Oxycodone vs. Codeine

Medically Reviewed on 12/1/2021

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.


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What are the side effects of oxycodone vs. codeine?

Oxycodone side effects

The most frequent side effects of oxycodone include:

Other side effects of oxycodone include:

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 If oxycodone is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop.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.

Codeine side effects

The most frequent side effects of codeine include:

Serious side effects of codeine include:

What is the dosage for oxycodone vs. codeine?

Oxycodone dosage

  • OxyContin 60 mg and 80 mg tablets, a single dose greater than 40 mg, or a total daily dose greater than 80 mg are only for use in patients in whom tolerance to an opioid of comparable potency has been established. Adult patients who are opioid tolerant are those receiving, for one week or longer, at least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral oxymorphone per day, 60 mg oral hydrocodone per day, or an equianalgesic dose of another opioid.
  • Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
  • Initiate the dosing regimen for each patient individually; taking into account the patient's severity of pain, patient response, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse.
  • Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy and following dosage increases with OxyContin and adjust the dosage accordingly.
  • Instruct patients to swallow OxyContin tablets whole, one tablet at a time, with enough water to ensure complete swallowing immediately after placing in the mouth. Instruct patients not to pre-soak, lick, or otherwise wet the tablet prior to placing in the mouth. Cutting, breaking, crushing, chewing, or dissolving OxyContin tablets will result in uncontrolled delivery of oxycodone and can lead to overdose or death.
  • OxyContin is administered orally every 12 hours.
  • OxyContin should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.
  • Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve OxyContin for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.
  • OxyContin is not indicated as an as-needed (prn) analgesic.

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?


  • Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome. There are no available data with oxycodone in pregnant women to inform a drug-associated risk for major birth defects and miscarriage.
  • Oxycodone is present in breast milk. Published lactation studies report variable concentrations of oxycodone in breast milk with administration of immediate-release oxycodone to nursing mothers in the early postpartum period.
  • The lactation studies did not assess breastfed infants for potential adverse reactions. Lactation studies have not been conducted with extended–release oxycodone, including oxycodone, and no information is available on the effects of the drug on the breastfed infant or the effects of the drug on milk production. Because of the potential for serious adverse reactions, including excess sedation and respiratory depression in a breastfed infant, breastfeeding is not recommended during treatment with oxycodone.


  • Small amounts of codeine are secreted in breast milk, but the risk of adverse events in the infant is small.


Oxycodone (OxyContin, Roxicodone, Oxaydo, Xtampza ER) and codeine are both narcotic pain relievers. Both are also used as cough suppressants similar to morphine and hydrocodone. Both are potentially addictive and cause withdrawal symptoms. Similar side effects of oxycodone and codeine include lightheadedness, dizziness, sedation, nausea, vomiting, constipation, dry mouth, itching, and rash.

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Medically Reviewed on 12/1/2021
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