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Vicodin vs. Percocet for Pain Reduction

A Side-by-Side Review

When over-the-counter remedies fail, your doctor may prescribe painkillers to treat pain and discomfort you’re feeling. These drugs interfere with the relay of painful signals through your central nervous system (CNS) to your brain. This reduces the pain you’re feeling and makes movement and everyday activities easier.

Hydrocodone bitartrate with acetaminophen (brand name: Vicodin) and oxycodone hydrochloride with acetaminophen (brand name: Percocet) are two powerful and commonly prescribed painkillers. For a short period of time, these medicines may be prescribed to treat pain that is the result of an injury, condition, or physical ailment. Your doctor may also prescribe these if you’ve had an accident or surgery and need temporary pain relief.

Read on for a comparison of the medications’ effectiveness, cost, dosing, and side effects.

Vicodin and Percocet

Both hydrocodone bitartrate with acetaminophen (Vicodin) and oxycodone hydrochloride with acetaminophen (Percocet) are narcotic medicines. They are most commonly prescribed for short-term pain relief, such as after a surgery or injury. Some doctors prescribe these medicines to treat chronic conditions, such as arthritis.

The biggest differences between the two medicines are in their chemical makeup, side effects, and how likely they are to become habit-forming. 

Vicodin is a combination of hydrocodone and acetaminophen. It’s often prescribed to treat moderate to severe pain. Percocet is a combination of oxycodone and acetaminophen, and is also prescribed to treat moderate to severe pain. Both of these products can also make you sleepy, uncoordinated, and affect your mood.

Who They’re For

Both medicines may be prescribed to patients who have been injured, or who are recovering from surgery. They are short-acting drugs and usually prescribed for short periods of time.

Drug Class and How That Class Works

Both medications are opioids, which means they have actions similar to morphine. Both are also Schedule II drugs, and have a high risk of abuse. You will need to get a written prescription from your doctor for either medication.

Forms and Dosing

Vicodin is available in several strengths. Tablets contain 5 mg, 7.5 mg, or 10 mg of hydrocodone and 300 mg of acetaminophen.

Generic combinations of hydrocodone/acetaminophen are available in a wider range of strengths, with tablets in 2.5 mg, 5 mg, 7.5 mg, and 10 mg of hydrocodone, and 300 to 325 mg of acetaminophen.

Other similar products include a liquid with hydrocodone and acetaminophen, and extended-release products, for those who need to continue taking these drugs for chronic pain.

If you are taking the solution, a pharmacist should give you a measuring spoon or oral syringe to accurately measure liquid medicine. Do not use household spoons because you will not receive an accurate dose.

Percocet is available in several strengths, including 2.5 mg, 5 mg, 7.5 mg, and 10 mg of oxycodone, all with 325 mg of acetaminophen.

Other similar products include combinations with oxycodone and 300 mg of acetaminophen, and an oral solution. There is also an extended-release product, for those who need long-term pain treatment.

Both medications are usually taken every 4-6 hours, as needed for pain.

Effectiveness

Both medications have been shown to be highly effective at treating pain. In cases of temporary pain from an injury, it’s difficult to tell which is more effective.

In a study of both drugs published by the Academic Emergency Medicine, researchers found that both medicines were equally effective at treating pain caused by fractures. The study looked at pain levels at 30 and 60 minutes after the medicine was taken in an emergency room. It found that patients reported equal levels of pain reduction. However, patients who took hydrocodone (Vicodin) reported experiencing constipation more frequently than patients who used oxycodone (Percocet).

Another study found that oxycodone (Percocet) was 1.5 times more potent than hydrocodone (Vicodin) when prescribed and taken at equal doses.

Doctors may prescribe one of these medicines over another based on your personal health history and how you have reacted to pain medication previously. What might work well for one person may not be as effective for another. Additionally, due to the habit-forming nature of these medicines, doctors may be cautious about prescribing either. 

Cost

Brand name and generic versions of both drugs are available. Brand name versions will cost more than the generic, and most insurance companies will require that you receive the generic version. There are several similar generic combinations of both hydrocodone/acetaminophen and oxycodone/acetaminophen.

Your doctor may decide to give you a product that does not have a generic equivalent, based on your needs. You can check the price by calling the pharmacy. If you have no insurance and the cost is high, ask your doctor if there is another generic version that you can take. The active ingredients in generics similar to Vicodin and Percocet are the same, and when they are taken daily, the effects will be about the same.

Side Effects

Both medications are narcotic painkillers, and they share similar side effects. These side effects include:

  • shallow or light breathing
  • drowsiness
  • dizziness, feeling like you may pass out when standing up
  • nausea
  • headache
  • mood changes
  • vomiting
  • lethargy
  • dry mouth
  • itching
  • motor skill impairment
  • constipation

Severe, though less common side effects include:

  • difficulty breathing; the risk is higher in older adults, those with serious illnesses, and those who have respiratory disease
  • seizures
  • lowered blood pressure; this risk is greater in those who have reduced blood volume or who are in shock
  • hypersensitivity reaction, which could include itching, hives, trouble breathing, or swelling of the tongue or throat
  • rapid heartbeat (leading to a possible heart failure)
  • painful urination
  • confusion

If you begin experiencing any of these symptoms, call 911 and seek emergency medical treatment.

