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Hydrocodone vs. Oxycodone – Key Differences and Similarities

Hydrocodone and Oxycodone are two of the most commonly prescribed narcotic, opioid painkillers on the market today.

These two opiates are quite similar and are often confused with each other. This confusion is understandable, since there are few differences (including spelling) between the two drugs. This guide will help you understand both the similarities and the subtle differences between hydrocodone and oxycodone.

  • Both are narcotic painkillers of nearly identical strength. They are traditionally prescribed for moderate to severe chronic pain.

When taken as prescribed, these drugs produce similar side effects, with a higher chance of fatigue and related symptoms with Oxycodone, and a higher chance of constipation and related symptoms with Hydrocodone.

Hydrocodone is the more flexible of the two drugs, prescribed for inflammation and clearing mucus in some combinations, while Oxycodone is more likely to be abused, due to the euphoric effect caused by taking it.

Similarities of Hydrocodone and Oxycodone

Both Hydrocodone and Oxycodone are Schedule II painkillers primarily prescribed to treat chronic, moderate to severe pain.

  • The most common dosage is 5mg to 30mg, every 4 to 6 hours. They are generally to be taken continuously until such time as a doctor ends the prescription, as necessary.
  • In terms of pain relief, both drugs are also nearly identical when compared at equal dosages.

According to a study published by the US National Library of Medicine National Institutes of Health, pain relief is nearly identical in patients at both 30 minutes and 60 minutes after taking each of the drugs separately. To quote from this study:

“Treatment with acetaminophen and either oxycodone, 5 mg PO, or hydrocodone, 5 mg PO, resulted in pain relief among ED patients with acute fractures, and there was no difference between the two agents at 30 and 60 minutes. These results suggest that both have similarly potent analgesic effects in the first hour of treatment for ED patients with acute fractures.”

Common Side Effects of Oxycodone and Hydrocodone

Another way in which oxycodone and hydrocodone are similar is that they share many of the same common side effects.

People who take oxycodone and hydrocodone typically suffer from the following side effects:

  • Shallowness of breath
  • Lethargy and drowsiness
  • Nausea
  • Vomiting sometimes occurs
  • Dizziness
  • Dry mouth
  • Itchy skin or eyes
  • Impairment of motor skills

Severe Side Effects

Both these drugs share less common, but more severe side effects, including:

  • seizures
  • confusion
  • heart palpitations

Hydrocodone vs. Oxycodone - What are the Key Differences and Similarities?

What are the Differences Between Hydrocodone and Oxycodone?

Probably the biggest difference between hydrocodone and oxycodone is that, according to a review of nine clinical studies published in the Official Journal of the American College of Medical Toxicology,

  • “Oxycodone is much more likely to be abused than Hydrocodone”

There is no clear reason for this, although the prevailing theory is that ocycodone is abused more often hydrocodone because it has the potential to induce a euphoric effect when taken. This euphoric effect is part of how oxycodone altars the way the brain perceives pain. Another major difference is that Oxy is available in a single-ingredient drug.

The most common brand name for Oxycodone is Oxycontin. The most common brand names for Hydrocodone is Hydrocodone/acetaminophen (Vicodin, Vicodin ES, Vicodin HP, Anexsia, Lortab, Lorcet, Lorcet Plus, Norco, Zydone).

  • Hydrocodone is the more commonly prescribed of the two drugs

This has nothing to do with the drug’s effectiveness. The main reason hydrocodone is prescribed more often is because it can be combined with other drugs in such a way that it can treat more than just pain.

Hydrocodone actually “blocks” pain signals sent to the brain, rather than just “how they are perceived by the brain,” the way Oxy does. But for pain management, both drugs are roughly equally effective.

Hydrocodone is almost never prescribed as a single-ingredient drug. When combined with acetaminophen, as in Percocet, it is used for pain relief, just like Oxycodone.

However, it can also be combined with ibuprofen, or with a decongestant and an expectorant. The former is primarily used to combat fever and inflammation, in addition to pain. The latter provides relief from nasal congestion and mucus buildup that usually result from a common cold.


Finally, there is one side effect that is incredibly common when taking Hydrocodone that is not a side effect of taking oxycodone and that is constipation. Constipation is usually combined with stomach pain, and often results from taking Hydrocodone. To again quote the above study:

  • “There was no difference between the groups in nausea, vomiting, itching, or drowsiness; however, the hydrocodone patients had a higher incidence of constipation (oxycodone 0%, hydrocodone 21%, difference in proportions 21%, 95% CI = 3% to 39% more with hydrocodone).”

One reason this and other opioids cause constipation is because they slow down the body’s metabolism. This is a commonly known side effect and many pharmacists will suggest stool softeners to take while on the medication.

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