Percocet vs. Lortab for Pain

  • Medical Reviewer: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Surprising Reasons You're in Pain Slideshow

Percocet (oxycodone/acetaminophen) vs. Lortab (hydrocodone/acetaminophen) review

  • Percocet and Lortab are combination prescription medications used to manage moderate to severe pain.
  • Percocet is a combination of oxycodone (a narcotic pain reliever) and acetaminophen (a non-narcotic pain reliever and fever reducer).
  • Lortab is a combination of hydrocodone (a narcotic pain reliever) and acetaminophen used to relieve mild to moderate pain, fever, inflammation, and as a cough suppressant.
  • Both oxycodone and hydrocodone are classified as Schedule II drugs by the US Food and Drug Administration (FDA), which means they have an increased risk for addiction and abuse. Withdrawal symptoms may occur if Percocet or Lortab are discontinued abruptly.
  • Percocet and Lortab have similar side effects that include:
  • Percocet and Lortab contains acetaminophen, and the most serious side effect of acetaminophen is liver damage or toxicity due to taking large doses of acetaminophen, chronic use, or use combined with alcohol.
  • Both Percocet and Lortab contain narcotic pain relievers that increase the effects of other drugs that slow brain function; for example, barbiturates, muscle relaxants, and benzodiazepines (including diazepam [Valium] and lorazepam [Ativan]). Combined use of these drugs with Percocet or Lortab may lead to increased respiratory depression, which may lead to respiratory arrest and death.
  • The safety of Percocet or Lortab during pregnancy has not been established. Newborns of mothers who were taking oxycodone for a prolonged period of time may exhibit withdrawal symptoms and respiratory depression.
  • Both Percocet and Lortab are secreted in breast milk and may cause side effects in the newborn.

What are Percocet (oxycodone/acetaminophen) and Lortab (hydrocodone/acetaminophen), and how do they block pain?

  • Oxycodone is a strong narcotic pain-reliever and cough suppressant similar to morphine, codeine, and hydrocodone. The precise mechanism of action of oxycodone is not known but may involve stimulation of opioid (narcotic) receptors in the brain. Oxycodone does not eliminate the sensation of pain but decreases discomfort by increasing tolerance to pain. In addition to tolerance to pain, oxycodone also causes sedation and respiratory depression. Acetaminophen is a non-narcotic pain-reliever and antipyretic (fever reducer). Acetaminophen relieves pain by elevating the threshold to sensing pain. It reduces fever through its action on the heat-regulating center of the brain. The combination of oxycodone and acetaminophen achieves greater pain relief than either taken separately. The FDA approved oxycodone/acetaminophen combinations in February 1980.
  • Hydrocodone is a narcotic pain-reliever and a cough suppressant, similar to codeine. Hydrocodone blocks the receptors on nerve cells in the brain that give rise to the sensation of pain. Acetaminophen is a non-narcotic analgesic (pain reliever) and antipyretic (fever reducer). Acetaminophen works by elevating the threshold to pain, that is, in order for pain to be felt, greater stimulation of the nerves responsible for the sensation of pain is necessary. It reduces fever through its action on the temperature-regulating center of the brain. Frequently, hydrocodone and acetaminophen are combined to achieve pain relief, as in Vicodin and Lortab. The FDA approved Lortab in January 1983.

Quick GuideChronic Pain: Causes and Solutions

Chronic Pain: Causes and Solutions

What are the uses for Percocet (oxycodone/acetaminophen) vs. Lortab (hydrocodone/acetaminophen)?

Percocet uses

  • Percocet (oxycodone/acetaminophen) is prescribed for the relief of moderate to moderately-severe pain.

Lortab uses

  • Hydrocodone/acetaminophen is prescribed for the relief of moderate to moderately severe pain. It also may be used as a cough supressant.

What are the side effects of Percocet (oxycodone/acetaminophen) vs. Lortab (hydrocodone/acetaminophen)?

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What are the side effects of Percocet (oxycodone/acetaminophen) vs. Lortab (hydrocodone/acetaminophen)?

Percocet side effects

The most frequent adverse reactions of Percocet (oxycodone/acetaminophen) include:

Other important side effects of Percocet include:

  • Drowsiness
  • Constipation
  • Spasm of the ureter, which can lead to difficulty in urinating

Possible serious side effects of Percocet include:

Oxycodone can depress breathing and, therefore, 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.

Is Percocet addictive?

  • Oxycodone can be habit-forming. Mental and physical dependence can occur, but are unlikely when used for short-term pain relief.

Lortab side effects

Common side effects of Lortab are:

  • lightheadedness,
  • dizziness,
  • sedation,
  • nausea, and
  • vomiting.

Other important side effects of Lortab include:

  • drowsiness,
  • constipation, and
  • spasm of the ureter, which can lead to difficulty in urinating.

Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone can depress breathing, and should be used with caution in elderly, debilitated patients and in patients with serious lung disease.

Acetaminophen can cause severe liver failure if excessive amounts are used and when combined with chronic alcohol use or other drugs that also impair liver function.

Is Lortab addictive?

Hydrocodone may be habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.

