Codeine vs. Oxycodone

Codeine and oxycodone are both opioids and narcotics. While they are derived from different substances, both can be addictive and have a high potential for abuse.

Comparing Codeine & Oxycodone

Many different opioids exist. Of these, oxycodone is one of the most commonly prescribed, while codeine is less common. Overall, about 31% of narcotic prescriptions in the United States are for oxycodone, while only about 1.9% are for codeine. To understand the discrepancy between the two drugs, it is important to understand not only their similarities but also their differences.

Similarities Between Codeine and Oxycodone

Codeine and oxycodone are both opioids and have the following in common:

• Both codeine and oxycodone are opioids: Both codeine and oxycodone are opioid narcotics and are available by prescription only in the U.S.
• Both codeine and oxycodone are addictive controlled substances: Both drugs are scheduled as narcotics by the Drug Enforcement Administration. As such, they can both cause abuse, dependence and addiction.
• Codeine and oxycodone share similar side effects: Common side effects of codeine and oxycodone can include sedation, drowsiness and depressed respiration.
• Both codeine and oxycodone are often used in combination medications: Oxycodone is commonly combined with the pain reliever acetaminophen and sold under the brand name Percocet. Similarly, codeine is often combined with cough and cold medicines and sold under brand names like Coditussin DAC.
• You can overdose on both codeine and oxycodone: As they are both opioids and central nervous system depressants, it is possible to overdose on either one of the drugs.
• Both codeine and oxycodone can cause withdrawal symptoms: If you have been taking either codeine or oxycodone over the long term, suddenly stopping can send you into withdrawal.

Differences Between Codeine and Oxycodone

For all their similarities, there are several differences between codeine and oxycodone, including:

• Oxycodone may be more addictive than codeine: While all oxycodone products are Schedule II controlled substances, codeine-based products range from Schedule II to Schedule V. The higher the schedule number, the lower risk of abuse, dependence and addiction.
• Codeine is often used for cough, while oxycodone’s use is limited to pain: Codeine is a component in many different narcotic cough medications. However, oxycodone is generally used for pain.
• Oxycodone and codeine are derived from different chemicals: The source of the drugs can help account for the differences between them. Codeine is derived from the natural opioid morphine, while oxycodone is a semi-synthetic drug, meaning it is man-made.

Does Oxycodone or Percocet Contain Codeine?

Oxycodone and oxycodone-containing drugs like Percocet do not contain codeine. The reverse is also true: codeine does not contain oxycodone or Percocet. Oxycodone and codeine are two separate and distinct opioids.

What Is Codeine?

Relative to other opioids, codeine is somewhat mild. For this reason, its products are sometimes designated as Schedule V, which are at the lowest risk of abuse. As such, codeine is less potent than many of the other prescription opioid pain relievers on the market.

Codeine is frequently prescribed in combination drugs. The drug can also be prescribed to treat pain, and it also is used in many cough syrups.

Is Codeine a Controlled Substance?

Codeine is a narcotic and controlled substance. Codeine products range from Schedule II to Schedule V. However, the specific schedule depends on the ingredients in the codeine product:

• Schedule II: Codeine products where codeine is the only ingredient
• Schedule III: Codeine products with acetaminophen (Tylenol), butalbital, aspirin, carisoprodol, papaverine and/or noscapine
• Schedule V: Codeine products with promethazine, chlorpheniramine and/or guaifenesin

What Is Oxycodone?

Oxycodone is a semi-synthetic opioid pain medicine that is mildly potent compared to other opioids. It’s prescribed in most cases for pain ranging from moderate to severe, and it can be prescribed as a single-ingredient medication as well as a combination medication. For example, oxycodone is often combined with acetaminophen to make it a more effective pain reliever.

Editor – Rob Alston

Rob Alston has traveled around Australia, Japan, Europe, and America as a writer and editor for industries including personal wellness and recovery. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more