Updated on February 6, 2024
6 min read

The Difference Between Hydrocodone and Oxycodone

Both hydrocodone and oxycodone are prescription drugs used to treat acute severe pain. For example, if you break a bone or get a tooth pulled, your provider may prescribe hydrocodone or oxycodone to treat the pain.

Both oxycodone and hydrocodone are semi-synthetics. However, oxycodone is synthesized from thebaine, an opium alkaloid, while hydrocodone is derived from codeine. Hydrocodone also has cough-suppressant properties.

While there is a difference between hydrocodone and oxycodone, studies have found that there is no known difference in their effectiveness in managing acute pain.9

What is Hydrocodone? 

Hydrocodone is a pain reliever sometimes used with other drugs. It’s primarily used to relieve severe pain. You should not use it to treat pain that can be relieved with medication taken on an as-needed basis.3

Hydrocodone is part of a class of medications called opiate (narcotic) analgesics. It alters how the brain and nervous system respond to pain.3

Hydrocodone comes in extended-release, long-acting capsules, tablets, or liquid.

What Does it Treat?

Hydrocodone, in combination with acetaminophen, is one of many narcotic pain medications that treat acute or chronic pain.2 Providers may prescribe hydrocodone pain relievers if you have a broken bone.

In combination with antihistamines or anticholinergics, hydrocodone can also treat coughs.2

Common Side Effects of Hydrocodone

Common side effects of hydrocodone include, but are not limited to:3

  • Stomach pain
  • Back pain
  • Head pain
  • Muscle pain
  • Dry mouth
  • Fatigue
  • Frequent and/or painful urination due to a urinary tract infection
  • Decreased appetite
  • Insomnia
  • Ringing in the ears
  • Leg and foot swelling
  • Shaking
  • Itching
  • Constipation

If you are experiencing any of these side effects, consult your doctor. They may prescribe you other pain medications instead.

Hydrocodone is a “DEA Schedule II controlled substance,” which means it has a high potential for abuse.2 It’s possible to develop a psychological or physical dependence on hydrocodone. If you use hydrocodone for a long time, it can become habit-forming.1

How Long Does Hydrocodone Stay in Your System?

Hydrocodone stays in your system for a few days.

A urine test may be able to detect hydrocodone in your system four days after you have taken it. But the half-life of hydrocodone is about three to four hours.

What is Oxycodone? 

Oxycodone is a semi-synthetic opioid drug. It’s also prescribed to treat pain. It may come in the form of OxyContin.6

Oxycodone exerts analgesic activity, binding to the central nervous system’s mu-receptors.7 It does the following:8

  • Mimics the effects of endogenous opioids
  • Inhibits the release of somatostatin, insulin, glucagon, and vasopressin
  • Reduces neuronal excitability, so you feel less pain

You should not take higher doses of oxycodone or more often than your doctor directed.8

What Does it Treat?

Oxycodone also treats acute and chronic pain. Like hydrocodone, a doctor may prescribe oxycodone for a fractured bone.

Common Side Effects of Oxycodone

Common side effects of oxycodone include but are not limited to:8

  • Stomach pain
  • Drowsiness
  • Head pain
  • Chest pain
  • Dry mouth
  • Nausea with or without vomiting
  • Mood changes
  • Flushing of the skin
  • Hives, rash, or itching
  • Difficulty breathing or swallowing
  • Seizures
  • Swelling of the face, throat, legs, or feet
  • Irregular menstruation
  • Low libido
  • Agitation
  • Hallucinations

Again, consult your doctor if you experience any of these side effects. Your doctor may prescribe you other pain medications instead.

Like hydrocodone, oxycodone is also a “DEA Schedule II controlled substance” with high abuse potential.6 In other words, it is a very addicting drug. Beyond pain relief, oxycodone promotes feelings of euphoria and relaxation.

How Long Does Oxycodone Stay in Your System?

Oxycodone has a half-life of about three to five hours. However, it may be detected in your system for much longer than that.5

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Similarities Between Hydrocodone and Oxycodone

Both hydrocodone and oxycodone treat acute and chronic pain by altering the central nervous system (CNS). They can also be addictive.

It’s essential to take both drugs exactly as prescribed. Don’t take any more or less than your doctor has prescribed. Also, don’t stop your treatment course without talking to your doctor. 

Talk to your doctor about other medications you may be taking that can interact with either of these drugs. 

Lastly, consult your doctor if you are taking either of these pain medications but your pain worsens or changes over time.

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Is Oxycodone Stronger Than Hydrocodone?

Both hydrocodone and oxycodone are considered equally effective in managing acute pain in adults.4 That said, oxycodone is a stronger drug than hydrocodone.

While oxycodone may be stronger, both drugs have the potential to become addictive. With long-term use of either drug, you may become reliant long after the pain has stopped. 

Hydrocodone vs. Oxycodone: Addiction Potential

Both hydrocodone and oxycodone are considered to be potentially addictive. With long-term use, they can take a psychological toll.

Don’t take either drug any more or longer without consulting your healthcare provider. If you or someone you know are worried about developing an addiction to hydrocodone or oxycodone, talk to your doctor about other options. 

If you think you’ve developed an addiction, reach out for medical support immediately.

Symptoms of Hydrocodone or Oxycodone Addiction

The symptoms of hydrocodone addiction include, but are not limited to:

  • Craving the drug to feel better, even after the pain has subsided
  • Using the drug even after the pain has subsided
  • Lying about or making excuses for using the drug
  • Taking the drug more often than prescribed
  • Taking the drug after the course of treatment has ended
  • Taking more of the drug than prescribed
  • Spending a lot of money on or engaging in illegal activities to obtain the drug
  • Having mood swings or dealing with depression if not using the drug

Addiction to opioid medications can be difficult to deal with. If you or someone you know has an addiction or may be developing an addiction to either drug, contact professional support immediately.

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Addiction Treatment Options

Several treatment options are available for those addicted to hydrocodone or oxycodone. Treatment options may include:

  • Inpatient treatment involves staying in a residential facility. You will receive 24-hour medical care and support from professionals during this time.
  • Outpatient treatment allows you to continue living at home while receiving therapy and counseling.
  • MAT involves taking medications such as buprenorphine or naltrexone to reduce cravings and withdrawal symptoms.
  • CBT involves talking with a therapist or counselor to address the underlying issues that may have led to addiction.

Summary

Hydrocodone and oxycodone are both powerful drugs used to manage pain. While they’re effective, they also have the potential to become addictive. 

If you or someone you know is struggling with an addiction to either of these drugs, it’s important to seek professional help. Treatment options are available and can be tailored to your needs.

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Updated on February 6, 2024
10 sources cited
Updated on February 6, 2024
  1. Drewes et al. “Differences between opioids: pharmacological, experimental, clinical and economical perspectives.” Br J Clin Pharmacol, 2013.
  2. Hydrocodone.” National Center for Biotechnology Information. PubChem Compound Database, U.S. National Library of Medicine.
  3. Hydrocodone: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine.
  4. Marco 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.
  5. Ordóñez et al. “Oxycodone: a Pharmacological and Clinical Review.” Clinical & Translational Oncology: Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, U.S. National Library of Medicine.
  6. Oxycodone.” DEA.
  7. Oxycodone.” National Center for Biotechnology Information. PubChem Compound Database, U.S. National Library of Medicine.
  8. Oxycodone: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine.
  9. Slawson, DC. “No Difference Between Oxycodone/Acetaminophen and Hydrocodone/Acetaminophen for Acute Extremity Pain.” American Family Physician, 2016.

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