Difference Between Oxycodone and Hydrocodone

Pain is one of the sensations that no one in the world is ready to experience, not even for a minute. So, the medications we use for pain-relieving must be efficient enough and should not lead to more pain after some time.


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The most efficient and widespread class of pain relievers is an opioid analgesic.

Oxycodone and hydrocodone are one of those opioid analgesics that are used in many situations to manage pain.

Key Takeaways

  1. Oxycodone and hydrocodone are opioid pain relievers for treating moderate to severe pain.
  2. Oxycodone is stronger and faster-acting than hydrocodone but also carries a higher risk of addiction and abuse.
  3. Both medications are available only by prescription and should only be taken under the supervision of a healthcare professional.

Oxycodone vs Hydrocodone

The difference between oxycodone and hydrocodone is that oxycodone is more efficacious in managing pain when compared to hydrocodone and is also having more adverse effects than hydrocodone.

Oxycodone vs Hydrocodone

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Comparison Table

Parameters of ComparisonOxycodoneHydrocodone
Level of pain managementModerate to severe painMinor to moderate pain
Elimination by the renal routeMostly through RenalLesser extent through the renal route
Controlled substance actSchedule IISchedule III
Combination formulationAvailable in single and combination formulationsAvailable only in combination formulation.
Prescription modeA hard copy of the prescription is essential in most places before buying.The prescription can be faxed or phoned to the pharmacy to place orders
UsageUsed for effective pain suppressionUsed commonly for cough suppression and symptomatic management of common cold and allergic rhinitis
Adverse effectsAs it is more potent, its negative effects are also severeAdverse effects are less severe in most instances.


What is Oxycodone?

Oxycodone is a drug that belongs to the class of medications called narcotic(opioid) analgesics.  It is a semi-synthetic compound.

The oxycodone drug acts by interacting with one of the analgesic receptors, called mu-receptors, and functions like those opioids which are endogenously produced by the body.

Oxycodone is a drug used for treating acute or chronic pain, which is moderate to severe in extent. Oxycodone may cause serious liver enzyme elevation when combined with hepatotoxic drugs like Acetaminophen.

Oxycodone is derived from thebaine, an alkaloid opiate and an intermediate compound in many opioids synthesis. Oxycodone, in addition to its pain-relieving property, also decreases the cough( anti-tussive).

Oxycodone is available more commonly as an oral formulation. For the treatment of chronic pain, there is a unique formulation called extended-release formulation, which will release a specific amount of drug over a more extended period.

The main problem related to oxycodone use is that it can lead to addiction. Because of this addiction potential, it is one of the leading causes of opioid abuse and overdose-related death in people.

Inappropriate dosage may lead to severe life-threatening complications like depression and respiratory suppression.

Oxycodone is almost always contraindicated in children, as even small dose ingestion by the children may lead to overdose complications and even death.

There is also an exciting concept concerning the use of opioid drugs like Oxycodone called Tolerance. It is the phenomenon in which chronic use of the oxycodone drug, which is needed for chronic pain management, will develop resistance or decreased effect caused by the dose used.

This brings the necessity for increasing the dose administered to get the desired effect level.

Oxycodone is metabolized inside the body and is eliminated through urine. This fact is important when prescribing the drug to patients with renal defects.

In renal failure patients, oxycodone, when prescribed, may cause serious toxicity effects as it fails to get excreted from the body.

The metabolism of oxycodone includes active metabolites like nor-oxycodone, oxymorphone, and nor-oxymorphone.

The half-time of elimination of various formulations of oxycodone ranges between 3.9 hours to 4.5 hours.

Commercial production of oxycodone is available under the name, Oxycontin. It is also among the most abused drugs in the market and is included under Schedule II of the Controlled Substances Act.

For testing the presence of Oxycodone in the given sample clinically, thin-layer chromatography is used. Other methods are high-performance liquid chromatography and gas chromatography with electron capture.

This oxycodone is also found to be abused in horses to increase pain tolerance while racing.


What is Hydrocodone?

Hydrocodone is also a semi-synthetic opioid drug used for treating moderate to severe pain in patients in whom other pain management treatments are inadequate.

Hydrocodone is a compound that is derived from morphinan, which is an intermediate in the synthesis of codeine from which hydrocodone is synthesized.

Hydrocodone is indicated for acute pain management with analgesics like acetaminophen and ibuprofen.

Hydrocodone is sometimes used with decongestants, antihistamines, and expectorants to manage the common cold and allergic rhinitis for symptom relief.

As hydrocodone is used as a combination drug with acetaminophen, in most instances, it causes hepatotoxicity.

Hydrocodone, in combination with anti-tussive medications, is used to manage the non-productive cough.

Hydrocodone should be administered in shallow doses and less frequently to prevent the development of tolerance to the drug, which may lead to harmful complications in the future.

Hydrocodone interferes with the pain signalling pathways in the brain and spinal cord. Along with the pain signalling pathways, it also acts on the mu receptors in other brain areas, causing euphoria, respiratory depression, and sedation.

It also acts on the tissue outside the nervous system to produce effects like constriction of pupils, decreased gastric motility, and physical dependence.

Hydrocodone is eliminated from the body by several routes, with renal clearance being involved only to a shallow extent. Hepatic elimination and metabolism are found to be playing a more significant role in the case of hydrocodone.

Hydrocodone, when given to breastfeeding mothers, will induce the effects of hydrocodone in breastfed babies, especially newborns and preterm babies.

The active metabolite of hydrocodone that is produced after the initial phases of metabolism is Hydromorphone.

The half-life of elimination of the hydrocodone is found to be between 7 to 9 hours. It is included under Schedule III of the controlled substances act, as it has somewhat lower abuse potential.

Main Differences Between Oxycodone and Hydrocodone

  1. Oxycodone is used to manage acute and chronic pain of a moderate to severe nature. Hydrocodone is commonly used for critical, minor, and mild pain management.
  2. Oxycodone is eliminated mainly through the kidneys. Hydrocodone is eliminated through the kidney to a lesser extent only.
  3. Oxycodone is placed in schedule II under the Controlled Substances act, whereas hydrocodone is placed in schedule III under the Act.
  4. Oxycodone is available in single and combination formulations, whereas hydrocodone is available alone.
  5. Oxycodone is used mainly for pain management in patients where other non-opioid pain management protocols fail. Hydrocodone is most commonly used in conditions like the common cold and allergic rhinitis than in pain management.
Difference Between Oxycodone and Hydrocodone
  1. https://journals.lww.com/stdjournal/00004714-200308000-00020.fulltext
  2. https://onlinelibrary.wiley.com/doi/abs/10.1197/j.aem.2004.12.005
  3. https://academic.oup.com/jat/article-pdf/32/2/165/2246682/32-2-165.pdf
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