Oxycodone and Hydrocodone are both opioids used to manage pain when non-opioid medications haven't provided enough relief. However, they differ in several ways. Oxycodone is taken every 12 hours for long-term pain relief, while Hydrocodone is taken every 4 to 6 hours as needed for pain. Oxycodone is available as both a brand and a generic, whereas Hydrocodone is only available as a generic. Both medications can cause side effects like constipation, nausea, and sleepiness, but Hydrocodone also carries a risk of liver damage because it contains acetaminophen. Oxycodone and Hydrocodone both have a high risk of misuse and addiction and interact with many other medications, so it's important to take them exactly as prescribed. Hydrocodone should be avoided with other acetaminophen-containing medications, including over-the-counter acetaminophen-containing products.
What is Oxycodone?
Oxycodone is an opioid that's used to treat long-term pain when non-opioid pain medications alone don't provide enough relief. Oxycodone is approved for adults and certain children aged 11 years and older, and it's also available as a lower-cost generic. The tablets are taken by mouth every 12 hours. Common side effects include constipation, nausea, and sleepiness. Oxycodone is a controlled substance because it has a warning for misuse and dependence.
What is Hydrocodone?
Hydrocodone is used to manage pain for people who've tried non-opioid medications but haven't gotten enough relief. Hydrocodone is a tablet that's taken by mouth. It takes about 30 minutes to start working. Side effects include constipation, nausea, and sleepiness. It's also a controlled substance because it has a high risk of misuse and dependency.
Is Oxycodone Stronger Than Hydrocodone?
Oxycodone and hydrocodone are both prescription opioids used to treat pain, but they are not equal in strength. Oxycodone is generally considered more potent than hydrocodone when comparing equal milligram doses. This means that a lower dose of oxycodone can provide the same level of pain relief as a higher dose of hydrocodone. For this reason, oxycodone is often used for more severe pain or when hydrocodone is not effective.
Side effects: mostly the same, with one real difference
The side effect lists are nearly identical: drowsiness, constipation, nausea, dizziness, itching, dry mouth, headache and, at higher doses or with other sedatives, dangerously slowed breathing. If you are trying to understand drowsiness specifically, we cover it in detail in Does Hydrocodone Make You Sleepy?, and the same answer applies to oxycodone.
The one difference with decent evidence behind it is constipation. In that same fracture trial, 21 percent of the hydrocodone patients reported constipation compared with none of the oxycodone patients, with no difference in nausea, vomiting, itching or drowsiness. That is a single small study, so treat it as a tendency, but it matches what clinicians see: hydrocodone is often the more constipating of the two. If you are prescribed either one for more than a couple of days, ask about a stool softener at the same time rather than waiting for the problem.
Can you take oxycodone and hydrocodone together?
Not unless a prescriber has deliberately set it up that way, which is uncommon. They act on the same receptors, so combining them is the same as taking a larger dose of one, with the same increase in overdose risk and no added benefit. If you have leftover pills of one and a new prescription for the other, do not mix them, and do not use one to “top off” the other when it wears off. Bring the leftovers to a pharmacy take-back kiosk.
Is it okay to switch from Oxycodone to Hydrocodone?
Yes, one can be switched from oxycodone to hydrocodone, but it should be done with a doctor’s guidance. Both are opioids, but they vary in potency, metabolism, and patient response. Oxycodone is more potent than hydrocodone (around 1.5 times as potent), so your doctor will have to reduce the dosage carefully to ensure adequate pain relief but prevent overdose or withdrawal.
Key factors for a doctor when switching:
- Current oxycodone dosing
- Reason for the exchange (any side effects, lack of availability, cost, effectiveness)
- Opioid course
- Health course including liver function
- Combination products (ex. includes with acetaminophen)
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