Oxycodone 10-325 and Oxycodone HCl 10 Are Equally Strong
Both formulations contain the same amount of active opioid (10 mg oxycodone) and therefore provide equivalent analgesic potency—the only difference is that the 10-325 formulation includes 325 mg of acetaminophen, which may provide modest additional pain relief through a different mechanism. 1, 2
Understanding the Formulations
Oxycodone Content
- Oxycodone 10-325 contains 10 mg oxycodone + 325 mg acetaminophen (also called Percocet) 2
- Oxycodone HCl 10 contains 10 mg oxycodone alone 3, 4
- The oxycodone component is identical in both formulations at 10 mg, providing the same opioid analgesic effect 1, 5
The Acetaminophen Addition
- The 325 mg acetaminophen in the combination product works through a different mechanism than opioids and may provide additive analgesia 5
- Combination therapy with oxycodone plus acetaminophen demonstrates improved efficacy compared to oxycodone alone in some studies, with a number-needed-to-treat of 2.7 for the combination versus 4.6 for oxycodone alone 5
- The combination provides longer duration of action (approximately 10 hours) compared to lower doses 5
Clinical Equivalence
Analgesic Potency
- When comparing equianalgesic doses of opioids, they are equally efficacious in relieving pain regardless of formulation 1
- Oxycodone has an oral bioavailability of 60-87% and is approximately 1.5-2 times more potent than oral morphine 3, 4
- The 10 mg oxycodone dose in both formulations provides the same opioid receptor activation 6, 7
Practical Considerations
- Choose the combination (10-325) when: The patient can benefit from the acetaminophen component and has no contraindications to acetaminophen (normal liver function, total daily acetaminophen <4000 mg) 2
- Choose oxycodone alone (HCl 10) when: The patient is already taking acetaminophen from other sources, has liver disease, or needs to avoid the acetaminophen component 2
- Neither formulation is inherently "stronger" from an opioid potency standpoint 1
Important Safety Considerations
Acetaminophen Limits
- Maximum daily acetaminophen dose should not exceed 4000 mg to avoid hepatotoxicity 2
- In patients with liver disease, limit acetaminophen to 2-3 grams per day 2
- Always account for acetaminophen from all sources when prescribing the combination product 2
Dosing Principles
- Both formulations should be prescribed at the lowest effective dose for limited duration (e.g., 1 week for acute pain) 1, 2
- For moderate pain management, low-dose combinations (oxycodone 5-10 mg with acetaminophen) are often effective and may reduce adverse effects 8
- Individual patient response can vary due to genetic polymorphisms affecting opioid metabolism 1
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