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Oxycodone vs Vicodin for Acute and Chronic Pain Relief

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With narcotics continuing to take the spotlight in our nation’s opioid epidemic, prescription pills are often pointed to as the gateway in which many of those who overuse substances have taken. With the United States continuing to maintain a commanding lead (1) in annual opioid prescriptions, many wonder if overprescription is at the root. If this is a root cause of this crisis, are there specific substances that are more effective for treating pain without being illicitly used? Oxycodone and Vicodin are two of the most widely prescribed opioids in America for pain relief, but how do they compare?

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What Is Oxycodone?

Among one of the most popular prescription opioids for the last decade, oxycodone (2) is a powerful semi-synthetic opioid. Semi-snthetic means that it contains both chemically manufactured as well as natural elements. The naturally occurring element of oxycodone is synthesized from thebaine, a constituent of the poppy plant. It is often referred to by its brand name OxyContin.

What Is Vicodin?

Vicodin is the brand name for a combination analgesic containing acetaminophen and hydrocodone. Hydrocodone is a semi-synthetic opioid used for pain relief with virtually the same effect as oxycodone due to nothing more than a slight variation in its chemical makeup. Acetaminophen is an active ingredient in hundreds of over-the-counter (OTC) and prescription medicines. It relieves pain and fever. Acetaminophen can also be combined with other active ingredients in medicines that treat allergy, cough, colds, flu, and sleeplessness. In combination with each other, this provides a powerful pain relieving and inflammation reducing substance making it the most prescribed medication (3) in the country by dentists after tooth extractions.

Oxycodone & Vicodin Drug Classification

Both oxycodone and Vicodin, because of its ingredient hydrocodone, are considered to be semi-synthetic opioids. They are deemed by the Drug Enforcement Administration (DEA) to be highly addictive while still maintaining medical usage and therefore carrying the classification of a Schedule II narcotic.

Similarities Between Oxycodone & Vicodin

Oxycodone and Vicodin are very similar in the prescription applications and makeup. Both are known for their powerful pain relieving properties. While oxycodone is simply an opioid by itself, Vicodin is the opioid hydrocodone mixed with acetaminophen making it have other pain relieving properties in conjunction with reduction of fever and swelling.

Purpose & Uses

Both substances are prescribed for pain relief of varying degrees. Often after surgical procedures or in the treatment of those enduring pain related to cancer. Vicodin is especially popular among dental professionals after a tooth extraction due to its powerful pain relieving properties and its reduction of swelling.

Chemical Effects on the Brain

Opioids (4) bind to the brain and body’s opioid receptors making it impossible for signals of pain to be communicated throughout the body. It is because of this that they are powerful pain relieving substances when used for medical purposes. They also interact with the brain’s production of chemicals like dopamine which is responsible for feelings of euphoria and rewarding behaviors that the body would like to repeat. This is how the cycle of addiction begins for many who use.

Generic Names for Commercial Brands

Oxycodone is the generic name but is often referred to by its brand name OxyContin. Vicodin is the brand name for the specific combination of hydrocodone and acetaminophen.

Differences Between Vicodin & Oxycodone

Though they are often marketed as completely different substances, oxycodone and Vicodin carry mostly the same chemical makeup and pain relieving properties. It is because of this that both substances are often used interchangeably by those using them for recreational purposes due to providing a similar “high.” The only major difference would be Vicodin’s addition of acetaminophen.

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What Are the Different Forms They Can Be Taken?

Both oxycodone and Vicodin are only available in pill forms to be taken orally. Both substances are time released, meaning that they will be delayed in their onset and interaction with the body. This and other measures have been taken so that their popularity as a recreational drug will be limited.

Is Oxycodone Stronger Than Vicodin for Pain Management?

In multiple studies done with large numbers of test subjects, it has been determined that both oxycodone and hydrocodone, the opioid pain relieving ingredient in Vicodin, have an undetectable difference (5) when used for the treatment of pain. The only reasons for the difference in prescription would be the presence of acetaminophen in Vicodin as well as factors like price and availability.

Common Side Effects

Common side effects for both oxycodone and Vicodin include:

  • Respiratory — severe respiratory depression, shortness of breath, respiratory tract infection
  • Cardiovascular — hypotension, bradycardia, peripheral edema
  • Neurologic — Headache, chills, anxiety, sedation, insomnia, dizziness, drowsiness, fatigue
  • Dermatologic — Pruritus, diaphoresis, rash
  • Gastrointestinal — Vomiting, dyspepsia, gastroenteritis, abdominal pain
  • Genitourinary — Urinary tract infection, urinary retention associated with prostatic hypertrophy
  • Otic — Tinnitus, sensorineural hearing loss
  • Endocrine — Secondary adrenal insufficiency

Addition of Acetaminophen Increase Risks to the Liver

A potential side effect specific to Vicodin is the additional increase to liver damage (6) due to the addition of acetaminophen. Studies have repeatedly shown that in low doses acetaminophen is safe for healthy adults but can begin to cause liver problems in higher doses or after extended periods of use.

What Are the Pros & Cons Between the Two?

Both oxycodone and Vicodin are powerful pain relievers delivering roughly the same potency. The only measurable difference is that Vicodin will have the addition of acetaminophen, and a medical professional may prefer this additive. With this, however, a prescriber may prefer oxycodone for someone with preexisting liver issues that may be further aggravated by the acetaminophen. Other factors that will determine which is prescribed include availability, price, coverage by insurance, and the potential for abuse. Many in recovery from opioid use disorders will prefer to pass on all opioid pain relievers opting for over the counter acetaminophen or ibuprofen.

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As many continue to struggle with opioid use disorders related to prescription pills, Guardian Recovery understands the urgency in addressing this national epidemic. Because of this, we are committed to providing you or your loved one with the highest quality of substance use treatment available. Call today any time day or night to have an admissions counselor conduct a free no obligation insurance check for you. Your journey to freedom from addiction may be one call away.


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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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