Oxycodone vs. Hydrocodone: A Comparison of Two of the Most Common Opiates

A Comparison of Two of the Most Common Opiates

Opiate drugs are processed from opium and have morphine-like effects. Morphine, Hydrocodone, Oxycodone, Heroin, and Fentanyl are some of the common opiate drugs.

In the medical field, opiate drugs are used as pain medication. They work by suppressing the central nervous system by blocking some of the nerve signals sent to the brain and thereby increasing the threshold of pain. Their powerful morphine-like effects make them ideal for managing short-term pain after a surgery or injury or managing pain where other pain medications have failed.

However, most opiate drugs like Oxycodone and Hydrocodone are prescription drugs that are prone to abuse. The DEA classifies Oxycodone and Hydrocodone as schedule II drugs, meaning they are drugs with a high potential for abuse and with a high likelihood of psychological dependence. According to the DEA 2017 drug threat report, Opioids prescription medication was reported to have been abused on a larger scale than Heroin, Methamphetamine, and Cocaine combined.

Oxycodone Vs Hydrocodone: Composition, Potency, and Efficacy

Oxycodone is a semi-synthetic Opioid developed in Germany in 1917. It was designed with the hope of producing better results compared to other narcotic pain medications used at the time such as morphine and codeine.

Oxycodone has been used effectively for pain management. Even though opioid drugs produce similar side effects, the controlled-release version of the drug was found to be as effective as morphine in managing pain, but with reduced side effects observed in the Central Nervous System.

Oxycodone can come in the form of controlled-release tablets (takes effect over an extended period of time) and Immediate-release (designed to take effect immediately).

Controlled-release and immediate-release are sold under several brand names:

  • Controlled-release: OxyContin – Pure Oxycodone. Taken orally every 12 hours.
  • Immediate release: OxyIR, OxyFast, Roxicodone, Oxynorm –Pure Oxycodone:

For some brands, Oxycodone is combined with a non-narcoticanalgesics such as Acetaminophen, Aspirin or Ibuforen. The addition of non-narcotic pain relievers helps to improve the outcomes of surgeries by minimizing the Opioid-related side effects of the drug. They may also decrease the time it takes to take effect and numb pain.

  • Oxycodone/ Acetaminophen: Percocet, Roxicet, Endocet.
  • Oxycodone/ Ibuprofen: Combunox

Hydrocodone was also developed in the early 20th century as an alternative to morphine and codeine. It has a chemical composition similar to codeine but it is considered to be significantly more powerful.

Just like Oxycodone and other Opioids, Hydrocodone can act on the central nervous system to numb the nerves and reduce the sensation of pain. It is used in postoperative care, in long-term pain management as well as for situations where no other drug is effective. In the treatment of musculoskeletal pain,Hydrocodone performed significantly better than Codeine as an analgesic.

Hydrocodone is a common opioid analgesic and is available in several brands such as:

  • Hydrocodone: (Zohydro ER)
  • Hydrocodone/Acetaminophen: (Lorcet, Lortab, Norco, Zydone, Vicodin)
  • Hydrocodone/Ibuprofen: (Vicoprofen)

Oxycodone vs. Hydrocodone: Which One is More Effective?

Both Oxycodone and Hydrocodone are considered to be effective in managing both moderate and severe pain. There are, however, no studies that can give a clear picture of whether there is a significant difference in efficacy between the two.

One study compared the efficacy of Oxycodone versus Hydrocodone in treating pain associated with fractures. The conclusion was that both drugs showed no noticeable differences in managing pain and addressing side effects such as vomiting and nausea.

Non-Opioid analgesics are used in combination with both drugs to reduce the time it takes for the drug to take effect. Another study indicates that there may be a significant difference between Oxycodone/Acetaminophen and its counterpart Hydrocodone/Acetaminophen. Oxycodone/Acetaminophen was found to be 1.5 more potent. However, it produced slightly more negative side effects.

Withdrawal and Addiction

Before 2014 both drugs were classified as Schedule III drugs. But due to the growing opioid problem in the United States, the DEA now classifies them as Schedule II drugs. This means that they are recognized by the government as substances with “high potential for abuse and which may lead to severe physical and psychological dependence.”

Physical and psychological dependence is possible even when using the medication as prescribed. However, sticking to the prescription as instructed by your doctor will significantly reduce any risks of dependency.

If you experience any withdrawal symptoms such as nausea, vomiting, or anxiety, consult your physician. Your physician can prescribe an alternative to reduce the negative effects of the drug. If you suspect you have developed dependency, consider seeking professional help.

Side Effects

Both drugs have common side effects which include:

  • Dizziness, Drowsiness
  • Nausea and Vomiting
  • Impairment of motor skills
  • Difficulty breathing

Severe side effects may include:

  • Seizures
  • Heart Attacks
  • Disorientation/Confusion


  • Breastfeeding mothers are cautioned against using Oxycodone or Hydrocodone, as significant quantities of the drug are excreted in breast milk.
  • If you have lung disease or a related problem you need to consult your doctor.
  • Both drugs can impair motor skills, therefore caution should be taken when driving or operating machinery.

Don’t forget to seek help if you’re dealing with an addiction to either of these substances.