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Hydrocodone and oxycodone are two types of opioids available for pain relief. Opioids are strong drugs that can minimize the body’s perception of either acute or chronic pain. 

Even though both are prescription opioids and listed as Schedule II substances, there are some minor differences between the two drugs. 

For example, hydrocodone (brand names include Hysingla® and Zohydro ER®) acts as a cough suppressant and narcotic analgesic drug (painkillers) for moderate to somewhat severe pain. It is comparable to codeine (used to suppress coughs), if not more effective, and is as powerful as morphine for pain management. When other pain medications do not perform as desired or cause tolerance problems, healthcare professionals may prescribe hydrocodone as a treatment option.


It is not uncommon to find hydrocodone combined with other painkillers like ibuprofen or acetaminophen. A hydrocodone/ibuprofen combination (brand names include Ibudone®, Reprexain®, and Vicoprofen®) helps treat acute pain that has become too severe. A hydrocodone/acetaminophen combination (brand names include Vicodin®, Norco®, and Lortab®) is the most common opioid/painkiller mix prescribed. 

Because of the high potential of substance abuse, prescriptions for hydrocodone-containing products have decreased in the past decade. In 2013, there were more than 136.7 million prescriptions of the sort in the United States. In 2018, there were only 70.9 million prescriptions. 

In contrast, oxycodone (brand names include OxyContin®, OxyIR®, and OxyFast®) does not act as a cough suppressant. While it does treat moderate to somewhat severe pain and is available in opioid/painkiller combinations (Percodan®, Percocet®, and Percodan®), it may not cause constipation as much as hydrocodone. 

Which Drug is Right for You?

Hydrocodone and oxycodone are two opioid medications that can effectively interfere with pain signals in the central nervous system (CNS).  

Studies comparing oxycodone and hydrocodone have not observed any significant differences in efficacy. Both drugs can aid in the treatment of acute pain or pain caused by chronic conditions. These conditions include arthritis, fractures, or cancer.

However, both drugs are also habit-forming. This means that individuals can develop psychological or physical addiction after long-term use. It is recommended to speak with a healthcare provider about the risks and benefits of taking either prescription drugs. It is equally important to define pain treatment goals, length of treatment, and other pain management avenues to help make the right decision. 

Individuals with low blood pressure or other conditions, such as mental illnesses or family history of alcohol abuse, should discuss these aspects with their doctor.

Elderly individuals who take hydrocodone may have a higher chance of experiencing confusion, severe drowsiness, and age-related liver, kidney, heart, or lung issues. 

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Side Effects of These Drugs

Using hydrocodone or oxycodone may produce some side effects. Here is a list of common side effects:

  • Severe drowsiness
  • Lightheadedness
  • Nausea
  • Constipation (this has been reported to be more frequent with hydrocodone use)
  • Slowed breathing 
  • Trouble sleeping 
  • Dry mouth
  • Headache 
  • Vomiting 
  • Back pain

Cost of Hydrocodone and Oxycodone

Hydrocodone and oxycodone are available as brand-name drugs or generic substitutes. This means that choosing the generic alternative of either of the two opioid medications will save you money. 

It is important to remember that the differences between generic alternatives and brand-name drugs are minor. The Food and Drug Administration (FDA) makes sure that generic drugs include the equivalent strength of active ingredients. 

Regardless, it is always best to speak with a healthcare professional to determine drug suitability and treatment plan. Those aspects can affect the final cost, as well as if there is insurance coverage.

Dangerous Drug Interactions

Individuals should not take hydrocodone and oxycodone with other medications without a doctor’s former approval. Doing so could result in undesired side effects and could lead to a severe health condition. 

Other drug medications that could result in serious health conditions include:

  • Anticholinergic agents (to block a neurotransmitter called acetylcholine) with hydrocodone  using both of these medications simultaneously may result in paralytic ileus (when the intestines become obstructed due to intestinal muscle paralysis). 
  • Opioids with serotonergic antidepressants some individuals may have a higher risk of developing serotonin syndrome (when too much serotonin builds up in the body and causes symptoms like anxiety or muscle spasms). 

Individuals should also not mix either opioid medications with alcohol, especially if it is an opioid/painkiller combination. Both substances depress the central nervous system (CNS). Drinking alcohol places an additional burden on the liver and may worsen the pain reliever’s side effects. Similarly, opioid/painkiller combination, like hydrocodone/acetaminophen, may cause acetaminophen acute liver injury (when the liver does not function properly).

Hydrocodone Vs Oxycodone: Questions and Answers

How much stronger is hydrocodone vs oxycodone?

Both hydrocodone and oxycodone are effective prescription pain medications. Different studies in emergency rooms have shown that the two semi-synthetic opiates provide pain relief. However, hydrocodone may cause constipation more often than oxycodone.

Can hydrocodone and oxycodone be mixed?

No. Combining hydrocodone and oxycodone is a type of opioid abuse that can lead to severe side effects, like slowed breathing, coma, or death.

Will hydrocodone and oxycodone test the same?

Hydrocodone and oxycodone will not test the same, even though the turn-around time for lab results may be the same. Different concentrations of the drugs are needed for detection. Also, the type of analysis used may affect whether the opioid is detected or not. Finally, an individual’s metabolism of the drug may influence the actual detection time.

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Resources +

Center for Drug Evaluation and Research. “Generic Drugs.” U.S. Food and Drug Administration, FDA, 21 Nov. 2019, www.fda.gov/drugs/buying-using-medicine-safely/generic-drugs.

“Hydrocodone (Oral Route) Description and Brand Names.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Sept. 2020, www.mayoclinic.org/dotorg/drugs-supplements/hydrocodone-oral-route/description/drg-20084881?p=1.

“Hydrocodone.” Drug Enforcement Administration. Diversion Control Division. Drug & Chemical Evaluation Section, Drug Enforcement Administration, Oct. 2019, www.deadiversion.usdoj.gov/drug_chem_info/hydrocodone.pdf.

“Hydrocodone.” National Center for Biotechnology Information. PubChem Compound Database, U.S. National Library of Medicine, pubchem.ncbi.nlm.nih.gov/compound/Hydrocodone.

“Hydrocodone: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, 15 Oct. 2019, medlineplus.gov/druginfo/meds/a614045.html.

Marco, Catherine A, et al. “Comparison of Oxycodone and Hydrocodone for the Treatment of Acute Pain Associated with Fractures: a Double-Blind, Randomized, Controlled Trial.” Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, U.S. National Library of Medicine, Apr. 2005, pubmed.ncbi.nlm.nih.gov/15805317/.

Slawson, David C. “No Difference Between Oxycodone/Acetaminophen and Hydrocodone/Acetaminophen for Acute Extremity Pain.” American Family Physician, 1 Mar. 2016, www.aafp.org/afp/2016/0301/p411.html.

“Want to Know More? Some FAQs about Opioids.” National Institute on Drug Abuse, National Institute on Drug Abuse, 3 June 2020, www.drugabuse.gov/publications/opioids-facts-parents-need-to-know/want-to-know-more-some-faqs-about-opioids.

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