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Hydrocodone vs. Oxycodone: Comparing Opioid Medications

Hydrocodone and oxycodone are two opioid painkillers. These are fairly powerful prescription medications that should usually only be used to treat moderate to severe pain when medications with less abuse and addiction potential cannot provide needed pain relief.[1] 

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Oxycodone is widely viewed as more potent than hydrocodone, but both are prescription opioid painkillers. Both drugs should be considered to have significant abuse and addiction potential. If taken in a high dose, either drug can cause a fatal opioid overdose in a user, especially if taken in combination with other drugs, including alcohol

Understanding hydrocodone & oxycodone

Both medications work in a similar way. These drugs bind to particular receptors in the brain, blocking pain signals and causing a sense of euphoria. They can cause a variety of negative side effects and both can be dangerous if taken in too high a dose.[2,3]

Proportionally, oxycodone is significantly more potent than hydrocodone.[4] Both medications should only be used exactly as prescribed and only for the minimum amount of time necessary. 

Comparing hydrocodone & oxycodone

The following chart compares some notable traits of these two medications:[1-5]

Primary UsesSevere pain reliefModerate to severe pain relief
FormsExtended-relief tablets, extended-relief capsulesSolution, concentrated solution, tablets, capsules, extended-relief tablets, extended-relief capsules
Typical DosingHydrocodone and Acetaminophen: Every 4-6 hours
Extended-release capsule: Every 12 Hours
Extended-release tablet: Once per day
Standard forms: Every 4-6 hours
Extended forms:Every 12 hours
Common Side EffectsDry mouth, stomach pain, tiredness, headache, back pain, difficulty or painful urination, muscle tightening, trouble falling/staying asleep, uncontrollable shaking of a part of the body, swelling of the foot, leg, or ankle,Dry mouth, stomach pain, drowsiness, flushing, headache, mood changes
Addiction PotentialSignificant, especially if abusedSignificant, especially if abused
Cost~ $1.50/tablet~ $6.00/tablet
Will Insurance Cover It?Usually, if deemed medically necessary by a professionalUsually, if deemed medically necessary by a professional
Efficacy and SafetyEffective painkiller with significant risk of abuse and addiction
Can cause dangerous overdose if taken in too high a dose, especially if combined with other drugs that cause respiratory depression
Effective painkiller with significant risk of abuse and addiction
Can cause dangerous overdose if taken in too high a dose, especially if combined with other drugs that cause respiratory depression

Key Differences Between Hydrocodone & Oxycodone

While these drugs share many similarities, some key differences between the drugs include the following:

Methods of Administration

Hydrocodone comes in fewer forms than oxycodone. It is typically only available via extended-release capsules or extended-release tablets. These are taken orally with water.[2]

Oxycodone comes in a wide variety of forms, including a liquid solution, a concentrated solution, tablets, capsules, extended-relief tablets, and extended-relief capsules. Most of these can be taken with or without food, although the extended-release capsules are specifically taken with food. Try to eat about the same amount of food with each dose.[3]

As with all information in this article, these are general recommendations. If your doctor provides different use instructions, follow those instead.  


A person prescribed hydrocodone combined with acetaminophen is usually started on a dose of one or two tablets every four to six hours as needed for pain, taking tablets composed of 5 mg of hydrocodone and 300 mg of acetaminophen. The dosing is similar if given a hydrocodone/acetaminophen solution.[6] 

Extended-release hydrocodone is designed to be taken less frequently. Initial dosing for hydrocodone capsules is typically 10 mg every 12 hours.[7] 

For acute pain in adults, oxycodone is typically given at an initial dose between 5 mg to 15 mg every four to six hours. For chronic pain, the dose a doctor begins a patient on is usually lower, between 2.5 mg and 10 mg.[8] Similar to hydrocodone, extended-release options are taken less frequently—generally only every 12 hours.

Always follow the dosing schedule your doctor gives you. Talk with them before making any changes in the way you take your medication. Your dosing is likely to change over time. 


The potency of opioids is usually measured relative to morphine, an opioid painkiller that could be considered to be of moderate strength. This makes a helpful baseline when trying to understand the strength of other opioids. 

Hydrocodone has a relative potency to morphine of 2/3, meaning it is about 66% as strong as morphine. Oxycodone has a relative potency to morphine of 1.5, meaning it is about 150% stronger than morphine. The manufacturer’s recommendation for oxycodone is to consider it to have a relative potency of 2, which is even higher, when doctors are trying to determine equivalent dosing between different opioids.[1]

Is Hydrocodone or Oxycodone More Addictive?

Hydrocodone is significantly less potent than oxycodone. This means that, if taking an identical dose of each medication, oxycodone would cause a more intense effect. Thus, it could arguably be called more addictive. However, this is an incomplete comparison.

Both drugs are opioids and act on the same part of the brain.[9] They both have the potential to cause a powerful sense of euphoria and hijack the brain’s reward system if misused. Both drugs will likely cause physical dependence if taken for a long enough period, even if only taken as prescribed. 

Because of this, both drugs should be considered addictive enough that their abuse should absolutely be avoided. You should not think of hydrocodone as safer than oxycodone, even if it technically is. Instead, think of both drugs as having the potential to cause serious harm.

Updated March 3, 2024
  1. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. World Health Organization. Published 2018. Accessed February 17, 2024.
  2. Hydrocodone. U.S. National Library of Medicine. Published May 15, 2023. Accessed February 17, 2024.
  3. Oxycodone. U.S. National Library of Medicine. Published May 15, 2023. Accessed February 17, 2024.
  4. Ethanol reversal of tolerance to the antinociceptive effects of oxycodone and hydrocodone. Jacob JC, Poklis JL, Akbarali HI, Henderson G, Dewey WL. Journal of Pharmacology and Experimental Therapeutics. 2017;362(1):45-52.
  5. Prescription painkillers cost up to 13 times more on street. Becker’s ASC Review. Published June 6, 2011. Accessed February 17, 2024.
  6. Hydrocodone and acetaminophen. Habibi M, Kim PY. StatPearls. Published January 2024. Accessed February 17, 2024.
  7. Hydrocodone bitartrate extended-release capsules (ZOHYDRO ER), C-II. VA Pharmacy Benefits Management Services, Medical Advisory Panel, and VISN Pharmacist Executives. Published November 2014. Accessed February 17, 2024.
  8. Oxycodone. Sadiq NM, Dice TJ, Mead T. StatPearls. Published January 2024. Accessed February 17, 2024.
  9. The neurobiology of opioid dependence: Implications for treatment. Kosten T, George T. Science & Practice Perspectives. 2002;1(1):13-20.
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