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OxyContin vs. Percocet: Is One More Addictive?

Oxycontin and Percocet are both Schedule II controlled substances in the United States. They have recognized medical purposes for the treatment of acute moderate to severe pain. While OxyContin is the brand-name formulation of oxycodone, Percocet is a combination of both oxycodone and acetaminophen. It is only recommended to take either drug for short-term management of pain that is not relieved by other medications. They are addictive opioid medications.

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Why Are Oxycontin & Percocet Used?

OxyContin (oxycodone) is an opioid medication prescribed for the treatment of acute severe pain. It is used when other non-opioid pain relievers are ineffective.[1] 

OxyContin is not recommended for the treatment of long-term chronic pain, as it is well known to be habit-forming and addictive. It is only legally available through a doctor’s prescription, though it has also become a widely misused substance.

Percocet is a combination of oxycodone and acetaminophen in tablet form.[2] It is prescribed to relieve moderate to moderately severe pain that does not respond to pain relievers, like acetaminophen, alone. 

The combination of oxycodone and acetaminophen can effectively treat a range of symptoms, including aches and chills, and increase the effects of oxycodone. Acetaminophen also comes with added risks.[3]

How These Drugs Work

Opioids, like oxycodone, work by interfering with opioid receptors throughout the body. They bind to pain receptors and effectively reduce the sensation of pain. The excitability of neurons throughout the central nervous system is reduced, and the central nervous system is generally depressed.[4]

Percocet works the same as oxycodone does, with the additional functions offered by acetaminophen. Acetaminophen is both a pain reliever and a fever reducer. It works by cooling the body (reducing fever) and reducing the sensation of pain.[5]

Comparing Oxycontin vs. Percocet

This chart compares Percocet vs. OxyContin:[4,5,7]

OxyContin Percocet
Generic NamesOxycodoneOxycodone and acetaminophen
Drug ClassOpioid agonist Opioid analgesic and antipyretic
Prescribed ForAcute and chronic moderate to severe painModerate to severe pain
FormulationsTablet, capsule, or oral solutionTablet, capsule, or oral solution
Typical Dosage5–30 mg for immediate release and 10–80 mg for extended release one capsule every six hours for immediate release or two tablets every 12 hours for extended release
Onset10–30 minutes for immediate release and approximately one hour for extended releaseWithin minutes 
Duration 3–6 hours for immediate release and 12 hours for extended releaseSimilar to oxycodone
Half-Life3–5 hours3–5 hours for oxycodone and 2–3 hours for acetaminophen
Potential for AbuseCan cause physical dependence and addiction Habit forming with long-term use
Safety for ChildrenBegin with lowest possible dose, starting at 0.05–0.15 mg/kgImmediate-release doses to be determined by a doctor, extended-release doses not recommended 

Key Differences Between the Two Drugs 

One of the key differences between OxyContin and Percocet is that Percocet also contains acetaminophen, which complicates potential health risks. The U.S. Food and Drug Administration (FDA) warns that prescription products containing acetaminophen should be limited to 325 mg per dosage unit and not taken more often than recommended to avoid severe liver damage.[3] 

Allergic reaction to acetaminophen, including swelling of the face, mouth, and throat, is an additional risk associated with taking Percocet rather than OxyContin.

Which Drug Is More Effective?

The effectiveness of each drug depends on the individual’s symptoms and response to the medications. OxyContin can effectively manage acute or chronic moderate to severe pain. 

While long-term use of opioids is not generally recommended, extended-release formulations can manage pain 24 hours per day. OxyContin is approximately 1.5 to two times as strong as morphine for the treatment of pain.[4]

If an individual is looking for additional pain relief from headaches or fevers, the acetaminophen in Percocet may be helpful. Since acetaminophen works on additional pathways throughout the body, it may provide additional pain relief than that offered by oxycodone alone.

