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Oxycodone vs Hydrocodone

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Oxycodone and hydrocodone are heavily regulated opioids used to treat moderate-to-severe acute and chronic pain. Their potency, however, also makes them popular for recreational use and they are both highly addictive substances.

The opioid crisis has magnified the importance of knowing the ins and outs of these powerful pain medications. Understanding which drug is best suited for you and whether it is safe for you to use either is paramount when discussing treatment options with your healthcare provider.

If you or someone close to you is struggling with a substance use disorder, Guardian Recovery can help. We will work with you to develop an individualized and effective program to help you recover from addiction and get you started on the road to long-term recovery. We believe in the benefits of a full curriculum of clinical care, beginning with medical detoxification, transitioning into a higher level of treatment, and concluding with personalized aftercare planning. Contact us today to learn more about our treatment options in your area.

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What Is Oxycodone?

Oxycodone is a semi-synthetic opioid medication derived from the poppy plant. It works by binding to specific receptors in the brain, which reduces pain signals and helps manage discomfort. When taken orally, oxycodone comes in immediate-release (IR) and extended release (ER) formulations designed for short-term or long-term relief, respectively. It is often mixed with acetaminophen and prescribed as Tylox®, Percodan®, and OxyContin®. On the street, it is known as hillbilly heroin, kicker, OC, ox, perc, and oxy.

In medical settings, oxycodone is administered as a solution, a concentrated solution, a tablet, or a regular or extended-release tablet. When used illicitly, tablets are crushed and sniffed or dissolved in water and injected. Users can also inhale the vapors made by heating a tablet on a piece of foil.

What Is Hydrocodone?

Used as a pain reliever and sometimes to treat coughs, hydrocodone is a semi-synthetic opioid related to codeine in structure and morphine in producing opiate-like effects. It binds to the brain in much the same manner as oxycodone. Hydrocodone is often combined with acetaminophen and comes in pill and capsule form. The compounds are legally marketed as Vicodin®, Lortab®, Lorcet-HD®, Hycodan®, and Vicoprofen®. On the street, users call it fluff, hydros, v-itamin, vic, vike, and Watson-387. Like oxycodone, those abusing hydrocodone either snort a crushed pill or dissolve it in water and inject it.

Oxycodone & Hydrocodone Drug Scheduling

The U.S. Drug Enforcement Administration (DEA) classifies drugs into schedules based on their medical use and potential for abuse and dependency.

  • Schedule I drugs have no known medical use, a high potential for abuse, and severe psychological and physical dependence.
  • Schedule II drugs also have a high potential for abuse and dependence but have known medical applications.
  • Schedule III, IV, and V drugs have progressively decreased potential for harm and wider medical use.

Both oxycodone and hydrocodone are classified as Schedule II drugs, along with fentanyl, Adderall, methadone, cocaine, and others, because of their potency and high risk for abuse and dependence even when taken as directed by a healthcare professional. In 2014, hydrocodone combination products (HCPs) were reclassified from Schedule III to the more restrictive Schedule II when DEA and Department for Health and Human Services (HHS) research showed that HCPs had the same high potential for abuse and dependence as hydrocodone alone.

How Are Oxycodone & Hydrocodone Similar?

Oxycodone, Hydrocodone, and HCPs are all used to relieve moderate to severe pain and work similarly – by binding to certain receptors in the brain, blocking pain signals. They also cause similar euphoric states in users. All are highly addictive and should only be taken as prescribed by a healthcare professional and for the shortest possible amount of time.

They also cause less pleasant side effects, including:

  • Slowed respiration and digestion.
  • Irregular heartbeat.
  • Hives.
  • Dry mouth.
  • Nausea.
  • Vomiting.
  • Facial swelling, including lips and tongue.

Addition of Acetaminophen

You may be offered oxycodone or hydrocodone combined with acetaminophen when other pain medications do not work or cause troubling side effects. Acetaminophen helps reduce fever and pain symptoms further but can also come with side effects such as stomach pain, nausea, or vomiting. Acetaminophen can also cause liver damage when taken in large doses.

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What Are the Different Forms They Can Be Taken?

Oxycodone is available in both IR and ER formulations, while hydrocodone typically only comes in IR form. IR medications are absorbed quickly into the bloodstream, providing fast relief but with a much shorter duration. ER medications, on the other hand, are designed to provide longer-lasting pain relief by slowly releasing medication over time.

Is Oxycodone Stronger Than Hydrocodone for Pain Relief?

Both drugs can provide effective pain relief, but generally, oxycodone is thought to be more potent than hydrocodone. Research, however, contradicts that idea. One study of 67 emergency department patients being treated for fractures revealed no difference in pain management or side effects in patients given oxycodone and acetaminophen and those given hydrocodone and acetaminophen. Another study of patients with acute pain came up with the same results.

Common Side Effects

The most common side effects of oxycodone and hydrocodone include constipation, nausea, headache, and drowsiness. It’s important to discuss potential risks with your healthcare provider before taking either medication. Long-term opioid use can cause:

  • Increased risk of bone fractures.
  • Infections.
  • Cardiovascular disease.
  • Sleep-disordered breathing.
  • Bowel problems.
  • Liver problems if used in conjunction with acetaminophen.

You should also be aware that these medications can interact negatively with other drugs, including those used to treat depression or anxiety, so speak with your doctor about all medications you are taking before using either oxycodone or hydrocodone.

Warnings When Using Oxycodone & Hydrocodone

Because of how they attach to the brain’s pleasure centers, both drugs can be addictive when taken for non-medical use or in higher doses than prescribed. It’s important to follow instructions from your healthcare provider carefully to reduce the chance of developing dependence.

What Are the Pros & Cons Between the Two?

The main benefit of using either oxycodone or hydrocodone is that they can provide powerful and effective pain relief for those suffering from moderate-to-severe pain. However, as with any opioid-based medication, these drugs have potential risks, including addiction and abuse.

Price Comparison

The prices of oxycodone and hydrocodone are very similar and only vary depending on the dosage, size of the bottle, form (IR or ER), and pharmacy. Acetaminophen-based medications are typically less expensive compared with those without acetaminophen. Generic versions of both drugs exist and generally cost less than name-brand products.


Oxycodone and hydrocodone are Schedule II controlled substances and are highly regulated by the U.S. Drug Enforcement Administration (DEA). You must first have a valid prescription from an authorized healthcare provider to get either medication. Refills are not allowed for these medications, and the DEA requires strict record-keeping of all transactions involving these drugs.

Which Is More Likely to Cause Abuse or Dependence?

Oxycodone and hydrocodone can both cause opioid dependence or addiction if taken for a prolonged period of time or in higher doses than prescribed. If you suffer from acute pain that cannot be controlled with other pain management medications, discuss the risks of taking either oxycodone or hydrocodone with your healthcare provider before beginning treatment. Follow-up care and plans for addiction prevention and management should also be addressed.

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Both oxycodone and hydrocodone semi-synthetic opioids are known to be effective in treating pain but using them comes with precautions. Once these opioids enter the brain, they bind tightly to opioid receptors activating the pleasure and reward centers. This binding makes it easy to become dependent on either substance.  The best way to overcome addiction is with the help of experienced, trusted professionals like those at Guardian Recovery. We provide comprehensive treatment, including medically-assisted detox, therapy, specialty programs, and reintegration support. Our caring and skilled administrative, medical, and clinical teams will guide you through every step of your recovery process from the first time you call. We provide a complimentary assessment and a free insurance benefits check and help coordinate local travel to our facility. All you have to do is ask; we will take care of the rest. Contact us today.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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