From the Guidelines
Oxycodone and hydrocodone have been found to be equal in terms of efficacy in relieving pain, with no significant difference in their potency. When considering the treatment of acute pain, the choice between oxycodone and hydrocodone should be based on individual patient needs and medical history, rather than potency alone 1. The study by Marco et al, although not directly referenced in the provided evidence, is mentioned as comparing single doses of oxycodone 5 mg combined with acetaminophen 325 mg with hydrocodone 7.5 mg combined with ibuprofen 200 mg, finding no differences in pain relief, doses taken, global evaluations of efficacy, health status, or pain interference with work 1.
- Key points to consider when prescribing these medications include:
- Equianalgesic doses of opioids are equally efficacious in relieving pain, regardless of their Drug Enforcement Administration classification 1
- Oxycodone and hydrocodone are both opioid analgesics used to treat moderate to severe pain, but may have different side effect profiles and risks for dependence and addiction
- Patients should always take these medications exactly as prescribed and be aware of the risks associated with opioid use
- The decision to prescribe oxycodone or hydrocodone should be based on individual patient needs and medical history, rather than potency alone 1. Given the equal efficacy of oxycodone and hydrocodone in relieving pain, the choice between these medications should prioritize patient safety, medical history, and potential side effects, rather than potency.
From the Research
Potency Comparison of Oxycodone and Hydrocodone
- The potency of oxycodone and hydrocodone can be compared based on their analgesic effects and risk of opioid-related adverse outcomes.
- A study published in 2005 2 found that oxycodone and hydrocodone had similarly potent analgesic effects in the first hour of treatment for emergency department patients with acute fractures.
- However, a study published in 2022 3 found that oxycodone had a higher risk of overdose compared to hydrocodone, with an adjusted hazard ratio of 1.65.
- Another study published in 2013 4 found that oxycodone was preferred by substance abusers due to its higher euphoric effects, suggesting that it may be more potent than hydrocodone in terms of its psychoactive effects.
- A study published in 2023 5 found that low-dose oxycodone was associated with a higher risk of opioid overdose compared to low-dose hydrocodone, with a hazard ratio of 1.79.
Risk of Opioid-Related Adverse Outcomes
- The risk of opioid-related adverse outcomes, such as overdose and substance use disorders, is an important consideration when comparing the potency of oxycodone and hydrocodone.
- Studies have consistently shown that oxycodone is associated with a higher risk of overdose compared to hydrocodone 3, 5.
- However, hydrocodone may be associated with a higher risk of chronic use and dependence 3.
- The choice between oxycodone and hydrocodone should be based on a careful consideration of the individual patient's needs and risk factors, as well as the potential benefits and risks of each medication.