by Nicole Evans M.D.

Created on: March 26, 2010   Last Updated: December 28, 2010

Oxycodone and hydrocodone are prescription pain relievers.  These medications are similar in that they both act upon the opiate receptors to improve pain.  Additionally, oxycodone and hydrocodone are structurally similar in that they are both phenanthrene derivatives.

When oxycodone and hydrocodone bind to opiate receptors, they alter the perception of and response to pain.  However, they both also produces generalized depression of the central nervous system.  Given these similar structures and mechanisms of action, oxycodone and hydrocodone also share a similar side effect and drug interaction profile.  Additionally, both medications are broken down by the liver and excreted in the urine.

Despite these similarities, significant differences do exist between hydrocodone and oxycodone.  Hydrocodone is always prescribed in tablets, capsules or liquids that contain an additional active medicine.  Oxycodone, on the other hand, has a more potent ability to relieve pain and is more frequently prescribed in tablet or capsule form containing solely the oxycodone.

Hydrocodone is not as potent a pain reliever as oxycodone and is usually combined with a variety of other medications.  As such, hydrocodone is used in a much wider variety of medical conditions, for example, pain, cough, cold symptoms, and allergy symptoms.

Oxycodone has significantly more limited indications for use.  Even when combined with other medications, the indication for use is always limited to the relief of pain.  Oxycodone is available alone or in combination with ibuprofen or acetaminophen. 

Oxycodone also differs from hydrocodone in that oxycodone is available in a controlled release formula in addition to the regular or immediate release formulations.  The controlled release form of oxycodone is known as Oxycontin.

Hydrocodone is available in combination with acetaminophen (tylenol) for the management of moderate-to-severe pain. It is also available in combination with aspirin for the same pain relief indication.  Hydrocodone and Ibuprofen in combination are indicated for pain, but only for use up to 7 days.

When hydrocodone is combined with Pseudoephedrine it is used for the symptomatic relief of cough and nasal congestion.  Hydrocodone and chlorpheniramine are indicated for the symptomatic relief of cough and upper respiratory symptoms associated with cold and allergy.  Hydrocodone with Pseudoephedrine is also available and is used for the symptomatic relief of cough and nasal congestion.

Hydrocodone in combination with Guaifenesin is used for the symptomatic relief of nonproductive coughs associated with upper and lower respiratory tract congestion.  Similarly, Hydrocodone and Homatropine in combination have the labeled indication of symptomatic relief of cough.

The many formulations on the market that contain hydrocodone make it a widely used medication.  Even children may take hydrocodone with surprising frequency in their cough syrups and allergy medications. 

Oxycodone, on the other hand, has more specific indications for its few formulations.  Oxycodone is most commonly prescribed alone as a single medicinal agent in tablet form for the relief of pain.  When comparing oxycodone and hydrocodone, individuals should work with their health care provider to determine which medication best meets their needs.

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