What Is Hydrocodone? How Is It Different From Oxycodone?


What is hydrocodone? What is hydrocodone used for? What’s the difference between hydrocodone and oxycodone? We’ll answer all these questions and more in this article, including why hydrocodone-acetaminophen combinations are so common for pain, hydrocodone dosage, and why you shouldn’t mix hydrocodone and alcohol.


What Is Hydrocodone?

Hydrocodone is a prescription painkiller that is an opioid and a narcotic.

What is hydrocodone used for? It is used to manage round-the-clock pain of at least moderate severity caused by surgery, illness, or a chronic condition. In other words, you won’t be taking hydrocodone the next time you get a little headache; it’s for managing anticipated bouts of intense pain.

Hydrocodone works by blocking pain signals sent by your nerves to your brain. Thus, you experience less pain.

Hydrocodone is available in a variety of formulations. It’s often paired with acetaminophen (common brands of hydrocodone-acetaminophen are Norco and Vicodin) or ibuprofen (common brands Reprexain and Ibudone) for pain management. Hydrocodone is also an antitussive (or cough suppressant) and is sometimes paired with antihistamines in prescription hydrocodone cough syrup. Finally, hydrocodone bitartrate extended-release tablets are also available as Hysingla ER and Zohydro ER.


er hydrocodone
Extended-release hydrocodone. Source: Pillbox.


Why Is Hydrocodone So Hard to Get?

Hydrocodone medications are only available via prescription, but those aren’t the only restrictions. Medications that contain hydrocodone are all classified as Schedule II drugs by the DEA, which means that they have a legitimate medical use but also have a high potential for abuse. Hydrocodone is habit-forming, and hydrocodone addiction is very serious.

As of fall 2016, hydrocodone/acetaminophen was the most prescribed drug in America. It’s also one of the most abused prescription drugs and a major part of the opioid epidemic.

Because hydrocodone is Schedule II, you need a physical prescription to get any drug with hydrocodone (your doctor can’t call it in), and you can’t get more than 90 days’ supply without seeing your doctor again. This is meant to limit the amount of hydrocodone circulating in the US and hopefully cut down on abuse of the drug.

This is also why it’s so common to see hydrocodone-acetaminophen combination medications for pain management—the acetaminophen component is meant to deter taking large doses because large doses of acetaminophen are very toxic to the liver.


hydrocodone acetaminophen
Hydrocodone/acetaminophen combination. Source: Pillbox.


What’s the Difference Between Hydrocodone and Oxycodone?

If you’re wondering about the difference between oxycodone and hydrocodone, we’ll go over that here.

Hydrocodone and oxycodone are both lab-created opioid narcotics used for pain management. They are also both Schedule II class drugs in the United States. Research indicates that they are about equally effective for pain management on a population level, however, you may respond to one drug better than the other. They are also the two most commonly abused prescription opioids, although they appear to be preferred by slightly different populations.

That said, there are a few differences between the two. They have similar side effects overall, but hydrocodone more frequently causes stomach pain and muscle pain. Oxycodone is more likely to cause sweating and itching. Anecdotally, people report that oxycodone withdrawal is worse than hydrocodone withdrawal.

Oxycodone seems to be somewhat safer for pregnant women than hydrocodone. Oxycodone is considered category B for pregnant women, while hydrocodone is category C.


You might get either oxycodone or hydrocodone in an emergency room situation.


What Are the Side Effects of Hydrocodone?

The following side effects of hydrocodone are common and typically do not require medical attention if they are not too severe:

  • Nausea/vomiting/stomach pain
  • Constipation
  • Fatigue/sleepiness/weakness
  • Mild dizziness
  • Mild headache
  • Appetite suppression
  • Minor dehydration
  • Slight difficulty urinating
  • Slowed reaction time and poor motor control
  • Minor itchiness
  • Minor increase in anxiety
  • Stuffy nose, sneezing, sore throat
  • Minor swelling in hands and feet
  • Tinnitus (ringing in the ears)
  • Back pain

Of course, call your doctor if any of these common side effects of hydrocodone become severe or unbearable.

In some people, hydrocodone also induces a euphoric state. This is one of the reasons why hydrocodone addiction is common. You should never drive or operate dangerous machinery while on hydrocodone.

Discontinue hydrocodone use and call your doctor immediately if any of these serious side effects of hydrocodone use occur:

  • Signs of an allergic reaction—hives, wheezing, swelling of the face and throat, rash, etc.
  • Difficulty breathing or feeling of tightness in chest
  • Pain or burning when urinating
  • Tremors
  • Missed period
  • Feeling of burning, numbness, or tingling
  • Memory loss
  • Seizures
  • Severe headache
  • Fast or pounding heartbeat
  • Intense anxiety

Hydrocodone can slow or even stop your breathing at high doses. Thus, overdose can be fatal. Symptoms of hydrocodone overdose include:

  • Blue lips and/or nail beds
  • Blurry vision
  • Dizziness/fainting/loss of consciousness
  • Inability to stay awake
  • Cold/clammy skin; sweating
  • Confusion, disorientation
  • Pinpoint pupils (constriction)
  • Unusual or irregular breathing, especially slowed breathing
  • Irregular heartbeat
  • Chest pain

Seek medical attention immediately if you or someone you are caring for exhibits signs of a hydrocodone overdose.

