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The Difference Between Oxycdone and Hydrocodone

Close up white oxycodone pills with a bottle on a blue background.  

Oxycodone and hydrocodone are both powerful narcotic prescription pain medications that produce equally similar effects. They are both opioids, which is a class of powerful pain-relieving drugs either naturally derived or synthesized from the seed pods of the opium poppy plant. Other opioids include prescription pain medications morphine, codeine, and fentanyl. Heroin is also an opioid.

Both oxycodone and hydrocodone are semi-synthetic. Oxycodone is made strictly from an opioid alkaloid called thebaine, while hydrocodone is derived from codeine. For this reason, hydrocodone may also treat a cough in addition to pain.

Other differences include some of the side effects and the frequency of misuse. Hydrocodone is not widely available outside of the United States. Oxycodone is more likely to be misused.

Opioids and Teens

The National Institute on Drug Abuse for Teens reports that teen drug statistics related to misuse of prescription medications have declined since 2009. Specifically, high school seniors’ misuse of oxycodone and hydrocodone has dropped steadily over the past 15 years, according to a survey funded by the National Institute on Drug Abuse.

In 2018, 2.3% of high school seniors reported misusing OxyContin (a popular brand of oxycodone) in some way. Approximately 1.7% of high school seniors also reported misusing Vicodin (a popular brand of hydrocodone). While this news is promising, there is still work to do when it comes to teens and prescription drugs.

Oxycodone and Hydrocodone Brand Names

Oxycodone is typically available in pill or capsule form. It appears under the following brand names:

  • Endocodone
  • Oxaydo
  • OxyContin
  • Percolone
  • Roxicodone

It is also available as part of a combination product, usually mixed with acetaminophen, ibuprofen or aspirin. Some common combination oxycodone brands are:

  • Endocet
  • Oxycet
  • Percocet
  • Percodan
  • Taxadone

Hydrocodone brands, which come in tablet, capsule and syrup form and may also be mixed with acetaminophen, include:

  • Lorcet
  • Lortab
  • Norco
  • Vicodin

Which Is Stronger: Oxycodone or Hydrocodone?

Studies have shown that both are equally effective for treating moderate to severe pain. However, when oxycodone is combined with acetaminophen, it can be up to one and a half times more effective than hydrocodone mixed with acetaminophen.

These drugs are typically prescribed to patients who have chronic pain or to people who’ve recently had surgery or gotten injured. Doctors may prescribe them to young people after a severe teen sports injury or after dental surgery. Doctors also sometimes prescribe them to lessen the pain associated with cancer treatment.

Hydrocodone vs. Oxycodone Side Effects

Both of these medications have a high potential for addiction and misuse. This risk can increase when people take more of the medication than their doctors prescribe or take the medication for longer than around five days. The risk for addiction also rises when people use hydrocodone or oxycodone recreationally. Many people take these medications to treat legitimate health concerns and end up addicted to them.

Even when taken as prescribed, prescription opioids like hydrocodone and oxycodone can produce mental and physical side effects. These drugs work by attaching to brain receptors that control feelings of pain and pleasure. The receptors then release chemicals that provide the mind and body with a sense of reward or euphoria.

There are not many differences between hydrocodone and oxycodone side effects. Both drugs may cause:

  • Drowsiness or lethargy
  • Dizziness
  • Nausea and vomiting
  • Shallow or lighter breathing
  • Dry mouth
  • Itchy skin
  • Impaired motor skills
  • Constipation (may be more likely with hydrocodone)

Some people may experience more severe side effects, like:

  • Seizures
  • Feeling faint or like passing out
  • Extreme confusion
  • Rapid heartbeat
  • Trouble with or painful urination
  • Breathing trouble in people who have asthma

Combining either medication with other drugs, like alcohol, barbiturates, benzodiazepines or muscle relaxers, can have serious consequences, including trouble breathing and death.

While the side effects are generally the same, there are some differences in the potential effects of hydrocodone vs. oxycodone. Oxycodone may cause headaches, and it’s more likely to lead to dizziness and drowsiness. Hydrocodone use is more often associated with constipation and stomach pain.

People who use either of these drugs for long periods of time — especially when a doctor hasn’t prescribed the medications to treat a legitimate health concern — are at a greater risk for addiction and overdose. Opioid overdose is one of the leading causes of death in the United States. The Centers for Disease Control and Prevention reports that over 70,000 people died from drug overdoses in 2017 alone. Opioids caused approximately 68% of those deaths, and the numbers are growing each year.

Signs that you or someone you know has overdosed on prescription opioids may include:

  • Difficulty breathing
  • Limpness
  • Blue fingernails and lips
  • Going in and out of consciousness
  • Cold, wet, blue or pale skin
  • Chills or shaking
  • Small pinpoint pupils
  • Vomiting or gurgling noises coming from within the body

Is Hydrocodone More Addictive than Oxycodone?

The U.S. government has labeled both medications Schedule II drugs, meaning they pose a high risk for physical and psychological dependence and for misuse. However, multiple studies have revealed that oxycodone use is far more likely to result in opioid addiction and dependence.

Signs of Prescription Drug Abuse Among Teens

After alcohol, tobacco, and marijuana, opioid prescription medications are some of the most popular drugs among teens. Misuse occurs when teens:

  • Take prescription drugs that doctors didn’t prescribe to them
  • Take their own prescription drugs in a way that doctors didn’t prescribe (for example, taking more than the specified dose)
  • Mix prescription medications with alcohol and other drugs
  • Use prescription opioids recreationally or to feel a high
  • Use prescription medication for other reasons, such as to relieve stress, suppress appetite or gain social acceptance

Signs of teen prescription drug abuse may include:

  • Stealing prescriptions or breaking the law to get them
  • Experiencing extreme mood swings or hostile or aggressive behavior
  • Making poor choices
  • Changing who they spend time with socially
  • Facing extremes in energy levels, ranging from lethargy to high energy
  • Lying about medications, such as telling a parent or doctor the medication was lost
  • Having extreme changes in sleep patterns

Prevention is an essential strategy for keeping your teen from developing an addiction to prescription drugs. If there are opioids or other controlled medications in your home, keep them safely locked up. Encourage regular, open conversations with your teen — about drugs and about life in general. Pay attention to your teenager’s whereabouts and get to know his or her friends. Your support and willingness to listen can play a role in your child’s choice to avoid misusing prescription painkillers.

If you or your child has a problem with opioid prescription misuse, there is no better time to take action. Contact Next Generation Village today to learn more and get started on the journey to substance-free living.

Medical Disclaimer: Next Generation Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.


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