Oxycodone vs. Hydrocodone: What’s the Difference?

Oxycodone and hydrocodone are prescription pain medications classified as narcotics. Narcotics, also called opioid pain relievers, are drugs that affect mood or behavior. These medications bind to opioid receptors in order to control feelings of pleasure and pain. Opioid receptors are a type of protein that are embedded in the outer membrane of nerve cells. When oxycodone or hydrocodone binds to these receptors, it interrupts the central nervous system’s pain signals before they reach the brain. As a result, these drugs are sometimes prescribed to temporarily treat pain that doesn’t respond to other forms of treatment. You should not use a narcotic drug for more than 3-4 months unless your doctor instructs you otherwise.

Oxycodone is used to treat moderate to severe pain. Not only can it interrupt pain signals to the brain, but it can also replace them with feelings of euphoria and relaxation. This explains its high potential for abuse. Oxycodone should not be taken on an as-needed basis like typical over-the-counter pain medications. It is intended to be used exactly as prescribed at regular intervals until the prescription runs out or a doctor advises you to stop.

Hydrocodone is also used to treat moderate to severe pain. It is a depressant in the central nervous system, which means it can stop pain signals from reaching the brain. Like oxycodone, hydrocodone is a powerful painkiller with a high potential for abuse and addiction. It is crucial to take it exactly as directed by your doctor. The main difference between oxycodone vs. hydrocodone is that oxycodone is a 12-hour release drug while hydrocodone is an instant release painkiller.

Differences between oxycodone & hydrocodone

Oxycodone & hydrocodone are very similar, but there are a few key differences. For example, oxycodone is considered stronger and more likely to lead to addiction than hydrocodone. However, both can result in abuse and addiction. The side effects of oxycodone vs. hydrocodone are also quite different. Oxycodone is more likely to cause things like dizziness, drowsiness, fatigue, headaches and feelings of euphoria, whereas hydrocodone is more likely to cause constipation and stomach pain.

The good news is some of these side effects may decrease after using the medication for a while. However, if they persist or worsen, talk to your doctor as soon as possible to avoid further discomfort.

To prevent constipation and stomach pain, try increasing your daily fiber intake, stay hydrated and exercise. In some cases, your doctor may recommend taking a laxative to alleviate constipation.

Hydrocodone vs. oxycodone side effects

Both medications have similar side effects, including:

  • Shallow or light breathing
  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting
  • Lethargy
  • Dry mouth
  • Itching
  • Motor skill impairment


Severe, though less common side effects include:

  • Seizures
  • Feeling like you might pass out
  • Rapid heartbeat (which could lead to heart failure)
  • Painful urination
  • Confusion

Signs of oxycodone & hydrocodone overdose

Opioid overdose is a major risk if you take a narcotic drug for a long time. Before you are prescribed this type of medicine, your doctor may first screen you to determine if you are at risk for or already have an opioid use problem. They may also educate you on what to do if you do have an overdose.

Whether you’ve been taking these medications for a while or have a new script, it is crucial to take them exactly as prescribed to lower your risk of addiction and overdose. Signs and symptoms of overdose include:

  • Respiratory depression
  • Extreme sleepiness that progresses into coma
  • Skeletal muscle limpness
  • Cold or clammy skin
  • Slow heartbeat
  • Hypotension (low blood pressure)
  • Apnea
  • Circulatory collapse
  • Cardia arrest or death


When narcotics are used over a period of time, the chance of developing an addiction greatly increases. This is especially true if you are using the drug outside of a doctor’s recommendation. Over time, and with repeated use, your body develops a tolerance to the drug, which means you need more of it to achieve the same feel-good results.

Addiction to prescription drugs is possible and just as dangerous as addiction to illicit drugs. If you or a loved one is in need of rehabilitation, call Miramar Recovery Center at (949) 691-5036 to schedule a free consultation. We offer both inpatient and outpatient rehabilitation programs to meet your unique needs and goals. If you know someone who may be addicted to prescription drugs but are unsure how to help, we can facilitate a structured conversation with a professional interventionalist that is built around the goal of persuading them to get the help they so desperately need.