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What is the difference between oxycodone and hydrocodone?

Oxycodone and hydrocodone are medications that belong to a class of drugs called opioid analgesics. A doctor may prescribe opioid analgesics to treat moderate-to-severe pain.

Prescription opioid medications can be very effective in treating pain. Unfortunately, such drugs are also very addictive and have high rates of abuse. They also have a tendency to interact with certain medications.

This article provides information on oxycodone and hydrocodone, including how to take these drugs and their possible side effects and risks. We also discuss some alternative treatment options for chronic pain.

Who are they for?

a drug factory producing either Oxycodone or hydrocodone

Doctors may prescribe either oxycodone or hydrocodone for people who experience moderate-to-severe pain. These people may include individuals who have injuries, cancer, or chronic pain, as well as those recovering from surgery.

Both drugs are available in extended-release forms, which are suitable for people who have taken opioids for at least a week and have pain that requires treatment on an ongoing basis.

Opioids can interact with other drugs, and they are also highly addictive. As such, they are not suitable for everyone. People should avoid taking them if they have a history of substance abuse or are taking medications that may interact with opioid medications.

Drug class

Oxycodone and hydrocodone both belong to a class of medications called opioid analgesics. These medications work by affecting how the brain and central nervous system process pain signals.

Opioid analgesics are Schedule II drugs, which means that they are medically useful but have a high potential for abuse. As such, they are available strictly via prescription only.

Dosing

A person should follow their doctor’s instructions regarding dosing for opioid medications. In general, the best dose for a pain reliever is the lowest effective dose, which is the minimum dose that keeps a person’s pain at tolerable levels.

Over time, a person’s body can adapt to oxycodone or hydrocodone, and the initial dosage will no longer be effective in controlling pain. In such cases, a person’s doctor may gradually increase the dosage to ensure sufficient pain relief.

How to take them

A person should always take oxycodone and hydrocodone according to their doctor’s instructions.

Oxycodone and hydrocodone are available in various forms, including:

  • liquids
  • concentrated liquids
  • extended-release tablets
  • extended-release capsules

Both drugs are also available in combination with other pain relievers, such as:

A person typically takes extended-release oxycodone every 12 hours with food, whereas they will usually take extended-release hydrocodone once daily, at about the same time each day.

A person should not crush, chop, soak, or otherwise tamper with extended-release tablets before taking them.

It is important that people follow their doctor’s guidance when discontinuing the use of an opioid medication. These medications are highly addictive, and stopping them suddenly could lead to symptoms of withdrawal.

Effectiveness

Many people believe oxycodone to be a better pain reliever than hydrocodone. A 2016 study set out to compare the effectiveness of an oxycodone and acetaminophen drug combination with that of a hydrocodone and acetaminophen drug combination.

The study found no significant differences between the two drug combinations with regard to treating acute musculoskeletal pain. In both groups, about 60% of participants reported at least a 50% reduction in pain.

Both oxycodone and hydrocodone are effective in reducing pain sensations. However, they will not address the underlying cause of the pain.

Due to the risks of dependence and addiction, many experts recommend exploring other pain options before taking opioids.

Side effects

Both oxycodone and hydrocodone can cause many side effects. Some can be serious.

Some possible side effects of these medications include:

Research has shown that oxycodone-acetaminophen combinations are more likely than hydrocodone-acetaminophen combinations to induce nausea and dizziness.

Other effects

People who take any opioid medication for a significant amount of time may experience drug tolerance. This effect means that a person needs to take increasing amounts of a medication for it to achieve the same effect. Tolerance increases the risk of substance abuse.

People who stop taking an opioid drug may experience withdrawal, especially if they have been taking high doses of the drug or have been taking it for an extended period. Withdrawal occurs because the body is learning to adjust to the absence of opioids in its system. Some potential symptoms of opioid withdrawal include:

Interactions

Hydrocodone and oxycodone can interact with many different drugs, including some medications belonging to the following groups:

Opioid medications also interact with alcohol and some recreational drugs, as well as certain supplements.

To avoid the risk of drug interactions, a person should provide their doctor with detailed information about all of the prescription medications and over-the-counter (OTC) supplements that they are taking. They should also refrain from drinking alcohol or using recreational drugs while taking either oxycodone or hydrocodone.MEDICAL NEWS TODAY NEWSLETTERStay in the know. Get our free daily newsletter

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Are they addictive? 

Both oxycodone and hydrocodone can lead to dependency and addiction, especially if a person takes either drug at a high dose or for an extended period.

Over time, people may develop a tolerance to oxycodone or hydrocodone. In an effort to sustain their pain relief, they may begin taking the drug more frequently or taking a dose that is higher than their doctor prescribed.

Opioid abuse is a major public health problem. The Substance Abuse and Mental Health Services Administration (SAMHSA) report that 10.3 million people over the age of 12 abused opiates in 2018. Of these, the vast majority were abusing prescription pain relievers.

Healthcare providers see many cases of opioid addiction in primary care settings, such as general practice clinics and community health centers. The Centers for Disease Control & Prevention (CDC) report that 1 in 4 people receiving long-term opioid treatment in a primary care setting experiences opioid addiction.

To reduce the potential for substance abuse, a person will need to work closely with their doctor to review their opioid dosage and overall pain treatment plan regularly.

Costs

There is very little difference in cost between oxycodone and hydrocodone. Generic versions of both medications are available, and these are generally cheaper than branded versions.

Medicare and private health insurance plans may cover the costs of oxycodone and hydrocodone, as well as offering recommendations for safe use.

Alternative options

Due to concerns about opioid abuse and addiction, healthcare professionals may recommend alternative options for pain relief. Some options include:

Summary

Oxycodone and hydrocodone are opioid medications. A doctor may prescribe such medications for the relief of moderate-to-severe pain. There is very little difference between the two medications in terms of effectiveness and cost.

As opioid drugs, both oxycodone and hydrocodone carry considerable risks for dependence and addiction. These risks increase with long-term use or high dosages. Many doctors recommend trying other pain relief options before considering opioids.

Many alternative pain treatments are available, including nonopioid prescription medications, mind-body pain management techniques, and complementary therapies. A person can talk to their doctor about the treatment options that are most likely to work for them.

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