Oxycodone vs. Hydrocodone: What’s the Difference?

Hydrocodone and oxycodone have many similarities. They’re both in the same drug class and designated as schedule II drugs with high potential for abuse and addiction by the U.S. Drug Enforcement Administration (DEA). Oxycodone and hydrocodone are both prescription opioids used to treat moderate to severe pain. They’re also both drugs of abuse that have played a large role in the opioid epidemic. Though their similarities outweigh their differences, there are a few distinguishing characteristics between hydrocodone vs. oxycodone.

What Is Oxycodone?

Oxycodone is a narcotic analgesic, which is a pain medication containing opioids. It goes by these brand names:

• OxyContin
• Percodan (contains aspirin)
• Percocet (contains acetaminophen)
• Roxicet (contains acetaminophen)
• Tylox (contains acetaminophen)
• Oxycodone hydrochloride extended-release tablets (generic version of OxyContin)

Oxycodone is a semi-synthetic opioid derived from the poppy plant. It is combined with thebaine to produce chemical reactions that give it pain-relieving properties. Doctors prescribe this opioid drug for severe pain from cancer, surgery, injuries, and dental procedures. Due to oxycodone’s high potential for abuse and addiction, there is an effort in the medical community to only prescribe OxyContin when non-opioids are not effective.

What Is Hydrocodone?

You may know hydrocodone by its brand name. These include Vicodin, Lortab, Norco, and Lorcet. Most of the hydrocodone’s forms also contain acetaminophen. Doctors may prescribe hydrocodone to relieve pain in terminally ill patients and those who have had surgery or dental procedures.

Hydrocodone is a semi-synthetic opioid. It’s created in labs but synthesized from the poppy plant. Like oxycodone, many doctors are prescribing hydrocodone less since the opioid epidemic shined a spotlight on prescription painkillers.

What Is the Difference Between Oxycodone and Hydrocodone?

There are more similarities than differences between oxycodone and hydrocodone. They’re both powerful opioids used to treat pain with a high potential for abuse. However, there are a handful of differences between oxycodone and hydrocodone, which include:

Drug Sources

Hydrocodone and oxycodone are both synthetic opioids synthesized in labs. However, oxycodone is derived from thebaine while hydrocodone is derived from codeine.

Drug Structure

The chemical structure of oxycodone and hydrocodone are the same except that oxycodone has one more oxygen atom than hydrocodone. A small difference, but a difference nonetheless. 

Drug Forms

Oxycodone is prescribed in 10, 20, 40, and 80 mg extended-release forms. It’s also dispensed in 5 mg immediate-release capsules. Oxycodone comes in the oval form in several different colors and can also be injected in a liquid form.

Hydrocodone comes in 2.5, 5, 7.5, and 10 mg tablets that are usually white, yellow, or orange. It also comes in liquid form and transdermal patches.

Drug Uses

Both oxycodone and hydrocodone are prescribed to treat severe pain, however, because hydrocodone comes from codeine, it can be used as a cough suppressant.

Drug “High”

People who abuse opioids say that there is a difference in the type of high between oxycodone and hydrocodone. One anonymous survey of over 3,000 people with opioid use disorders found that 75% of opioid abusers used oxycodone or hydrocodone. Of those, 54% said they preferred oxycodone to hydrocodone because oxycodone highs were stronger than hydrocodone highs. They believed that the acetaminophen in hydrocodone was a deterrent to taking more of the drug in order to enhance the high.

Drug Side Effects

There is a lot of overlap in hydrocodone and oxycodone side effects. Some studies show that the effects of hydrocodone may cause more stomach pain and gastrointestinal issues like constipation. Common side effects of oxycodone that aren’t as pronounced in hydrocodone use include drowsiness, dizziness, and headaches.