Comparing Percocet (Acetaminophen and Oxycodone) vs. Hydrocodone
Medically reviewed by Alex Yampolsky, PharmD
Percocet (acetaminophen and oxycodone) and hydrocodone are two narcotic pain relievers that relieve moderate to severe pain. Both medications are similarly effective at reducing pain. However, oxycodone is considered to be a more potent opioid than hydrocodone.
Percocet is a combination drug that contains both an opioid (oxycodone) and a nonopioid analgesic (acetaminophen). Hydrocodone is an opioid that is a single agent, although it is commonly dispensed in combination products. Hydrocodone may be combined with other medications like acetaminophen as in the brand-name drug Norco.
This article will discuss the similarities and differences between Percocet and hydrocodone for pain relief.
Getty Images / Tom Kelley
What Is Percocet?
Percocet is an opioid pain medication. It contains a combination of acetaminophen (the active ingredient in brand-name Tylenol) and oxycodone, which helps to treat moderate to severe pain. It is only available with a healthcare provider's prescription and should be taken as prescribed for the best results.
Due to its risk of addiction and misuse, Percocet is typically reserved for those who are not able to achieve adequate symptom relief with nonopioid pain relievers alone.
How Does Percocet Work?
Oxycodone binds to specific opioid receptors, such as mu, kappa, and delta receptors, to help reduce pain levels.
Acetaminophen helps with minor aches and pains while boosting the effects of oxycodone.
What Is Hydrocodone?
Hydrocodone is an opioid medication often prescribed to treat pain. It is marketed under the brand name Hysingla in an extended-release (ER) tablet for pain severe enough to require daily, long-term opioid treatment. It acts on the central nervous system (made up of the brain and spinal cord) and changes how the body recognizes pain.
It should be used only as directed by a healthcare provider because of its high potential for addiction and abuse.
How Does Hydrocodone Work?
Hydrocodone is a mu-opioid (μ-opioid) receptor agonist, which means it activates the mu-opioid receptors. It can also bind with different opioid receptors at higher concentrations. By doing this, hydrocodone blocks pain signals from being sent throughout the body. This alters how pain is perceived by the brain.
Related: What's the Difference Between Oxycodone and Hydrocodone?
Dosage: Percocet vs. Hydrocodone
Percocet, a combination of oxycodone and acetaminophen, is prescribed for moderate to severe pain relief. The dosage combines two active ingredients, oxycodone and acetaminophen, with different strengths.
Hydrocodone is available in ER formulations. The dosage will vary depending on the condition being treated and the individual's response to it.The ER hydrocodone products have different dosing schedules, but are often taken once daily.
The following table summarizes the dosing information for Percocet and hydrocodone.
| Percocet | Hydrocodone |
Forms & strengths | Oral tablets: 2.5 milligrams (mg) oxycodone/325 mg acetaminophen, 5 mg/325 mg, 7.5 mg/325 mg, 10 mg/325 mg | ER oral tablets: 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, 120 mg |
Recommended dosage | 2.5 mg/325 mg: One or two tablets every six hours as needed | Starting dose in people who are opioid-naive (have not taken opioids before) or not opioid tolerant: 20 mg every 24 hours |
Side Effects: Percocet vs. Hydrocodone
Both Percocet and hydrocodone have similar side effects, which can include:
Nausea
Headache
Dizziness or light-headedness
Drowsiness
Severe side effects that are associated with both Percocet and hydrocodone include:
Respiratory depression (slowed breathing)
Hypotension (severely low blood pressure)
Adrenal insufficiency (most often when using it for more than one month)
Serotonin syndrome (when used with other drugs that boost serotonin)
Because both medications are opioids, there is a potential risk of dependence and misuse, which can lead to an overdose. Talk to your healthcare provider if you are concerned about substance dependence.
Both medications should be taken with caution and under the supervision of a healthcare provider.
Safety Precautions with Opioid Use
When using Percocet or hydrocodone, keep in mind the following safety considerations:
Avoid driving or operating machinery when taking opioids: Opioids can cause drowsiness and impaired coordination. Operating heavy machinery while taking opioids increases the risk of accidents and injuries.
Do not mix opioids with alcohol or other drugs: Always consult your healthcare provider before using opioids in combination with other medications. Opioids, together with alcohol, can have dangerous consequences since this combination intensifies sedative effects, potentially leading to respiratory depression or overdose.
Take as directed by your healthcare provider: Strictly adhere to the dosing instructions provided by your healthcare provider. Do not alter the dosage or frequency without their guidance. Taking opioids as prescribed helps manage pain effectively while minimizing the risk of dependence or misuse.
