy and cognitive behavioral therapy. Other natural treatment options include exercise, lifestyle changes, social activities, acupuncture, chiropractic care, and herbal remedies.

One of the most effective nonpharmaceutical treatments for pain is cognitive behavioral therapy for chronic pain (CBT-CP), a form of psychotherapy that involves coping strategies, emotional regulation, changing one’s thinking, and lifestyle changes. The U.S. Centers for Disease Control and Prevention (CDC), the U.S. National Institutes of Health (NIH), pain treatment organizations, and hospitals all recommend it as a first-line treatment for chronic pain, regardless of its cause. Studies have shown that CBT, either alone or with other treatments, can improve pain and related issues. However, the treatment can take several months to complete.

For some types of pain, like chronic lower back pain or acute pain due to injuries, physical therapy is a highly effective treatment. Doctors will prescribe it along with painkillers when appropriate. Physical therapy involves exercises, stretching, manual therapy, heat, cold therapy, electrical stimulation, and other physical interventions to improve neuromuscular and skeletal function. It is a long-term therapy, so it may take weeks or months to notice significant improvement. 

Other non-drug treatments include acupuncture and chiropractic care, though healthcare professionals are divided on their usefulness. 

A 2022 review of natural alternatives to prescription pain medicine highlighted topical options, such as rosemary and lavender, and oral options, like peppermint, ginger, and turmeric. They may be effective, but the clinical trial evidence is limited. The review suggests that their use would be more appropriate for chronic, persistent pain than acute, short-term pain. Talk to a healthcare professional about how these therapies may complement other treatments like drugs, CBT, or physical therapy.

How to switch to an oxycodone acetaminophen alternative

Stopping an opioid or switching to another opioid is a delicate and risky process that requires the help of a medical professional. 

When switching to another opioid, the process has to be closely monitored by the prescriber. Opioids are not exactly alike, so the initial doses of the new opioid may be too low or too high. When switching to a non-opioid, withdrawal is a risk, particularly in people who have been using an opioid long-term. The opioid dose will need to be gradually reduced before it can be stopped, a process called tapering. The tapering process can take anywhere from weeks to months to complete.

Choosing the right path for pain management

There is no perfect painkiller to manage pain. Both pain control and drug safety are serious concerns, but people with moderate or severe pain, like cancer pain, are usually more concerned with pain relief. People with more tolerable types of pain should be more concerned about safety. That’s why healthcare professionals individualize pain treatment, which requires a dialogue between patient and physician. 

The place to start is to tell the truth. The effectiveness and safety of pain treatment depend on patients accurately describing the pain and its impact on their daily lives. Exaggerating the pain will compromise safety. Making the situation less serious than it is will result in ineffective therapy. 

Second, make sure you understand the treatment plan. Ask the doctor how long opioid medications are needed, how much pain relief is reasonable to expect, what the alternatives are, what side effects to report, and when you can switch to a non-opioid pain medication. 

Expert takeaway

“Oxycodone carries significant risks, and when combined with acetaminophen, the risk of liver failure with overdose is introduced,” explains Chad Shaffer, MD, a member of the SingleCare Medical Board. “For that reason, as an alternative to the combination tablet, I often suggest using a low dose of oxycodone alone or, better yet, a non-opioid pain reliever.”