Hydrocodone vs Oxycodone: Which Painkiller Is More Potent And Addictive?

Hydrocodone vs Oxycodone: Which Painkiller Is More Potent And Addictive?


Opioid medications like hydrocodone and oxycodone are commonly prescribed for the treatment of moderate to severe pain. Both fall under the drug class of narcotic analgesics and work by binding to opioid receptors in the brain and body to provide pain relief.

This article provides an in-depth comparison of hydrocodone vs oxycodone – two of the most popular prescription opioid pain medications. We will examine the similarities and differences between these two drugs in terms of strength, side effects, risks, and overall efficacy in treating pain. Our goal is to help readers better understand how hydrocodone and oxycodone work and determine which may be a more appropriate option for certain individuals based on factors like type of pain, risk of addiction, and personal preference. With opioid misuse and addiction rising, it’s important for patients to be informed about the pros and cons of different opioid treatment options.

What are Opioids?

Opioids belong to a category of drugs that are derived from the opium poppy plant. Some prescription opioids are made directly from the plant, while others are made by scientists in labs using the same chemical structure.

Opioids are commonly used as medications due to their ability to relax the body and alleviate pain. Prescribed opioids are used mostly to treat moderate to severe pain, though some opioids can be used to treat coughing and diarrhea.

Some common types of opioids include:

  • Codeine – a mild opioid often combined with acetaminophen or aspirin and sold under brand names like Tylenol with Codeine. Used to treat mild pain and cough.

  • Morphine – a strong opioid used to treat severe pain, such as after surgery or injury. Brand names include MS Contin, Oramorph, and Roxanol.

  • Oxycodone – a strong opioid sold under brand names like OxyContin and Percocet. Used to treat moderate to severe pain.

  • Hydrocodone – a potent opioid commonly combined with acetaminophen and sold as brands like Vicodin and Norco. Used for pain relief.

  • Fentanyl – a very potent opioid used for severe pain, often after surgery or for advanced illness. It is available under brand names like Actiq, Duragesic, and Sublimaze.

  • Heroin – an illegal and highly addictive opioid derived from morphine. It has no accepted medical use.

  • Natural opium – the dried “milk” extracted from opium poppy seed pods. Contains various opium alkaloids like morphine and codeine. Used historically as a painkiller and sedative.

While they can treat pain very effectively, opioids carry a high risk of abuse and addiction. They must be used carefully under medical supervision.

What is Hydrocodone?

Hydrocodone is an opioid pain medication that’s used to treat moderate to severe pain. It works by binding to opioid receptors in the brain and spinal cord to reduce feelings of pain.

Some common brand names for hydrocodone include Vicodin, Lorcet, Lortab, and Norco. These medications combine hydrocodone with other ingredients like acetaminophen or ibuprofen.

Hydrocodone is available only by prescription and comes in tablet, capsule, solution, and syrup forms. It’s often prescribed after surgery or injury, or for chronic conditions like cancer or osteoarthritis.

Doctors may prescribe hydrocodone when over-the-counter pain relievers like acetaminophen or ibuprofen aren’t providing enough pain relief. It’s considered more potent than those other medications.

Hydrocodone is an effective option for acute pain management. However, it does come with the risk of dependence and addiction with long-term use. It’s important to take hydrocodone only as directed by a doctor and to monitor for side effects.

What is Oxycodone?

Oxycodone is a strong prescription opioid painkiller that works by changing the way the brain and nervous system respond to pain. It provides short-term pain relief for moderate to severe pain.

Oxycodone was first developed in Germany in 1916 and was approved for use in the United States in 1939. Brand names for oxycodone include OxyContin, Roxicodone, Oxecta, and OxyFAST.

Oxycodone can be prescribed on its own or combined with other medications like acetaminophen or aspirin. Some common uses of oxycodone include managing pain after surgery, injury, or due to conditions like cancer.

It’s available in immediate-release and extended-release tablets. The extended-release versions release the medication slowly over time to provide consistent pain relief. Immediate-release oxycodone starts working faster but only provides pain relief for 4-6 hours.

