Dilaudid vs. Percocet for Pain: Which One Is Better?

Dilaudid vs. Percocet quick comparison

Dilaudid (hydromorphone hydrochloride) and Percocet (oxycodone and acetaminophen) are both opioid narcotic pain relievers.
Percocet has an additional non-narcotic pain reliever added (acetaminophen) which achieves greater pain relief than either drug taken separately.
Both Dilaudid and Percocet are available as generic drugs.
Side effects of both Dilaudid and Percocet are similar and include lightheadedness, dizziness, sedation, nausea, vomiting, constipation, itching. Dilaudid may also cause sweating, flushing, and dry mouth. Percocet may also cause euphoria, rash, drowsiness, and difficulty urinating.
Serious side effects of both Dilaudid and Percocet include slowed breathing and trouble breathing.
Combining opioids such as Dilaudid and Percocet with alcohol or other central nervous system depressants may result in severe sedation, respiratory depression, coma, and death.
Both Dilaudid and Percocet have potential for abuse and addiction. Withdrawal symptoms for both drugs include restlessness, watery eyes, runny nose, yawning, sweating, chills, muscle pain, and dilated pupils.

What is Dilaudid? What is Percocet? How do they relieve pain?

Dilaudid (hydromorphone hydrochloride) is an opioid narcotic pain reliever similar to oxycodone, morphine, methadone, fentanyl, and other opioids. Dilaudid, like other opioids, stimulates receptors on nerves in the brain to increase the threshold to pain and reduce the perception of pain.

Percocet (oxycodone and acetaminophen) is a combination of a strong narcotic pain-reliever and cough suppressant, and a non-narcotic pain reliever and fever reducer. Oxycodone does not eliminate the sensation of pain, but decreases discomfort by increasing tolerance to pain. Oxycodone also causes sedation and respiratory depression. Acetaminophen relieves pain by elevating the threshold to sensing pain. It reduces fever through its action on the heat-regulating center of the brain. The combination of oxycodone and acetaminophen achieves greater pain relief than either taken separately.

What are the uses for Dilaudid vs. Percocet?

Hydromorphone is used for management of acute pain and moderate-to-severe chronic pain in patients when the use of an opioid is appropriate.

Percocet is prescribed for the relief of moderate to moderately severe pain.

Differences between side effects of Dilaudid vs. Percocet

Dilaudid Black Box Warning

BLACK BOX WARNING: Hydromorphone (generic name for Dilaudid)

Dilaudid-HP Injection should not be confused with other types of Dilaudid injections or other opioids, as overdose and death could result.
Avoid dosing errors from confusion between mg and mL when dispensing, prescribing, or administering the oral solution. Dosing errors can result in accidental overdose and death.
Hydromorphone exposes patients to risks of addictions, abuse, and misuse, which can lead to overdose and death.
Patients should be monitored closely because serious, life-threatening, or fatal respiratory depression may occur.
Prolonged use of hydromorphone during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. Pregnant woman should be advised of the risk of neonatal opioid withdrawal syndrome and appropriate treatment should be available.
Combining opioids with benzodiazepines, alcohol, or other central nervous system (CNS) depressants may result in severe sedation, respiratory depression, coma, and death.

Dilaudid side effects

Common side effects

Lightheadedness
Dizziness
Sedation
Nausea
Vomiting
Constipation
Sweating
Flushing
Itching
Dry mouth

Other serious side effects:

Other serious and important side effects of Dialudid are respiratory depression and trouble breathing.
Since Dialudid is a controlled narcotic, it carries a box warning of respiratory depression and abuse potential. Use with alcohol or other medications affecting central nervous system can worsen respiratory depression and may lead to death.

Percocet side effects

The most frequent adverse reactions of Percocet (brand name for oxycodone/acetaminophen) include:

Lightheadedness
Dizziness
Sedation
Euphoria
Dysphoria
Rash
Itching
Nausea
Vomiting

Other important side effects include:

Drowsiness
Constipation
Spasm of the ureter, which can lead to difficulty in urinating

Possible serious side effects include:

Severe reduction in blood pressure (hypotension)
Shock
Seizures
Paralytic ileus
Serious allergic reactions
Severe skin reactions

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

Are Dilaudid and Percocet addictive?

Dilaudid and oxycodone (the narcotic drug in Percocet) both can be addicting even at doses prescribed. Caution should be used with these medications in individuals who have addiction problems.

What is the dosage for Dilaudid vs. Percocet?

Dilaudid dosage

Immediate-release tablets: Take 2 to 4 mg tablets by mouth every 4 to 6 hours as needed. Increase to 8 mg after careful observation and if needed to control pain.
Extended-release tablets: Start after discontinuation of all other opioid extended-release tablets. Dosed once-daily, individualized based on prior opioid therapy.
Injections: Give 1 to 2 mg intramuscularly or subcutaneously every 2 to 3 hours as needed. Give 0.2 to 1 mg intravenously over 2 to 3 minutes every 2 to 3 hours as needed.
Oral solution: Give 2.5 to 10 mg every 3 to 6 hours as needed.
Rectal suppository: Insert one 3 mg suppository rectally every 6 to 8 hours OR3 to 6 mg rectally every 3 to 4 hours, when appropriate.
Safe and effective use of hydromorphone in children has not been established.

Percocet dosage

The dose of Percocet (oxycodone/acetaminophen) is variable and depends on the needs of the patient and specific circumstances.
The usual dose is one tablet every six hours as needed.
The maximum oxycodone/acetaminophen dose is 60 mg/4 g per day.

Which drugs interact with Dilaudid vs. Percocet?

Dilaudid drug interactions

Dilaudid should be used very cautiously with medications that depress the central nervous system (for example, hypnotics, anesthetics, tranquilizers, phenothiazines, and alcohol).
Dilaudid should be used with caution with mixed agonist/antagonist opioid analgesics (for example, pentazocine, nalbuphine, butorphanol, and buprenorphine) because it may take away the analgesic effect of hydromorphone.

Percocet drug interactions

Oxycodone, like other narcotic pain-relievers, increases the effect of drugs that slow brain function, such as alcohol, barbiturates, skeletal muscle relaxants, for example, carisoprodol (Soma), cyclobenzaprine (Flexeril), and benzodiazepines such as diazepam (Valium) and lorazepam (Ativan). Combined use of muscle relaxants or benzodiazepines and oxycodone may lead to increased respiratory depression.
Since oxycodone causes constipation, the use of antidiarrheals, for example, diphenoxylate (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.
A fatty meal may increase the absorption of oxycodone by 27%.

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Are Dilaudid and Percocet safe to take during pregnancy or while breastfeeding?

Dilaudid safety

There are no adequate studies of hydromorphone to determine safe and effective use in pregnant women.
Low levels of opioid medications may be excreted in breast milk; therefore, it should not be used in nursing mothers.

Percocet safety

Safety of oxycodone/acetaminophen during pregnancy has not been established. Newborns of 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.