Dispose of them safely: Properly dispose of unused opioids to prevent misuse or accidental ingestion by others. Follow local guidelines or consult your pharmacist for safe disposal methods.
Store medications safely: Keep opioid medications out of reach of children and pets. Store them securely, away from moisture and direct sunlight, per the medication's specific storage requirements.
Takeaway
If you or a loved one is struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Drug Interactions
Drug interactions occur when two drugs influence each other, affecting how they work in the body.
Interactions can produce unwanted effects, reduce the efficacy of one or both medications and even increase the risk of side effects. It is essential to ask your healthcare providers which medications to avoid when taking hydrocodone.
Acetaminophen is a component of Percocet. Therefore, it's important to consider acetaminophen interactions.
Acetaminophen can be found in over-the-counter (OTC) medications such as cough and cold medicines such as DayQuil and Tylenol Cold and Flu.
The maximum dosage for acetaminophen is 4,000 mg/day, and exceeding this amount can cause liver damage and failure. Be cautious when using OTC medications that also contain acetaminophen, and ensure you stay within the daily limit.
In general, you should not take multiple opioid products at the same time unless advised to by your healthcare provider. Doing so can increase your risk of respiratory depression and overdose.
Percocet and hydrocodone can also interact with the following:
Macrolide antibiotics, such as erythromycin
Azole-antifungal agents, such as ketoconazole
Protease inhibitors, such as Norvir (ritonavir)
Certain seizure medications, such as Tegretol (carbamazepine) and Dilantin (phenytoin)
Rifampin
Benzodiazepines and other sedatives
Other drugs that boost serotonin, such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and triptans
Muscle relaxants, such as Amrix (cyclobenzaprine)
Diuretics, such as Bumex (bumetanide)
Anticholinergic drugs, such as atropine
Overdose Risk
Overdosing on medications or drugs can cause severe health problems and even death. Taking more of a drug than prescribed or recommended carries a high risk of overdose. Always follow the instructions given by your healthcare provider and pharmacist to ensure the safe use of any medication or drugs.
Possible symptoms of overdose include:
Slowed or stopped breathing or heartbeat
Purple/blue lips or fingertips
Small pupils (pinpoint)
Passing out or unresponsiveness
If you are prescribed an opioid treatment, your healthcare provider may recommend Narcan (naloxone). Narcan can reverse the overdose effects of Percocet, hydrocodone, or similar medications. Reversal of an overdose will also likely result in reversal of the therapeutic effect, so pain symptoms may return. Always call 911 in the event of an overdose, even if Narcan is administered.
Percocet vs. Hydrocodone: Which One Works Better?
Percocet and hydrocodone are similar narcotic medications used to manage pain. Both medications have similar effectiveness in relieving pain, although oxycodone is considered to be stronger than hydrocodone.
Ultimately, the best medication will depend on your specific needs and should be discussed with a healthcare provider.
Summary
Percocet and hydrocodone are medications used to relieve moderate to severe pain. They work by acting on opioid receptors in the body, which changes how the body responds to pain. However, Percocet also contains acetaminophen, a nonopioid pain reliever, which adds to its analgesic effects.
Both medications come in different strengths and have similar side effects and interactions. Your dosage will depend on your tolerance and condition. Whether you are prescribed hydrocodone or Percocet, it's important to follow your healthcare provider's instructions for taking your medication safely.
Frequently Asked Questions
Can you take Percocet and hydrocodone together?
No, it is not recommended to take Percocet and hydrocodone together, as both medications contain opioids. Taking them together can increase the risk of severe side effects, including but not limited to respiratory depression and a potential overdose.
What alternative treatments are available for pain relief?
Alternative treatments for pain relief include physical therapy, chiropractic care, acupuncture, massage, and yoga. Heat or ice applications can also be used to help reduce muscle tension that contributes to pain. Pain relief medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen sodium) and Motrin or Advil (ibuprofen), can help relieve acute pain and reduce inflammation.
If you're considering herbal or dietary supplements, remember that some supplements can have side effects or interactions with certain medications. Always consult a healthcare provider before trying new herbal or dietary supplements.
Can I take a sleep aid with Percocet or hydrocodone?
No, it is not recommended to take a sleep aid with Percocet or hydrocodone. Doing so may increase your risk of severe side effects like breathing problems. Talk to your healthcare provider before taking any sleep-promoting medications to reduce the potential risks and find a safe treatment alternative if needed.
The author would like to recognize and thank Leen Alyaseen for contributing to this article.
Read the original article on Verywell Health.
