Oxycodone vs. Percocet: 4 Differences You Should Know

Oxycodone (Roxicodone, OxyContin, Xtampza ER) and Percocet (oxycodone / acetaminophen) are pain medications. Both contain oxycodone, which is an opioid. And both medications are controlled substances with risks for dependence and misuse.

Though they have many similarities, oxycodone and Percocet are not the same. Here we’ll review three important differences between oxycodone versus Percocet.

1. Both medications contain oxycodone, but Percocet also contains acetaminophen

Oxycodone and Percocet are both FDA approved to treat pain that can’t be controlled by non-opioid medications. And they both contain oxycodone as a main ingredient. But oxycodone doesn’t have acetaminophen (Tylenol) in it, while Percocet does. Acetaminophen is a pain reliever, but it’s not an opioid.

Oxycodone works by attaching to opioid receptors throughout the body. This helps lessen feelings of pain. But researchers don’t know exactly how acetaminophen works. It likely affects multiple chemicals in the brain and spinal cord to create pain relief and lower fevers.

So what does this mean? Since Percocet contains both oxycodone and acetaminophen, it addresses pain in multiple ways. For some people, this may work better than oxycodone alone. Additionally, taking acetaminophen for pain may help you take a lower opioid dose. 

Regardless of which opioid you take, it’s always a good idea to take the lowest dose for the shortest amount of time possible. This will help minimize your risk of dependence and misuse. 

EXPERT PICKS: WHAT TO READ NEXT

• Pain management options: Check out other ways to manage pain besides using opioids. 

• Opioid side effects: Read about common opioid side effects and when to consult a healthcare provider.

• Avoiding opioids and alcohol: Learn why combining opioids and alcohol can come with several risks, including increased drowsiness and slowed breathing

2. Oxycodone and Percocet come in different forms

Oxycodone and Percocet are both oral medications, but they come in different dosage forms.

Percocet is available in two immediate-release (IR) forms. The first is a tablet (Percocet, Oxycet). The second is a liquid solution. Oxycodone is available in several dosage forms, including IR and extended-release (ER) products:

• IR tablet (Roxicodone, Roxybond)

• IR capsule

• IR liquid solution

• Extended-release (ER) tablet (Oxycontin)

• ER capsule (Xtampza ER)

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Both medications are available in generic forms. Percocet generics are available for both the tablet and liquid solution. For oxycodone, the IR tablet, capsule, and liquid solution are available as generics. The ER versions aren’t generic as of now.

Sometimes, a specific dosage form may be best for you. For example, a liquid dosage form may be a good option if you aren’t able to swallow pills. And if you need a long-acting opioid medication, Percocet likely isn’t a good option. Oxycodone ER tablets or capsules may work better in this case, and don't need to be taken as frequently as Percocet.

3. Percocet and oxycodone are dosed differently

When comparing oxycodone and Percocet dosages, oxycodone IR products are typically taken every 4 to 6 hours. And Percocet is typically taken every 6 hours. 

But oxycodone ER products are taken less frequently. For example, OxyContin and Xtampza ER are typically taken once every 12 hours (twice a day).

4. Oxycodone and Percocet may have different side effects

Oxycodone and Percocet have similar side effects. But Percocet has some additional risks due to the acetaminophen ingredient. We’ll cover the differences below.

Oxycodone-related side effects

All opioids have similar side effects, including:

• Nausea

• Drowsiness

• Dizziness

• Constipation

Since oxycodone and Percocet both contain an opioid (oxycodone), they have these risks as well. And more severe side effects can also happen with both medications. This includes low blood pressure (hypotension) and severe dizziness, which can cause falls and injuries. Opioid misuse — leading to opioid use disorder — is another possible risk.

In severe situations, slowed breathing and overdose can happen with these medications. This is more likely if you take them in a way that’s different from how they’re prescribed. And overdose is also more likely if you combine oxycodone or Percocet with other substances and medications that can slow breathing. Examples include:

• Benzodiazepines, such as alprazolam (Xanax) and lorazepam (Ativan)

• Sleep medications, such as zolpidem (Ambien) and eszopiclone (Lunesta) 

• Muscle relaxers, such as carisoprodol (Soma) and tizanidine (Zanaflex)

• Alcohol

Acetaminophen-related side effects

Percocet may also have additional side effects from the acetaminophen component. Acetaminophen side effects are rare, but liver damage and serious skin reactions can occur in severe cases.

At recommended acetaminophen doses, the risk of liver damage is very low. A safe daily dose is generally less than 4,000 mg in 24 hours. Some people, though, may need a lower daily maximum dose to be safe, including people with existing liver problems. 

Liver damage from acetaminophen is more likely if you take large amounts of acetaminophen, have existing liver disease, or drink large amounts of alcohol. Symptoms of liver damage from acetaminophen can include stomach pain, urinating less, and low blood pressure.

Severe skin reactions can happen with acetaminophen, too. Initial symptoms can include reddening of the skin, rash, and blisters. Several types have been reported, including:

• Stevens-Johnson Syndrome (SJS)

• Acute generalized exanthematous pustulosis (AGEP)

• Toxic epidermal necrolysis (TEN)

These serious skin reactions can be fatal. So let your healthcare team know if you notice an abnormal rash or blisters on your skin while taking any product containing acetaminophen, including Percocet.

Good to know: Several over-the-counter (OTC) and prescription medications contain acetaminophen as an ingredient. Examples include OTC medications like NyQuil Cold & Flu (acetaminophen / dextromethorphan / doxylamine) and Excedrin Migraine (acetaminophen / aspirin / caffeine). Taking more than one medication that has acetaminophen increases your risk of taking too much. So make sure you ask your pharmacist to check your medication list if you’re taking Percocet. They can let you know if any of your other medications contain acetaminophen.

Are oxycodone and Percocet controlled substances?

As mentioned earlier, both oxycodone and Percocet are controlled substances due to the oxycodone component. And like all opioids, they’re both “Schedule 2” controlled substances. 

The Drug Enforcement Administration (DEA) has classified controlled substances into “schedules” that range from 1 to 5. Medications and substances with a higher potential for dependence and misuse are placed in a lower schedule. For example, schedule 1 substances, like heroin, are all illegal. Schedule 5 substances are those with the lowest risk for misuse among all controlled substances, like cough medications with codeine.

Since oxycodone and Percocet are Schedule 2 controlled substances, they have a higher potential for misuse, dependence, and overdose than most medications. This is why it’s a good idea to carry naloxone (Narcan, Zimhi) if you take oxycodone or Percocet. It’s a lifesaving medication that can reverse an opioid overdose. It’s even available OTC. Another medication, called nalmefene (Opvee, Zurnai), can also reverse an opioid overdose. But it’s only available with a prescription from a healthcare professional.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area. 

Can you take oxycodone and Percocet together?

It’s usually best to avoid combining opioid medications like oxycodone and Percocet. They both contain oxycodone, so it raises your risk for oxycodone side effects. And it increases the chances of misuse, dependence, and overdose.

But in certain situations, combining opioids may be necessary. For example, taking a long-acting opioid (like oxycodone ER) and a short-acting opioid (like Percocet) may be necessary in people who have pain from cancer. But this should only be done under the close supervision of a qualified healthcare professional.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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