Risk of Addiction With OxyContin & Percocet

Both OxyContin and Percocet are associated with a high risk of abuse and addiction. Anyone taking prescription opioids can become addicted to them, warns the Centers for Disease Control and Prevention (CDC). As many as 25% of people who take opioids for the long-term treatment of pain become addicted to them.[6] 

Taking too many opioids at once increases the risk of an accidental overdose, which can be fatal. This is true whether Percocet or oxycodone is taken. High doses of either can result in a fatal overdose. This risk is further raised if either opioid is combined with other substances, such as alcohol or benzodiazepines.[7,8]

In 2016, over 11.5 million Americans reported misusing prescription opioids.[6] Misuse of such medications can quickly lead to addiction. Oxycodone is one of the most common prescription opioids involved in opioid overdose deaths.

Side Effects of OxyContin & Percocet

There are many risks associated with taking prescription opioid medications like OxyContin and Percocet. Common side effects to watch out for include the following:[1] 

  • Drowsiness and sleepiness
  • Dizziness
  • Nausea
  • Depressed breathing and heart rate 

Additional side effects of acetaminophen include the following:[5]

  • Skin rash
  • Hives and itching
  • Swelling of the face, throat, tongue, mouth, eyes, hands, feet, and ankles
  • Hoarse voice 
  • Difficulty swallowing or breathing 

Dangers Associated With Both Drugs

Taking too much of either OxyContin or Percocet can lead to life-threatening breathing problems.[1] 

OxyContin and Percocet should not be combined, with other opioid medications, or other types of drugs, or taken in higher doses than as prescribed by a doctor. Pregnant and breastfeeding women should avoid taking opioids, as they can pass to the child and cause damage to the baby, such as low birth weight and neonatal abstinence syndrome.

In addition to the risks of opioids, Percocet can cause further damage due to acetaminophen. If high doses are taken, acetaminophen toxicity is possible in addition to the potential for opioid overdose.[9] 

For individuals with chronic pain or who are at risk of complications associated with taking opioids, alternative pain treatment options are available. Other less addictive medications and lifestyle changes, such as improving physical fitness and utilizing relaxation techniques, may be more appropriate and less risky forms of pain management. Talk to your doctor about the best path forward for you.

If you’ve been misusing OxyContin, Percocet, or any opioids, it’s important to get help. Continued misuse greatly increases your likelihood of overdose, which can cause severe damage to the body and brain, and even be fatal. With comprehensive addiction treatment that includes medication and therapy, you can learn to manage your opioid use disorder and build the foundation of a better life in recovery.

Updated November 6, 2023
Resources
  1. Oxycodone. HealthDirect. Published May 2023. Accessed September 5, 2023.
  2. Oxycodone and Acetaminophen (Oral Route). Mayo Clinic. August 1, 2023. Accessed September 5, 2023.
  3. FDA Drug Safety Communication: Prescription acetaminophen products to be limited to 325 mg per dosage unit; Boxed warning will highlight potential for severe liver failure. U.S. Food & Drug Administration. Published February 7, 2018. Accessed September 5, 2023.
  4. Sadiq N., Dice T., Mead, T. Oxycodone. National Library of Medicine. Published August 22, 2022. Accessed September 5, 2023.
  5. Acetaminophen. MedlinePlus: National Library of Medicine. Published January 15, 2022. Accessed September 5, 2023.
  6. Prescription opioids. Centers for Disease Control and Prevention. Published August 29, 2017. Accessed September 5, 2023.
  7. Tori ME, Larochelle MR, Naimi TS. Alcohol or benzodiazepine co-involvement with opioid overdose deaths in the United States, 1999-2017. JAMA Netw Open. 2020;3(4):e202361. Published 2020 Apr 1. doi:10.1001/jamanetworkopen.2020.2361
  8. Jakobsson G, Gustavsson S, Jönsson AK, Ahlner J, Gréen H, Kronstrand R. Oxycodone-related deaths: The significance of pharmacokinetic and pharmacodynamic drug interactions. Eur J Drug Metab Pharmacokinet. 2022;47(2):259-270. doi:10.1007/s13318-021-00750-9
  9. Dimitropoulos E., Ambizas E. Acetaminophen toxicity: What pharmacists need to know. U.S. Pharmacist. 2014; 39(3): 2-8.
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