Oxycodone vs. Vicodin & Pain: Side Effects, Differences & Addiction

Oxycodone vs. Vicodin (hydrocodone/acetaminophen)
for pain review

Oxycodone is a strong opioid narcotic pain reliever (analgesic), and
Vicodin is a combination of two drugs, hydrocodone (a strong narcotic pain
reliever) and
acetaminophen (Tylenol).
Oxycodone and hydrocodone are similar to other drugs that are opioid narcotics,
for example,
methadone,
fentanyl, and morphine.
Both oxycodone and Vicodin are prescribed to treat moderate to severe
pain. However, hydrocodone also may prescribed to treat fever, inflammation,
and cough.
Oxycodone also is available in combination with acetaminophen (Percocet, Roxicet, Tylox, Oxycet).
Other brand names for hydrocodone and acetaminophen, for example,
include Vicodin ES, Vicodin HP, Lortab, Lorcet, and Norco.
Common side effects of both oxycodone and Vicodin include:
- Lightheadedness
- Dizziness
- Sedation
- Nausea
- Vomiting
The dosages for oxycodone and Vicodin are not the same and should be
reviewed prior to taking either medication.
Oxycodone and Vicodin interact with several other medications, for
example, neither drug should be taken with monoamine oxidase inhibitors
(MAOI), a class of antidepressants. Combining oxycodone or Vicodin with
alcohol or other drugs may lead to increased sedation and cause confusion.
Acetaminophen taken in large doses or when used with other drugs like
alcohol may lead to
liver toxicity or liver damage.
Oxycodone and Vicodin are listed as schedule II drugs by the Controlled
Substances Act because their use may lead to addiction and withdrawal
symptoms.

What are oxycodone and Vicodin (hydrocodone/acetaminophen), and how do they work?

Oxycodone: Oxycodone is prescribed strong narcotic
pain-reliever and
cough suppressant similar to morphine,
codeine, and
hydrocodone. The precise mechanism of action is not known but may involve
stimulation of opioid receptors in the brain. Oxycodone does not eliminate the
sensation of pain but decreases discomfort by increasing the tolerance to pain.
In addition to tolerance to pain, oxycodone also causes sedation and depression
of respiration.
Vicodin is a prescribed combination of hydrocodone and
acetaminophen. Hydrocodone is a strong narcotic pain-reliever (analgesic) and a
cough suppressant, similar to codeine. Hydrocodone blocks the receptors on nerve cells in the brain that give rise to the sensation of pain. Acetaminophen is a non-narcotic analgesic (pain reliever) and antipyretic (fever reducer).
Acetaminophen works by elevating the threshold to pain, that is, in order for pain to be felt, greater stimulation of the nerves responsible for the sensation of pain is necessary. It reduces fever through its action on the temperature-regulating center of the brain. Frequently,
hydrocodone and acetaminophen are combined to achieve pain relief, as in
Vicodin.

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What brand names are available for
oxycodone and hydrocodone/acetaminophen?

Oxycodone brand names

Examples of brands of oxycodone available in the US include:

OxyContin
Roxicodone
Oxecta

There are many other brand name for oxycodone to include
combinations with other drugs, for example:

Endocet
Percodan
Percocet
Oxycet

Hydrocodone and acetaminophen brand names

Brand names available for hydrocodone and acetaminophen in the US
include:

Vicodin
Vicodin ES
Vicodin HP
Lortab
Lorcet
Lorcet Plus
Norco
Zydone
Hycet
Maxidone
Stagesic
Verdrocet
Xodol
Zamicet
Zolvit
Anexsia is a discontinued brand and is no longer available in the US.

What are the uses for oxycodone vs. Vicodin (hydrocodone/acetaminophen)?

Oxycodone uses

Oxycodone is prescribed for the management of
pain severe enough to require daily, around-the-clock, long-term treatment with
a narcotic, and for which alternative treatment options are inadequate for the
relief of moderate to severe pain.

Vicodin uses

Vicodin (hydrocodone/acetaminophen) is prescribed for the relief of
moderate to moderately severe pain. It also may be used as a cough suppressant.

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What are the side effects of oxycodone vs. Vicodin (hydrocodone/acetaminophen)?

Oxycodone side effects

The most frequent side effects of oxycodone oxycodone include:

Other side effects of oxycodone include:

Faintness
Heart attack
Rash
Itching
Depression
Abnormal heartbeats

Oxycodone can depress breathing and is used with caution in elderly,
debilitated patients and in patients with serious lung disease.

Oxycodone can impair thinking and the physical abilities required for driving
or operating machinery.

Is oxycodone additive?

Oxycodone is habit forming. Mental and physical dependence can occur but are
unlikely when used for short-term pain relief. If oxycodone is suddenly
withdrawn after prolonged use, symptoms of withdrawal may develop. The dose of
oxycodone should be gradually reduced in order to avoid withdrawal symptoms.

