Is Oxycodone stronger than Percocet (oxycodone and acetaminophen)?

Oxycodone vs. Percocet: Strength Comparison

Oxycodone alone is not stronger than Percocet (oxycodone/acetaminophen) on a per-pill basis, as they contain the same opioid component, but pure oxycodone is available in higher individual doses and extended-release formulations that Percocet is not. 1, 2

Understanding the Components

• Percocet: A combination medication containing:

  • Oxycodone (opioid component): 2.5mg, 5mg, 7.5mg, or 10mg
  • Acetaminophen (non-opioid component): 325mg

• Oxycodone: Available as a single-ingredient medication in:

  • Immediate-release (IR): 5mg, 10mg, 15mg, 20mg, 30mg tablets
  • Extended-release (ER): Various higher doses for chronic pain

Strength Comparison

Same Opioid Component

• The oxycodone in both medications is identical and provides the same opioid effect at equivalent doses 1
• A 5mg oxycodone tablet provides the same opioid potency as a Percocet tablet containing 5mg oxycodone 2

Differences in Formulation

• Percocet has the added benefit of acetaminophen, which provides additional analgesia through a different mechanism 3
• The combination in Percocet offers synergistic pain relief, potentially making it more effective for certain types of pain than the same dose of oxycodone alone 3, 4

Available Strengths

• Oxycodone is available in higher individual doses (up to 30mg IR and higher for ER) than the oxycodone component in Percocet (maximum 10mg per tablet) 2
• Percocet is limited by the acetaminophen component, which cannot exceed 325mg per tablet due to FDA regulations to reduce hepatotoxicity risk 1

Clinical Implications

Potency Considerations

• Oxycodone is approximately 1.5-2 times more potent than oral morphine 1
• Both oxycodone alone and Percocet are classified as Schedule II controlled substances, reflecting their high potential for abuse 1

Appropriate Use

• For moderate to severe pain requiring opioids, either medication may be appropriate depending on the clinical situation 2
• The synergistic effect of oxycodone with acetaminophen in Percocet may allow for lower opioid doses while maintaining efficacy 3, 4
• Extended-release oxycodone formulations should not be used for acute pain management 1, 2

Side Effect Profile

• Both medications carry risks of typical opioid side effects (constipation, nausea, respiratory depression)
• Percocet has the additional risk of acetaminophen-related hepatotoxicity if total daily acetaminophen intake exceeds 4000mg 2

Common Misconceptions

• Misconception: Pure oxycodone is always stronger than Percocet

  • Reality: At equivalent oxycodone doses, Percocet may provide better analgesia due to the synergistic effect with acetaminophen 3

• Misconception: Percocet is stronger because it has two medications

  • Reality: While the combination is synergistic, the opioid potency is determined by the oxycodone dose, which is the same in both medications at equivalent doses

Clinical Decision Making

When deciding between oxycodone and Percocet:

1. For moderate pain requiring short-term treatment: Percocet may be preferred due to synergistic effects 3
2. For patients requiring higher opioid doses: Pure oxycodone may be preferred to avoid acetaminophen toxicity
3. For chronic pain: Extended-release oxycodone formulations may be appropriate, while Percocet is not available in extended-release form 2

Remember that the total daily acetaminophen dose from all sources should not exceed 4000mg to prevent hepatotoxicity 2.