Oxycodone works by binding to opioid receptors in the brain, spinal cord, and gastrointestinal tract. It prevents pain signals from being transmitted to the brain. It also triggers the release of dopamine in the brain, creating a euphoric feeling or “high.”

While oxycodone is very effective for managing severe pain, it carries a high risk of misuse, abuse, and addiction. The use of this should be strictly monitored by a physician. The dosage needs to be carefully monitored and tapered off when stopping usage to avoid withdrawal symptoms.

Differences in Strength

hydrocodone vs oxycodone are both potent prescription opioid pain medications. However, oxycodone is considered to be more potent than hydrocodone.

Oxycodone is about 1.5 times stronger than hydrocodone. This means that a 10mg dose of oxycodone would be equivalent to around a 15mg dose of hydrocodone in terms of analgesic effect. The strength differences are due to variations in how the medications bind to and activate opioid receptors in the body.

The differing potencies between these two medications are important factors for doctors to consider when determining the appropriate opioid to prescribe to a patient. If a higher level of pain relief is needed, oxycodone may be chosen over hydrocodone. However, the increased potency of oxycodone also comes with increased risks in terms of side effects and addiction potential.

Doctors must weigh the benefits of better pain relief with oxycodone versus the potentially elevated risks. In some cases, it may be preferable to prescribe a lower strength opioid like hydrocodone if it can provide sufficient pain management for the patient with a lower chance of side effects and dependence. Careful consideration of the differences between these two opioids can lead to better clinical decisions and outcomes.

Side Effects

hydrocodone vs oxycodone can cause similar side effects, but some differences exist.

Common side effects of hydrocodone include:

  • Drowsiness
  • Dizziness
  • Nausea, vomiting, or stomach pain
  • Constipation
  • Headache
  • Dry mouth
  • Itching or rash

Serious side effects of hydrocodone may include slowed or difficult breathing, extreme drowsiness, confusion, or unusual thoughts and behavior.

Common side effects of oxycodone include:

  • Drowsiness
  • Dizziness
  • Nausea, vomiting, constipation
  • Headache
  • Itching, rash, or swelling of the face
  • Dry mouth
  • Sweating

Serious side effects of oxycodone can include severe drowsiness, slowed breathing, confusion, seizures, or serotonin syndrome when taken with certain other drugs.

Both opioids carry risks of addiction, dependence, and overdose, which can lead to coma or death. It’s important to take them exactly as prescribed and contact your doctor if side effects become severe. Those with lung or breathing problems should use extra caution with these medications.

Risk of Addiction

Both hydrocodone vs oxycodone have a high potential for addiction and abuse. Studies show that about 1 in 4 patients prescribed opioids for chronic pain misuse them, and 1 in 10 develop an opioid use disorder.

hydrocodone vs oxycodone work by binding to opioid receptors in the brain that control pain and pleasure. This provides pain relief but also leads to euphoric effects, which can be highly addictive.

People who use hydrocodone and oxycodone continuously can develop a tolerance, needing higher doses to achieve the same effect. Stopping the drugs abruptly can cause severe withdrawal symptoms like anxiety, insomnia, muscle pain, diarrhea, vomiting, and more.

According to one national survey, hydrocodone is the most commonly abused opioid in the country. Around 9.5 million Americans reported misusing hydrocodone products in 2018.

Oxycodone also has a very high potential for abuse and addiction. In fact, it is considered more potent than hydrocodone and more likely to lead to dependence. One study found that almost 1 in 8 patients prescribed oxycodone for chronic pain ended up misusing it.

The bottom line is that both hydrocodone and oxycodone carry serious risks of addiction, dependence, and withdrawal symptoms. They should only be used for a short time under medical supervision to manage severe acute pain. Long-term use requires extreme caution.

Warnings and Precautions

Both hydrocodone and oxycodone have serious risks and side effects that should be considered before taking either medication. Patients and doctors should weigh the benefits against the potential harms.


  • Both hydrocodone and oxycodone can interact with other medications and substances. Taking them together with certain antidepressants, antihistamines, barbiturates, or benzodiazepines can increase side effects like drowsiness, breathing problems, and overdose.