Taking hydrocodone for a long time can have adverse effects on your fertility, especially male fertility. Additionally, even taking the drug as directed for needed pain relief, you may end up in withdrawal after stopping hydrocodone. Withdrawal symptoms include:

  • Restlessness and irritability
  • Dilated pupils
  • Aching muscles
  • Insomnia
  • Gastrointestinal issues
  • Sweating, watery eyes, runny nose
  • Shivering
  • Depression and anxiety
  • Tapering off the drug gradually may help stave off withdrawal.


Sorry li’l puppy, withdrawal is hard!


What Drugs Interact With Hydrocodone?

The following substances can have dangerous interactions with hydrocodone and should be avoided when taking hydrocodone:

Alcohol: Alcohol is a depressant. When you mix hydrocodone and alcohol, it can cause dangerously slow or weak breathing and even death.

Other depressants or sedatives: Any drug with a depressant or sedative effect (including sleeping pills, benzodiazepines, muscle relaxants, tranquilizers, antipsychotics, and other narcotics/opioids) will magnify hydrocodone’s sedative properties. This could lead to dangerously slow breathing and potentially death.

Drugs that impact serotonin levels: Any drug that impacts serotonin levels in your body (including antidepressants, medicine for Parkinson’s, migraine medication, and anti-nausea drugs) can cause serotonin syndrome when paired with hydrocodone. Serotonin syndrome can be life threatening. Symptoms of serotonin syndrome include:

  • Twitching
  • Agitation
  • Hallucinations
  • Fever
  • Sweating/shivering
  • Pounding heart rate
  • Stiff muscles
  • Poor coordination
  • Diarrhea

Stimulant substances: When stimulants and depressive substances are paired, it leads to greater intoxication levels and greater potential for overdose.

Other drugs may also interact with hydrocodone. Be sure to tell all of your doctors, including your dentist, what drugs and supplements you are on, including over-the-counter medicines. This will help your doctor prevent any unsafe interactions between your medications when creating a pain management regimen for you.


Put the wine down, froggy!


Who Shouldn’t Take Hydrocodone?

Hydrocodone is not safe for everyone. Hydrocodone may not be safe for you if you have any of the following conditions:

  • Breathing trouble/lung disease
  • A history of substance abuse
  • Liver, kidney, gallbladder, pancreas, or thyroid disease
  • Sleep apnea
  • Blockage or narrowing in the gastrointestinal tract
  • Long QT syndrome (a heart condition that causes irregular heartbeats)
  • Trouble with urination
  • Prior head injury or brain tumor
  • History of seizure
  • Enlarged prostate
  • Glaucoma

Individuals who are 65 or older may experience more serious side effects.

Additionally, hydrocodone may not be safe if you are pregnant or breastfeeding. Hydrocodone can be passed on to the fetus or infant and cause dependency, leading to potentially life-threatening hydrocodone withdrawal.


Hydrocodone is not safe for everyone!


How Should I Take Hydrocodone? Dosage and Other Concerns

Hydrocodone dosage and the timing of each dose will depend on the specific hydrocodone product that you are taking. Follow the instructions on your prescription exactly.

If you are taking a liquid hydrocodone product, you may need special, precise measuring implements to measure out your dose. Consult with your doctor on whether this is the case.

You may be able to reduce nausea or stomach pain caused by hydrocodone if you take it on a full stomach.

If you are taking extended-release hydrocodone, do not break, crush, or otherwise tamper with the pills. If you do this, you risk releasing too much hydrocodone into your system at once with potentially fatal consequences.

Hydrocodone should be stored in a cool, dry place. Keep hydrocodone away from children. Do not allow anyone else to take your hydrocodone. Pay attention to whether any of your pills go missing.

Sometimes, when people have leftover hydrocodone pills, they keep them with the thought that they can use the pills next time they have a really terrible headache or painful injury. This is not a good idea because hydrocodone has such high addiction potential.

Different hydrocodone products also have different disposal protocols. For hydrocodone combination products, you can try to find a drug take-back program or place the extra pills in a baggie mixed with something inedible like coffee grounds or kitty litter. For extended-release hydrocodone, the FDA recommends that you actually flush them down the toilet.


Extra extended-release hydrocodone can go down the toilet.


What Is Hydrocodone? The Bottom Line

We answered all your critical hydrocodone questions:

What is hydrocodone? What is hydrocodone used for? Hydrocodone is a prescription narcotic painkiller for managing severe pain due to surgery, injury, or a chronic condition. As a painkiller, hydrocodone-acetaminophen combinations are common, although you can also get extended-release hydrocodone bitartrate. Hydrocodone an antitussive (cough suppressant) so you can also get prescription hydrocodone cough syrup.

Why is hydrocodone so hard to get? You can only get hydrocodone products via a physical prescription and in a limited supply because hydrocodone is highly addictive and hydrocodone abuse is a common problem.

What’s the difference between hydrocodone and oxycodone? Both are prescription narcotic painkillers. The main differences are in the side effects.

What are the side effects of hydrocodone? Hydrocodone has a number of side effects, some of which are potentially dangerous. Make sure someone is monitoring your status when you are taking a hydrocodone product and be very careful with taking the proper hydrocodone dosage.

What drugs interact with hydrocodone? A number of drugs interact with hydrocodone, so be sure to tell your doctor about any prescription, OTC drugs, or supplements you are taking. Hydrocodone and alcohol is an especially dangerous combination that can result in death.

Who shouldn’t take hydrocodone? Hydrocodone is not safe for everyone. Many chronic conditions can make hydrocodone unsafe. It is not safe to take hydrocodone while pregnant or breastfeeding.

How should you take hydrocodone? Different products with have different hydrocodone dosage schedules. Be sure to closely follow the instructions on your prescription. Never take more than advised.


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