What brand names are available for Percocet (oxycodone/acetaminophen) and Lortab (hydrocodone/acetaminophen)?

  • Brand names available for oxycodone and acetaminophen in the US include:
    • Percocet
    • Roxicet
    • Tylox
    • Oxycet
  • Brand names available for hydrocodone and acetaminophen in the US include:
    • Vicodin
    • Vicodin ES
    • Vicodin HP
    • Lortab
    • Lorcet
    • Lorcet Plus
    • Norco
    • Zydone
    • Hycet
    • Maxidone
    • Stagesic
    • Verdrocet
    • Xodol
    • Zamicet
    • Zolvit
    • Anexsia is a discontinued brand and is no longer available in the US.

How should Percocet (oxycodone/acetaminophen) vs. Lortab (hydrocodone/acetaminophen) be taken (dosage)?

Percocet dosage

  • The dose of Percocet (oxycodone/acetaminophen) is variable and depends on the needs of the patient and specific circumstances.
  • The usual dose is one tablet every six hours as needed.
  • The maximum oxycodone/acetaminophen dose is 60 mg/4 g per day.

Lortab dosage

  • The usual dose of Lortab (hydrocodone/ibuprofen) for adults is 1 to 2 tablets or capsules (hydrocodone 2.5 to 10 mg; acetaminophen) 300 to 750 mg) every 4 to 6 hours or 15 mL of liquid every 4 to 6 hours as needed.

Quick GuideChronic Pain: Causes and Solutions

Chronic Pain: Causes and Solutions

Which drugs interact with Percocet (oxycodone/acetaminophen) vs. Lortab (hydrocodone/acetaminophen)?

Percocet drug interactions

  • Oxycodone, like other narcotic pain-relievers, increases the effect of drugs that slow brain function, such as alcohol, barbiturates, skeletal muscle relaxants, for example, carisoprodol (Soma), cyclobenzaprine (Flexeril), and benzodiazepines such as diazepam (Valium) and lorazepam (Ativan). Combined use of muscle relaxants or benzodiazepines and oxycodone may lead to increased respiratory depression.
  • Since oxycodone causes constipation, the use of antidiarrheals, for example, diphenoxylate (Lomotil) and loperamide (Imodium), in persons taking oxycodone, can lead to severe constipation.
  • Drugs which stimulate and also block opioid receptors, for example, pentazocine, nalbuphine (Nubain), butorphanol (Stadol), and buprenorphine (Subutex) may reduce the effect of oxycodone and may precipitate withdrawal symptoms.
  • A fatty meal may increase the absorption of oxycodone by 27%.

Lortab drug interactions

  • Combining alcohol and other sedatives with hydrocodone can lead to increased sedation and even cause confusion.
  • Combining carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) with acetaminophen may increase the risk of liver toxicity.
  • Hydrocodone should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Hydrocodone should not be administered within 14 days of stopping an MAOI.

Are Percocet (oxycodone/acetaminophen) and Lortab (hydrocodone/acetaminophen) safe to take during pregnancy or while breastfeeding?

Safety of Percocet during pregnancy or while breastfeeding

  • Safety of oxycodone/acetaminophen during pregnancy has not been established. Newborns of 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 and may cause side effects in the newborn.

Safety of Lortab during pregnancy or while breastfeeding

  • There are no adequate studies of hydrocodone and acetaminophen in pregnant women.
  • Hydrocodone/acetaminophen is excreted in breast milk, and, therefore should be used cautiously by nursing mothers.

REFERENCES:

Drug Enforcement Agency. "Drug Fact Sheet Oxycodone."
<https://www.dea.gov/druginfo/drug_data_sheets/Oxycodone.pdf>

FDA Prescribing Information.

U.S. Department of Justice; Drug Enforcement Administration; Diversion Control Division. "Answers to Frequently Asked Questions Regarding OxyContin®."
<https://www.deadiversion.usdoj.gov/drug_chem_info/oxycodone/oxycontin_faq.htm>

U.S. National Library of Medicine; DAILYMED."LABEL: PERCOCET - oxycodone hydrochloride and acetaminophen tablet."
<https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3af57f54-117e-43fc-b0ae-21ef772d854e>

United States Drug Enforcement Administration. "Drug Schedules."
<https://www.dea.gov/druginfo/ds.shtml>

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Reviewed on 12/28/2016
References
REFERENCES:

Drug Enforcement Agency. "Drug Fact Sheet Oxycodone."
<https://www.dea.gov/druginfo/drug_data_sheets/Oxycodone.pdf>

FDA Prescribing Information.

U.S. Department of Justice; Drug Enforcement Administration; Diversion Control Division. "Answers to Frequently Asked Questions Regarding OxyContin®."
<https://www.deadiversion.usdoj.gov/drug_chem_info/oxycodone/oxycontin_faq.htm>

U.S. National Library of Medicine; DAILYMED."LABEL: PERCOCET - oxycodone hydrochloride and acetaminophen tablet."
<https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3af57f54-117e-43fc-b0ae-21ef772d854e>

United States Drug Enforcement Administration. "Drug Schedules."
<https://www.dea.gov/druginfo/ds.shtml>

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