  • Alcohol should be avoided completely when taking either opioid. The combination dramatically increases the risks of dangerous side effects and overdose. Even a small amount of alcohol with hydrocodone or oxycodone can be unsafe.

  • Grapefruit juice can also increase blood levels of both medications and should be avoided.


  • Those with severe asthma, breathing issues, or lung problems should use extreme caution with hydrocodone and oxycodone due to the risk of dangerous breathing complications.

  • People with head injuries, brain tumors, or increased pressure in the brain should avoid both medications as well.

  • Hydrocodone and oxycodone should not be used in patients with severe kidney or liver problems, which can cause the drugs to build up to toxic levels.

  • Neither medication should be used in children younger than 18 years old or in women who are pregnant or breastfeeding. The risks to unborn babies and infants are too high.

  • Those with a history of drug or alcohol abuse should use extreme caution with hydrocodone and oxycodone due to the high risk for addiction and overdose. Close monitoring is essential.

Which is Better?

Both hydrocodone and oxycodone are effective at treating moderate to severe pain. However, there are some key differences between these two opioid pain medications that are important to understand when determining which one may be better for your individual situation.

Pros of Hydrocodone

  • Hydrocodone is available in combination products with non-opioid pain relievers like acetaminophen or ibuprofen. This allows patients to get pain relief from two different medications.

  • Hydrocodone is less potent than oxycodone mg per mg. This means it may cause slightly less drowsiness and cognitive impairment compared to oxycodone.

  • Hydrocodone is sometimes viewed as having a lower abuse potential than oxycodone, although both carry risks of abuse and addiction.

  • Hydrocodone combo products tend to be less expensive than oxycodone products. This makes hydrocodone more accessible and affordable for some patients.

Cons of Hydrocodone

  • Hydrocodone must be taken in combination with other medications, which can limit dosing flexibility compared to oxycodone alone.

  • Hydrocodone may not provide adequate pain relief for some moderate to severe chronic pain conditions. It is less potent than oxycodone.

  • Hydrocodone has a higher risk of liver toxicity compared to oxycodone, especially at high doses.

Pros of Oxycodone

  • Oxycodone is available as a single-ingredient medication. This allows for more dosing flexibility to meet individual patient needs.

  • Oxycodone is more potent than hydrocodone, providing more powerful pain relief. This makes it useful for managing more moderate to severe pain.

  • Oxycodone has less acetaminophen than hydrocodone combo products, reducing the risk of liver toxicity at high doses.

Cons of Oxycodone

  • Oxycodone tends to be more expensive than hydrocodone combination products. The costs may be prohibitive for some patients.

  • Oxycodone has a higher potential for abuse and addiction than hydrocodone. More careful patient selection and monitoring is required.

  • Oxycodone can cause more cognitive impairment, drowsiness, and other side effects compared to hydrocodone.

Overall, hydrocodone and oxycodone both have a place in pain management. Which one is better depends on the individual patient’s condition, risk factors, and preferences. It’s important to weigh the pros and cons of each with your doctor.


Hydrocodone and oxycodone are both powerful prescription opioid pain medications. While they are similar in some ways, there are important differences between them:

  • Hydrocodone is weaker than oxycodone – it contains a lower percentage of the active opioid ingredient. This means hydrocodone may be less effective for severe pain but also less prone to abuse.

  • Oxycodone is very potent and acts faster. But it comes with a higher addiction risk and more side effects like nausea, headaches, and dizziness.

  • Both meds can cause dangerous side effects like slowed breathing, confusion, and even overdose death if misused or combined with alcohol or other drugs. Tolerance also builds quickly.

  • With any opioid, risks have to be weighed against benefits. Doctors may start with hydrocodone for moderate pain but oxycodone for more advanced illnesses like cancer.

The key takeaway is that both hydrocodone and oxycodone are powerful narcotic medications that require a prescription and should only be used with medical guidance. While similar, oxycodone is the stronger of the two and requires more caution.

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