Hydrocodone vs Oxycodone – Key Differences and Similarities

Oxycodone vs Hydrocodone 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 between these two substances and the subtle differences.

Commonalities Between Oxycodone vs Hydrocodone
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Both Oxycodone and Hydrocodone 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 oxycodone and hydrocodone have similarly potent analgesic effects in the first hour of treatment for ED patients with acute fractures.”

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Common Side Effects

Another way in which both drugs are similar is in common side effects. People who take both Oxycodone and Hydrocodone commonly suffer the following side effects:

• Shallowness of breath
• Lethargy and drowsiness
• Nausea and vomiting
• Dizziness
• Dry mouth
• Itching
• Impairment of motor skills

Severe Side Effects

Both Oxycodone and Hydrocodone share less common, but more severe side effects, including:

  • seizures
  • confusion
  • heart palpitations

Difference Between Hydrocodone and Oxycodone

Probably the biggest difference between the two drugs is that, according to a review of nine clinical studies published in the Official Journal of the American College of Medical Toxicology, quote;

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

There is no clear reason for this, the prevailing theory is Oxycodone is abused more often 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 Oxycodone is available in a single-ingredient drug.

The most common brand name for Oxycodone is Oxycontin. The most common brand name 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 effectiveness. The reason it 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.

The Brain’s Perception

Hydrocodone blocks pain signals sent to the brain, rather than adjusts how they are perceived by the brain, as Oxycodone does, both drugs are roughly equally effective.

Single vs Combination Drug

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 Oxycodoneconstipation. Constipation is usually combined with stomach pain, 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).”


In summary, oxycodone vs hydrocodone are both narcotic painkillers, of nearly identical strength, that 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.


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