When these medicines are used for a long period of time, they may become habit-forming. In other words, these medicines may create a mental or physical dependency in the person using them. For that reason, doctors are very cautious when prescribing these medicines. Great care should be taken to make sure you’re using the medicine only in the manner prescribed.

If you take either of these drugs for more than a few days, talk to your doctor before you stop taking them. Your doctor can help you taper off the medication slowly, which reduces the risk of withdrawal.

Both drugs affect your ability to drive or use machinery. Do not drive if you are taking either medication. Your judgement and physical skills can be affected.

Both of these drugs can also lead to overdose and are very dangerous for children. Keep your medication locked and away from any children in your household, and away from visitors to your home.

Interactions and Warnings

Tell your doctor about all other medications you take (including vitamins and supplements) beforehand. Opioids affect your CNS. It’s dangerous to mix them with other medications that slow down the brain. These may include:

  • anticholinergic drugs (antihistamines, drugs used for urinary spasms, and other drugs)
  • other opioids
  • muscle relaxers
  • sedatives, tranquilizers, sleeping pills
  • barbiturates
  • anti-seizure medications (like carbamazepine and phenytoin)
  • anti-depressants, anti-psychotic drugs

Hydrocodone/acetaminophen (Vicodin) should not be taken with these drugs:

  • acetaminophen (there is already acetaminophen in each dose, and taking more could be harmful)
  • alcohol
  • azelastine
  • MAO inhibitors
  • orphenadrine

Listed below are some of the drugs that interact with hydrocodone/acetaminophen. However, you may still be able to take these drugs while using hydrocodone. Before taking hydrocodone, talk to your doctor if you take any of these drugs:

  • erythromycin
  • voriconazole
  • CNS stimulants
  • magnesium sulfate
  • sodium oxybate
  • ritonavir
  • rifampin

Oxycodone/acetaminophen (Percocet) should not be taken with these drugs:

  • acetaminophen (there is already acetaminophen in each dose, and taking more could be harmful)
  • alcohol
  • azelastine
  • orphenadrine

Listed below are some of the drugs that interact with oxycodone/acetaminophen. However, you may still be able to take them while using oxycodone. Before taking oxycodone, talk to your doctor if you take any of these drugs:

  • CNS stimulants
  • magnesium sulfate
  • sodium oxybate
  • ritonavir
  • rifampin

Do not use these medications without first consulting with your doctor about your health history and any pre-existing conditions you have.

If you have asthma or breathing difficulties, you may have additional risks if you take these drugs because they can suppress your breathing. Also, because of the risk of increased constipation, people who have blockages or difficulty with constipation may not want to take hydrocodone.

If you have kidney or liver disease, tell your doctor before taking either of these drugs. You may need a different dose or dose schedule.

Additionally, do not drink alcohol while taking these medications. The combination of alcohol and painkillers can be deadly. You may experience extreme dizziness or drowsiness. If you have alcoholic liver disease, drink more than three alcohol beverages a day, or have a history of alcohol abuse, your risks are greater. The combination can damage your liver.

If you are pregnant, talk with your doctor about the risks of taking these medications while you’re expecting. A study published in the American Journal of Obstetrics and Gynecology found that there was an association between opioid treatment and certain birth defects. Also, some of the side effects of the medication could cause problems for you while you are pregnant. These side effects include behavior changes, difficulty breathing, constipation, and lightheadedness.

If you are breastfeeding, do not take these painkillers. These medications can pass through breast milk and harm your baby.

Even at low levels and when taken exactly as prescribed, these medications can be habit-forming. Misuse of these narcotics can lead to addiction, poisoning, overdose, or even death. Do not leave these pills in a place where children could reach them.

Which Is Best for You?

Both medications are highly effective at treating acute pain caused by injury or surgery. If you have chronic pain, there are extended-release versions of these drugs that give long lasting pain relief. The difference between the medications comes down to how well the medication works for you and the side effects that you experience.

Consult with your doctor about each medicine and the potential side effects and interactions. Both medicines are designed for short-term use.

Because of the risk of dependency when taking these medicines, your doctor will want to monitor your usage closely and make sure you are not developing dependence. If you have any questions about these medicines or develop any unusual symptoms once you begin taking them, be sure to consult with your doctor. Together, the two of you can find the right treatment for you.

Read This Next

Oxycodone vs. Hydrocodone for Pain Relief
Tramadol vs. Vicodin: How They Compare
Tramadol vs. Hydrocodone: Two Powerful Drugs for Pain
Codeine vs. Hydrocodone: Two Ways to Treat Pain
Percocet Addiction
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