Pain is one of the sensations, that no one in the world is ready to experience, not even for a minute. So, the medications we use for pain-relieving must be efficient enough and should not lead to more pain after some time. The most efficient and most popular class of pain relievers to date is an opioid analgesic.
Oxycodone and hydrocodone are one of those opioid analgesics that are used in many situations to manage the pain.
Oxycodone vs Hydrocodone
The main difference between oxycodone and hydrocodone is that oxycodone is more efficacious in managing pain when compared to hydrocodone and is also having more adverse effects than hydrocodone.
Comparison Table Between Oxycodone and Hydrocodone (in Tabular Form)
| Parameters of Comparison | Oxycodone | Hydrocodone |
|---|---|---|
| Level of pain management | Moderate to severe pain | Minor to moderate pain |
| Elimination by the renal route | Mostly through Renal | Lesser extent through the renal route |
| Controlled substance act | Schedule II | Schedule III |
| Combination formulation | Available in single and combination formulations | Available only in combination formulation. |
| Prescription mode | A hard copy of the prescription is essential in most of the places before buying | The prescription can be faxed or phoned to the pharmacy for placing orders |
| Usage | Used for effective pain suppression | Used commonly for cough suppression and symptomatic management of common cold and allergic rhinitis |
| Adverse effects | As it is more potent, its adverse effects are also severe | Adverse effects are less severe in most instances. |
What is Oxycodone?
Oxycodone is a drug that belongs to the class of drugs called narcotic(opioid) analgesics. It is a semi-synthetic compound. The oxycodone drug acts by interacting with one of the analgesic receptors, called mu-receptors, and functions like those opioids which are endogenously produced by the body.
Oxycodone is a drug that is used for treating acute or chronic pain which is moderate to severe in extent. The oxycodone may cause serious elevation of liver enzymes when it is combined with hepatotoxic drugs like Acetaminophen.
Oxycodone is derived from thebaine, which is an alkaloid opiate and an intermediate compound in many opioids synthesis. The oxycodone in addition to the pain-relieving property also has a property of decreasing the cough( anti-tussive).
Oxycodone is available more commonly as an oral formulation. For the treatment of chronic pain, there is a special formulation called extended-release formulation, which will release a specific amount of drug over a longer period.
The main problem related to oxycodone use is that it can lead to addiction. Because of this addiction potential, it is one of the leading causes of opioid abuse and overdose-related death in people.
Inappropriate dosage may lead to several serious life-threatening complications like depression and respiratory suppression.
The oxycodone is almost always contraindicated in children, as even small dose ingestion by the children may lead to overdose complications and even death.
There is also an interesting concept concerning the use of opioid drugs like Oxycodone, called Tolerance. It is the phenomenon in which chronic use of the oxycodone drug, that is needed for chronic pain management, will lead to the development of resistance or decreased effect caused by the dose used. This brings the necessity for increasing the dose administered, to get the desired level of effect.
The oxycodone is metabolized inside the body and is eliminated through urine. This fact is important when prescribing the drug to patients with renal defects. In renal failure patients, oxycodone, when prescribed, may cause serious toxicity effects, as it fails to get excreted from the body.
The metabolism of oxycodone includes active metabolites like nor-oxycodone, oxymorphone, nor-oxymorphone.
The half time of elimination of various formulations of oxycodone ranges between, 3.9 hours to 4.5 hours.
Commercial production of oxycodone is available with a name, Oxycontin. It is also one of the most abused drugs in the market and hence is included under Schedule II of Controlled substances Act.
For testing the presence of Oxycodone in the given sample clinically, thin layer chromatography is used. Other methods employed are high-performance liquid chromatography, gas chromatography with electron capture.
This oxycodone is also found to be abused in horses, to increase pain tolerance while racing.
What is Hydrocodone?
Hydrocodone is also a semi-synthetic opioid drug that is used for treating moderate to severe pain in the patients in whom other pain management treatments are inadequate.
Hydrocodone is a compound that is derived from morphinan, which is an intermediate in the synthesis of codeine from which hydrocodone is synthesized.
Hydrocodone is indicated for acute pain management, in combination with analgesics like acetaminophen and ibuprofen.
Hydrocodone sometimes is used along together with decongestants, antihistamines, and expectorants for the management of common cold, allergic rhinitis for symptom relief.
As hydrocodone is used as a combination drug with acetaminophen, in most instances, it causes hepatotoxicity.
Hydrocodone in combination with anti-tussive medications is used for the management of the non-productive cough.
Hydrocodone should be administered in very low doses and less frequently, to prevent the development of tolerance to the drug, which may lead to deleterious complications in the future.
Hydrocodone acts by interfering in the pain signaling pathways in both the brain and spinal cord. Along together with the pain signaling pathways it also acts on the mu receptors in other areas of the brain causing euphoria, respiratory depression, and sedation.
It acts on the tissue outside the nervous system also, to produce effects like constriction of pupils, decreased gastric motility, and physical dependence.
Hydrocodone is eliminated from the body by several routes with renal clearance being involved only to a very low extent. Hepatic elimination and metabolism are found to be playing a larger role in the case of hydrocodone.
Hydrocodone, when given to breastfeeding mothers, will induce the effects of hydrocodone in breastfed babies, especially the newborns and preterm babies.
The active metabolite of hydrocodone that is produced after initial phases of metabolism, is Hydromorphone.
The half-life of elimination of the hydrocodone is found to be between 7 to 9 hours. It is included under Schedule III of controlled substances act, as it is having somewhat lower abuse potential.
Main Differences Between Oxycodone and Hydrocodone
- Oxycodone is used for the management of acute and chronic pain, of moderate to severe nature. Hydrocodone is used most commonly for acute, minor to moderate pain management.
- Oxycodone is eliminated mainly through kidneys. Hydrocodone is eliminated through the kidney to a lesser extent only.
- Oxycodone is placed in schedule II under Controlled Substances act whereas, hydrocodone is placed in schedule III under the Act.
- Oxycodone is available both in single as well as combination formulation whereas, hydrocodone is available in combination formulations alone.
- Oxycodone is used mainly for pain management in patients where other non-opioid pain management protocols fail. Hydrocodone is most commonly used in conditions like common cold, allergic rhinitis than in pain management.
Conclusion
Adequate knowledge of substances like oxycodone and hydrocodone are essential when it comes to managing pain in the people. Inappropriate usage of these substances will lead the people to the entrance of death.
On the other side, the benefits of using these substances lie above the deleterious effects, it causes. It should always be kept in mind that these substances are not a plaything to play with.
References
- https://journals.lww.com/stdjournal/00004714-200308000-00020.fulltext
- https://onlinelibrary.wiley.com/doi/abs/10.1197/j.aem.2004.12.005
- https://academic.oup.com/jat/article-pdf/32/2/165/2246682/32-2-165.pdf