Oxycodone vs. Codeine

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Oxycodone vs. codeine

What is oxycodone? What is codeine? How do they work?

Oxycodone is a strong opioid (narcotic) pain reliever and cough suppressant similar to morphine, codeine, and hydrocodone. The mechanism of action of oxycodone is not known but may involve stimulation of opioid receptors in the brain. Oxycodone decreases discomfort by increasing the tolerance to pain. Oxycodone also causes sedation and drowsiness, and depresses breathing.

Codeine is another narcotic pain-reliever and cough suppressant similar to morphine and hydrocodone. The mechanism of action of codeine is not known but codeine binds to receptors in the brain and increases tolerance to pain, decreasing discomfort, but the pain still is apparent to the patient. Codeine also causes sedation and drowsiness, and depresses breathing. Codeine is often combined with acetaminophen or aspirin for more effective pain relief.

What are the uses for oxycodone vs. codeine?

Oxycodone uses

Oxycodone is prescribed for the management of pain severe enough to require daily, around-the-clock, long-term treatment with a narcotic, and for which alternative treatment options are inadequate for the relief of moderate to severe pain.

Codeine uses

Codeine is used for the relief of mild to moderately severe pain and for suppressing cough.

What are the side effects of oxycodone vs. codeine?

Codeine side effects

The most frequent side effects of codeine include:

Serious side effects of codeine include:

Oxycodone side effects

The most frequent side effects of oxycodone include:

Other side effects of oxycodone include:

  • Faintness
  • Heart attack
  • Rash
  • Itching
  • Depression
  • Abnormal heartbeats

Oxycodone can depress breathing and is used with caution in elderly, debilitated patients and in patients with serious lung disease.

Oxycodone can impair thinking and the physical abilities required for driving or operating machinery.

Oxycodone is habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief. If oxycodone is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop. The dose of oxycodone should be gradually reduced in order to avoid withdrawal symptoms.

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What is the dosage for oxycodone vs. codeine?

Oxycodone dosage

  • The usual starting dose using immediate release oxycodone tablets is 5 to 30 mg every 4 to 6 hours. Patients who have never received opioids should start with 5-15 mg every 4 to 6 hours. Some patients may require 30 mg or more every 4 hours.
  • The usual starting dose using extended release tablets is 10 mg every 12 hours. Extended release tablets are used when around the clock treatment is required for an extended period. Extended release tablets should not be broken, crushed, or chewed but should be swallowed whole. Breaking, crushing or chewing extended release tablets may lead to rapid absorption of the drug and dangerous levels of oxycodone.
  • Patients who have been using opioids and have become tolerant to opioid therapy should only use the 60 and 80 tablets or single doses greater than 40 mg. Administration of large doses to opioid-naïve patients may lead to profound depressed breathing. Administration of large doses to opioid-naïve patients may lead to profound depression of breathing.
  • The usual adult dose of the oral concentrate (20 mg/ml) is 5 mg every 6 hours.
  • The usual adult dose for the oral solution (5 mg/5 ml) is 10-30 mg every 4 hours.

Codeine dosage

  • The usual adult dose of codeine for pain is 15-60 mg every 4-6 hours as needed.
  • The dose for cough is 10 to 20 mg every 4-6 hours as needed.
  • The maximum dose for treating cough is 120 mg every 24 hours.

Are oxycodone or codeine safe to take if I am pregnant or breastfeeding?

  • Safety during pregnancy has not been established. Children born to mothers who were taking oxycodone for a prolonged period may exhibit respiratory depression or withdrawal symptoms.
  • Small amounts of oxycodone are secreted in breast milk, which may cause side effects in the newborn.
  • Small amounts of codeine are secreted in breast milk, but the risk of adverse events in the infant is small.

Summary

Codeine and oxycodone are both opioid (narcotic) pain relievers and cough suppressants. Codeine and oxycodone both are similar to hydrocodone and morphine. Similar side effects of oxycodone and codeine include constipation, dry mouth, itching, rash, dizziness, sedation, and lightheadedness. Serious side effects of codeine include severe low blood pressure (hypotension), adrenal insufficiency, and life-threatening respiratory depression. Serious side effects of oxycodone include heart attack, depression, and abnormal heartbeats.

Both codeine and oxycodone are addictive when taken long-term, and may cause withdrawal symptoms if stopped suddenly. Oxycodone or codeine taken accidentally can result in a fatal overdose.

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Medically Reviewed on 7/31/2018
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