Vicodin side effects

Common side effects of Vicodin are:

lightheadedness,
dizziness,
sedation,
nausea, and
vomiting.

Other important side effects of Vicodin include:

drowsiness,
constipation, and
spasm of the ureter, which can lead to difficulty in urinating.

Hydrocodone can impair thinking and the physical abilities required for
driving or operating machinery. Hydrocodone can depress breathing, and should be
used with caution in elderly, debilitated patients and in patients with serious
lung disease.

Acetaminophen can cause severe liver failure if excessive amounts are used
and when combined with chronic alcohol use or other drugs that also impair liver
function.

Is Vicodin addictive?

Hydrocodone may be habit forming. Mental and physical dependence can occur
but are unlikely when used for short-term pain relief.

How should oxycodone vs. Vicodin (hydrocodone/acetaminophen) be taken (dosage)?

Oxycodone dosage

The usual starting dose using immediate
release oxycodone tablets is 5 to 30 mg every 4 to 6 hours. Patients who have
never received opioids should start with 5-15 mg every 4 to 6 hours. Some
patients may require 30 mg or more every 4 hours.
The usual starting dose using extended
release tablets is 10 mg every 12 hours. Extended release tablets are used when
around the clock treatment is required for an extended period of time. Extended
release tablets should not be broken, crushed or chewed but should be swallowed
whole. Braking, crushing or chewing extended release tablets may lead to rapid
absorption of the medication and dangerous levels of oxycodone.
The 60 and 80 tablets or single doses greater
than 40 mg should only be used by patients who have been using opioids and have
become tolerant to opioid therapy. Administration of large doses to opioid-naïve
patients may lead to profound depression of breathing.
The usual adult dose of the oral concentrate
(20 mg/ml) is 5 mg every 6 hours.
The usual adult dose for the oral solution (5
mg/5 ml) is 10-30 mg every 4 hours.

Vicodin dosage

The usual dose of Vicodin (hydrocodone/acetaminophen) for adults is 1 to 2 tablets or capsules (hydrocodone
2.5 to 10 mg; acetaminophen) 300 to 750 mg) every 4 to 6 hours or 15 mL of liquid
every 4 to 6 hours as needed.

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Which drugs interact with oxycodone vs. Vicodin (hydrocodone/acetaminophen)?

Oxycodone drug interactions

Oxycodone, like other narcotic pain-relievers, increases the effects
of drugs that slow brain function, such as:
- Alcohol
- Barbiturates
- Skeletal muscle relaxants, for
  example, carisoprodol (Soma), cyclobenzaprine (Flexeril)
- Benzodiazepines, for
  example, lorazepam (Ativan)
Combined use of the above drugs and oxycodone
may lead to increased respiratory depression.
Oxycodone should not be taken with any of the
monoamine oxidase inhibitor (MAOI) class of antidepressants, for example,
isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine
(Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs
that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such
combinations may lead to confusion, high blood pressure,
tremor, hyperactivity, coma, and death. Oxycodone should not be administered
within 14 days of stopping an MAOI.
Since oxycodone causes constipation, the use
of antidiarrheals, for example, diphenoxylate and atropine (Lomotil)
and loperamide (Imodium), in persons taking oxycodone, can lead to
severe constipation.
Drugs which stimulate and also block opioid
receptors for example, pentazocine, nalbuphine (Nubain), butorphanol (Stadol),
and buprenorphine (Subutex) may reduce the effect of oxycodone and may
precipitate withdrawal symptoms.
Combining oxycodone with drugs that affect
activity of certain liver enzymes or discontinuing such drugs may result in
fatal oxycodone overdose.
A fatty meal may increase the absorption of
oxycodone by 27%.

Vicodin drug interactions

Combining alcohol and other sedatives with hydrocodone can
lead to increased sedation and even cause
confusion.
Combining
carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) with
acetaminophen may increase the risk of
liver
toxicity.
Hydrocodone should not be taken with any of the monoamine oxidase inhibitor
(MAOI) class of
antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil),
tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or
other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such
combinations may lead to confusion, high blood pressure,
tremor,
hyperactivity,
coma, and death. Hydrocodone should not be administered within 14 days of
stopping an MAOI.

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Are oxycodone and Vicodin (hydrocodone/acetaminophen) safe to take during pregnancy or while
breastfeeding?

Oxycodone, pregnancy, and
breastfeeding safety

Safety during pregnancy has not been
established. Children born to mothers who were taking oxycodone for a prolonged
period may exhibit respiratory depression or withdrawal symptoms.
Small amounts of oxycodone are secreted in
breast milk and may cause side effects in the newborn.

Safety of Vicodin during pregnancy or while breastfeeding

There are no adequate studies of hydrocodone and acetaminophen in
pregnant women.
Hydrocodone/acetaminophen is excreted in
breast milk,
and, therefore should be used cautiously by
nursing mothers.