Saturday December 20th 2014

Hydrocodone vs. oxycodone

Hydrocodone vs. oxycodone

Natural Synthetic | DeliveryEfficacyWithdrawal |     DEA |         Dosage

H no            yes               oral        reliable      less difficult  Sched. II      4-6 hrs; 12 hrs (ER)

O no            yes               oral        reliable     more difficult Sched. II     4-6 hrs; 12 hrs (ER)

Natural or synthetic?

Both hydrocodone and oxycodone are formulated in laboratories. Although the formulas are based on naturally occurring opiates (codeine and thebaine), they are technically called “semi-synthetic opioids”, meaning that they have been derived from natural opiate products.

Delivery

Both oxycodone and hydrocodone are taken orally. Take oxycodone and hydrocodone exactly as directed. Hydrocodone is usually prescribed in combination with at least one other medication. Oxycodone is also available in combination with acetaminophen, aspirin and ibuprofen. Both types of medication are prescribed to be taken as needed, generally once every 4-6 hours or once every 12 hours as needed for the extended-release versions.

Hydrocodone comes as a tablet, a capsule, a syrup, a clear liquid solution, an extended-release capsule, and an extended-release liquid suspension. Oxycodone comes as a liquid solution, concentrate solution, a tablet, capsule, and extended-release tablet.  How long does hydrocodone stay in the body?  For 2 – 4 days in the urine, 12 – 36 hours in the saliva and up to 90 days in the hair.

Efficacy

Both hydrocodone and oxycodone are highly effective for moderate to severe pain relief. During clinical trials, oxycodone and hydrocodone have shown similar potent pain relieving effects in the first hour of treatment. However, some people claim that oycodone pain relief is more intensive than hydrocodone. You can speak with your prescribing doctor about the relative merits and dosing effectiveness for each of these pain medications.

Cost

Generic forms of oxycodone with acetaminophen or generic oxycodone extended release are recommended by Consumer Report for value. Keep in mind that high doses or extended release versions of opioid medications can be more expensive than low dose prescriptions. But most low dose prescriptions of generic hydrocodone or oxycodone will cost < $150 per month. See pages 16 and 18 of  the Consumer Reports “Opioids Best Buy Drugs” for the real numbers and cost comparisons of hydrocodone and oxycodone.

Effects

Some people worry about pain pill effects like hydrocodone hair loss (this doesn’t occur).  However, opioids like oxycodone and hydrocodone can produce dizziness, drowsiness, constipation and depending on the amount taken, can depress breathing. In general,  possible adverse side effects of oxycodone are greater than those of hydrocodone therefore, making it a riskier choice.

Possible adverse side effects of oxycodone can include:

  • hallucinations
  • hives, swelling or skin rash
  • loss of consciousness
  • seizures

Potential for abuse

Long-term use of opioids such as hydrocodone and oxycodone can lead to physical dependence and addiction, though they are rarely addictive in people who genuinely need them to control pain and take prescription medications as prescribed. Both are classified as Schedule II narcotics by the DEA. This means that U.S. law describes oxycodone and hydrocodone as having a relatively high potential for abuse than other medications.

If you are worried that you may become addicted to your pain medications, you are not alone. The exact risk of pain pill addiction is not known, but some factors which may increase chances of addiction include past drug or alcohol problems, problem with anxiety, depression or other mental health disorders. This is also true if someone in your family has been diagnosed with substance abuse problems.

Withdrawal

People who have gone through withdrawal from both opioids claim that oxycodone withdrawal is worse than hydrocodone withdrawal. Withdrawal from both drugs can be painful, but can be eased by first tapering the dose of each medicine before stopping dosage completely. And it helps to know that getting the drugs out of your system during detox is not life threatening. Nonetheless, withdrawal from opioids is safest when completed under the supervision of a medical professional, because additional medications or interventions may help related symptoms.

Reference sources: DEA Drug Scheduling classifications
Online community forum topic RE: hydrocodone withdrawal versus oxycontin withdrawals
Medline Plus info on oxycodone
Medline Plus info on hydrocodone
Comparison of oxycodone and hydrocodone for the treatment of acute pain associated with fractures

Photo credit: isado

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