Drug vs. Drug

Oxycodone vs Hydrocodone: Main Differences and Similarities

By | October 29, 2018

Oxycodone and hydrocodone are two opioid medications indicated for the treatment of moderate to severe pain. These medications can help relieve pain in different conditions such as acute pain from a surgery to chronic pain from cancer. Both oxycodone and hydrocodone work by binding to mu receptors in the brain to produce a feeling of analgesia.

While they are both effective treatments for pain, they also have a high potential for abuse and addiction due to their euphoric effects. Their effects on the central nervous system also increase the risk for severe respiratory depression or even death when large amounts are ingested. The main difference between oxycodone and hydrocodone lies in how they are formulated.

Oxycodone

Oxycodone is the generic name for Oxycontin and OxyIR, which are controlled release and immediate release formulations, respectively. Depending on the formulation, oxycodone can be dosed twice daily up to 3 to 4 times per day. Oxycodone is also found combined with non narcotic analgesics such as acetaminophen (Percocet) and aspirin (Percodan). Oxycodone tablets come in strengths of 5, 10, 15, 20, and 30 milligrams.

Hydrocodone

Hydrocodone is the generic name for Zohydro ER, Vicodin, and Lortab among other brand names. Zohydro ER is the extended release tablet form of hydrocodone while Vicodin and Lortab contain other non narcotic components, such as acetaminophen or paracetamol. Hydrocodone is also found in Hycodan, which contains subtherapeutic amounts of homatropine to reduce the risk of overdose. Hycodan is typically prescribed for chronic cough. Unlike oxycodone, hydrocodone also comes in a 24 hour formulation called Hysingla ER that can be taken once daily.

Both kidney and liver impairment may be an important consideration for dosing oxycodone and hydrocodone depending on the formulation.

Oxycodone vs Hydrocodone Side by Side Comparison

Oxycodone and hydrocodone are common treatments for the effective management of pain in patients. Both medicines have several similarities and differences that are summarized below.

Oxycodone Hydrocodone
Prescribed For
  • Moderate to Severe Pain
  • Moderate to Severe Pain
Drug Classification
  • Opioid
  • Opioid
Manufacturer
  • Generic
  • Generic
Common Side Effects
  • Constipation
  • Drowsiness
  • Dizziness
  • Headache
  • Nausea
  • Vomiting
  • Pruritis
  • Lethargy
  • Anxiety
  • Fatigue
  • Chills
  • Irritability
  • Withdrawal symptoms
  • Flushing
  • High blood pressure
  • Constipation
  • Drowsiness
  • Dizziness
  • Headache
  • Nausea
  • Vomiting
  • Pruritis
  • Lethargy
  • Anxiety
  • Fatigue
  • Chills
  • Irritability
  • Withdrawal symptoms
  • Flushing
  • High blood pressure
Is there a generic?
  • Oxycodone is the generic name
  • Hydrocodone is the generic name
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Oral capsule
  • Oral solution
  • Oral tablet
  • Oral capsule
  • Oral solution
Average Cash Price
  • $152 (per 100 capsules)
  • $17 (per 12 oral tablets)
SingleCare Discount Price
Drug Interactions
  • Almivopan
  • Amiodarone
  • Buprenorphine
  • Butorphanol
  • Carbamazepine
  • Erythromycin
  • Ketoconazole
  • MAO inhibitors
  • Nalbuphine
  • Pentazocine
  • Phenytoin
  • Pramipexole
  • Quinidine
  • Rifampin
  • Ritonavir
  • Voriconazole
  • Zolpidem
  • Almivopan
  • Amiodarone
  • Buprenorphine
  • Butorphanol
  • Carbamazepine
  • Erythromycin
  • Ketoconazole
  • MAO inhibitors
  • Nalbuphine
  • Pentazocine
  • Phenytoin
  • Pramipexole
  • Quinidine
  • Rifampin
  • Ritonavir
  • Voriconazole
  • Zolpidem
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Oxycodone is in Pregnancy Category B. It may not harm an unborn baby but may cause withdrawal symptoms and breathing problems. Consult a doctor regarding steps to take while planning pregnancy. Oxycodone is not recommended while breastfeeding.
  • Hydrocodone is in Pregnancy Category C. While adverse effects have been reported in animals, not enough research has been performed in humans. Consult a doctor regarding steps to take while planning pregnancy. Hydrocodone is not recommended while breastfeeding.

Summary

Both oxycodone and hydrocodone are Schedule II narcotics that require a prescription from a physician. They are both commonly prescribed medications for the treatment of pain that is not relieved by other non narcotic analgesics. Both drugs are often combined with other medications to reduce their risk of addiction and overdose. While hydrocodone has a formulation with effects that last up to 24 hours, the longest duration of oxycodone controlled release is up to 12 hours. Therefore, oxycodone is not typically dosed once daily.

It is important to note that both medications cause similar, if not identical, side effects and drug interactions because they in the same drug class. Constipation and drowsiness are very commonly experienced side effects of both medications. Severe respiratory depression, or slow breathing, is also a sign of overdose and possible death if not treated in a timely manner. Due to the potential of risk with these medications, it is important to consult with a physician or healthcare provider when initiating treatment with one or the other.