Oxycodone vs OxyContin - What's the difference?
Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 12, 2020.
Oxycontin is a long-acting form of oxycodone. Both may be given to relieve moderate-to-severe pain, but Oxycontin should only be considered in those with chronic severe pain that have already found a trial of oxycodone to be beneficial. Oxycodone and Oxycontin are different versions of the same drug.
What is oxycodone?
Oxycodone is a short-acting tablet/capsule/solution that is available as OxyIR®, OxyFast®, or generic oxycodone. It relieves pain for about 4 to 6 hours and takes just over an hour (1.3 to 1.8 hours) to reach its peak effect. This means oxycodone needs to be given four to six times a day to provide all day pain relief. Oxycodone is usually given for acute pain, such as that following surgery or trauma, or it may be used to cover break-through pain that occurs during regular dosing of Oxycontin.
Oxycodone is also available in combination with other nonnarcotic analgesics such as aspirin (Percodan®) or acetaminophen (Percocet®).
What is Oxycontin?
Oxycontin is a long-acting form of oxycodone. It is called a controlled-release or an extended-release form of oxycodone and it has been designed to release oxycodone continuously over 12 hours. This means it only needs to be given twice daily.
The design of an Oxycontin tablet is such that the active drug, oxycodone, is released in two phases. The first layer allows for the initial rapid release of oxycodone from the surface of the tablet, providing pain-relief within about 20 minutes. The inner layer slowly releases the remainder of the oxycodone over 12 hours.
Oxycontin should only be used by people who have already tried and tolerated shorter-acting forms of oxycodone and who have severe pain requiring round-the-clock pain relief. Oxycontin should not be taken on an 'as needed' or 'as required' basis. Oxycontin is usually only given for pain that is continuous and unlikely to ever go away – this is called chronic pain. It may be associated with terminal cancer or other conditions where a poor prognosis.
What are the similarities and differences between oxycodone and Oxycontin?
Both oxycodone and oxycontin are strong pain-relieving medicines. They work by binding to the mu opioid receptor, which they are relatively selective for, although they may bind to other opioid receptors at higher dosages. Oxycodone and Oxycontin are full agonists at the mu receptor (full agonists have a larger effect at higher dosages).
Both belong to the class of medicines known as opioids or opioid analgesics. They may also be called narcotic analgesics.
Both oxycodone and Oxycontin are addictive.
|Used for:||Moderate-to-severe acute pain such as that following surgery or from trauma||Moderate-to-severe chronic pain such as that associated with cancer or other terminal conditions|
|Is a generic available?||Yes||Yes|
|Dosage||Every four to six hours||Every 12 hours|
|Duration of treatment||Short-term||Long-term|
Which is more effective? Oxycodone or Oxycontin?
Both oxycodone and Oxycontin are highly effective at relieving pain. Oxycontin may be considered more effective at relieving chronic pain because it lasts for a longer time, which means pain signals remain suppressed, and less breakthrough pain occurs.
What are the side effects of oxycodone and Oxycontin?
Oxycodone and oxycontin have similar side effects because they are the same medicine (oxycodone), Oxycontin is just a longer-lasting version of it. Side effects of both include:
- Sedation, which may impair your reaction skills and affect your ability to drive or operate machinery. Avoid alcohol as the combination of oxycodone or Oxycontin and alcohol can lead to dangerous or fatal side effects
- Constipation, dizziness, nausea, vomiting, or confusion
- Low blood pressure, which may increase your risk of falling. May also cause flushing, red eyes, sweating, and an itchy rash (although oxycodone or oxycontin are less likely than other opioids to cause a rash). Insomnia, anxiety, and abnormal dreams
- An increased risk of seizures in people with seizure disorders
- Habit-forming (addictive), even at prescribed dosages. Both oxycodone and Oxycontin have high abuse potential, and personal legitimate supplies may be sought out by drug seekers
- Respiratory depression (suppressed breathing), which may be fatal or life-threatening. The risk is greatest during the first 24 to 72 hours after drug initiation, after a dosage increase, or with overdosage. Children, the elderly, the frail, or those with pre-existing respiratory disease are more at risk.
Abrupt discontinuation of either oxycodone or Oxycontin in a person who has become physically dependent on it may lead to a withdrawal syndrome and symptoms such as restlessness, pupil dilation, watery eyes and a runny nose, sweating, muscle aches, insomnia, irritability, and gastrointestinal complaints. Babies born to mothers who are physically dependent on oxycodone or Oxycontin will also be physically dependent.
What other medications interact with oxycodone or Oxycontin?
Oxycodone and Oxycontin have the same interactions.
Common medications that may interact with oxycodone or Oxycontin include:
- antibiotics, such as clarithromycin and erythromycin
- antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
- antifungal agents, such as itraconazole and ketoconazole
- anticonvulsants, such as carbamazepine, phenytoin, phenobarbital, or primidone
- antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
- any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
- migraine medications, such as almotriptan, eletriptan, or sumatriptan
- muscle relaxants, such as cyclobenzaprine
- any other medication that inhibits hepatic enzymes CYP3A4 or CYP2D6 or induces CYP3A4.
- other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John's Wort.
Is oxycodone or Oxycontin safe to take during pregnancy?
Oxycodone and Oxycontin should not be used during pregnancy and breastfeeding unless specifically recommended by your doctor.
Babies born to mothers who are physically dependent on oxycodone or OxyContin will also be physically dependent.
Oxycodone is a potent short-acting pain-relieving medicine that should be reserved for mainly cancer-related pain. It carries a high potential for addiction and common side effects include sedation and constipation.
Oxycontin is a long-lasting form of oxycodone, a potent narcotic pain-relieving medicine that should be reserved for mainly cancer-related pain. Use is limited by its potential for addiction and side effects such as respiratory depression and constipation. It should not be used until a trial of oxycodone immediate-release has taken place and proved beneficial.
- Oxycodone. Drug Enforcement Administration March 2020 https://www.deadiversion.usdoj.gov/drug_chem_info/oxycodone/oxycodone.pdf
- Oxycontin (oxycodone hydrochloride extended-release) [Package Insert]. Revised 10/2019. Purdue Pharma LP. https://www.drugs.com/pro/oxycontin.html
- Oxycodone tablets [Package Insert]. Revised 08/2020. Drugs.com https://www.drugs.com/ppa/oxycodone.html
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