Oxycodone is an active ingredient of Percocet, an opioid medication, typically prescribed to treat severe pain. But it is also available on its own as a prescription medication. In 2017, Oxycodone-containing prescriptions were the 52nd most frequently prescribed agents in the United States.

They are both extremely powerful prescription opioid drugs with a high potential for abuse, but they’re not exactly the same. They differ in their strength, side effects, and risks.  They’re often mistaken for the same medication. Both are opioid medications and have been in the news lately due to the opioid epidemic, so it makes sense that they can be confused for one another at times.

Oxycodone is a powerful opioid agonist and acetaminophen is an analgesic (over-the-counter medication, also known by its brand name– Tylenol). Together they create a narcotic analgesic, commonly known as Percocet. 

The Differences Between the Two

The fact that Percocet contains oxycodone , does not mean that they are the same thing. Although they produce similar results, they do differ from each other as well. The difference between them is that oxycodone is a derivative of opium and Percocet is the combination of oxycodone with acetaminophen. Both substances work similarly, binding to opioid receptors and blocking pain signals from the body. But, Percocet offers even more relief because it contains acetaminophen (Tylenol). 

Researchers are frequently comparing these two substances because they both provide similar results. These substances have become famous on the news in recent years because they’re two of the common substances contributing to overdose during the opioid epidemic. Although they’re different, both are still capable of leading to addiction, producing both Percocet withdrawal and Oxycodone withdrawal symptoms (such as muscle aches and chills), and leading to an opioid overdose. Both of these substances should only be taken as prescribed by a healthcare provider, as they can be very dangerous and result in serious consequences if abused. 

Both are classified as schedule II drugs by the DEA. This means that they have a high potential for misuse. Possibly leading to physical dependence and opioid addiction. Due to this risk, neither of these prescriptions are meant for long-term use or chronic pain, they should always be taken under medical supervision.

Side Effects (other than pain relief)

As stated, both substances produce similar reactions. The most common of the side effects include: 

• A relaxed and calm sensation
• fatigue or lethargy 
• constipation
• nausea 
• Abdominal discomfort
• loss of appetite
• dizziness
• liver damage
• Unusual fluctuations in heart rate

Risk of Liver Damage Caused by an Opioid Agonist

Because Percocet also contains acetaminophen, it carries more risks than oxycodone alone, but less than acetaminophen alone. As of 2009, the FDA recommended removing prescription strength, acetaminophen-containing medications, such as Percodan, from pharmacy shelves. The agency warned that these could cause serious consequences, including liver damage and failure. Later, in 2011 the FDA advised manufacturers that they must limit the amount of acetylsalicylic acid (aspirin) in prescription medications to 325 milligrams per tablet or less. You shouldn’t ever take more than the recommended amount of anything containing acetaminophen, including the nonsteroidal anti-inflammatory drug versions like Tylenol. Percocet’s addictive potential makes it easier for people to take more than the recommended dose. This can have serious consequences.

Constipation Resulting From Opioid Use

Constipation is a common side effect of pain medication that continues until you stop taking the medications. This condition can often be managed well with the following preventative measures: drinking 8-10 glasses of water a day (warm can be helpful), increasing physical activity when possible, attempting a bowel movement at the same time each day and eating plenty of fruits and vegetables.

4 ounces of prune juice (or 3-4 dried prune/plum) can help promote bowel movements However, high fiber food (e.g., beans) and fiber supplements (such as Metamucil) can actually make constipation worse and should be avoided.

You may be advised by your doctor to use a bowel regimen, including stool softeners and/ or laxatives, to prevent constipation. Stool softeners work by bringing water into your stool, making it softer so it passes through your system easier. Stimulants or laxatives work by stimulating the movements of feces through the colon. You may be recommended by your doctor to take Miralax, which is an osmotically active laxative. It works by causing fluid to be retained in the stools, making them softer so they’re easier to pass. Constipation can lead to a blockage of your bowels if left untreated, so let your care provider know if you don’t have a bowel movement for three or more days.

Drug Interactions

Both substances are known to cause interactions with other medications. Therefore, it is essential that you tell your doctor about any medications you’re taking before you take one of these substances. This list does not include all possible interactions — other medications not listed here may also cause an interaction. The following are significant known interactions:

• inhibitors of CYP3A4 and CYP2D6, such as macrolide antibiotics (erythromycin), azole-antifungal agents (ketoconazole), and protease inhibitors (ritonavir)
• CNS depressants, such as benzodiazepines and other sedatives or hypnotics, anxiolytics, muscle relaxants, general anesthetics, antipsychotics, and tranquilizers
• certain types of antidepressants, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), 5-HT3 receptor antagonists, serotonin and norepinephrine reuptake inhibitors (SNRIs), and triptans

Risk of Addiction & Physical Dependence

When you develop a physical dependency on any substance, your body becomes tolerant to them, requiring more of them to achieve the outcome. Even if you take the prescribed dose as directed, a physical dependence can still occur. Being physically dependent isn’t the same thing as having an addiction, although physical dependency often accompanies addiction. If your body becomes dependent on a substance, you may experience mental and physical symptoms when you stop taking it suddenly. These are known as withdrawal. If you want to prevent yourself from going through withdrawal, you should start by lowering your dose gradually, usually over a week or two. Your doctor can help guide you through this process, in a way that is best suited for you. 

Opioid addiction is when you’re unable to stop using an opiate, despite its harmful impact on your body and your daily activities. Tolerance, physical dependence, and withdrawals are all terms that are commonly associated with addiction.

An opioid addiction can present with the following signs and symptoms: 

• Using, even when you’re experiencing no discomfort
• Using a prescription medication, in a way other than suggested by the physician
• Mood swings
• Irritability and agitation
• difficulty sleeping

Additional Risks of Oxycodone & Other Opioids

These are powerful medications that shouldn’t be taken without consulting a physician first. Some medical conditions may affect the use of these prescriptions. Be sure to let your doctor know if you have any of the following medical conditions:

• breathing or lung problems
• respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD)
• kidney disease
• liver disease
• low blood pressure
• possible allergic reaction

Comparing the Cost of Oxycodone and Percocet

The cost of painkillers can vary, typically depending on the form and strength of the prescription. The price will also vary depending on whether you decide to purchase the name brand or the generic version of the medication. The generic versions are usually cheaper. 

In most cases, your insurance will cover at least part of the cost of the prescription, when prescribed by your physician. 

Dr. Andre Waismann

Dr. Waismann identified the biological roots of opioid dependency, Since then he has successfully treated more than 24,000 patients worldwide that are struggling with opioid addiction.
Throughout his career, he has lectured and educated health professionals in dozens of countries around the world to this day.