Fentanyl vs. Oxycodone for Pain: Important Differences and Potential Risks.

Key takeaways

Fentanyl (Duragesic) and oxycodone (Roxicodone) are both opioids used to treat pain, but they have some key differences. Fentanyl is available as a transdermal patch and is used for severe, long-term pain in people who are already opioid-tolerant. It works by releasing medication through your skin over 72 hours. Fentanyl patches are not recommended for short-term pain control or for those who are not opioid-tolerant. Oxycodone, on the other hand, is an immediate-release medication available in forms like tablets, capsules, and liquid, and is used for pain that isn't relieved by non-opioid medications. It starts working within 10 to 30 minutes and lasts for about 3 to 6 hours. It is typically taken every 4 to 6 hours as needed for pain. Both medications have a high risk of misuse and dependence, which is why they are both considered controlled substances. Both medications have a high risk of misuse, dependency, and addiction, but Fentanyl requires special monitoring and training for healthcare providers due to its higher risk of life-threatening side effects.

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Oxycodone

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Summary for Fentanyl

Prescription only

The fentanyl transdermal patch, previously known by the brand name Duragesic, is an opioid. It's a patch that's applied on the skin every 3 days to manage severe, long-term or chronic pain. The fentanyl patch is only approved for people who are "opioid tolerant" whose pain isn't controlled well enough with other treatment options. Fentanyl is a very powerful opioid, so the medication can be especially dangerous for those who aren't opioid tolerant because of their high risk for extremely slowed breathing and overdose. Some side effects include nausea, vomiting, and sleepiness.

Indications for Fentanyl

Severe, chronic pain in people who are opioid tolerant

Pros and Cons for Fentanyl

Pros

A possible option for severe, chronic pain if you've already tried other treatments and they don't work well enough for you
A possible choice if you have trouble swallowing pills
Replaced on the skin every 3 days

Cons

Only approved for people who are already taking opioids around-the-clock (opioid tolerant)
High risk for dangerously slow breathing, misuse, and addiction
Not intended to use as needed, for short-term pain, or for mild pain

Common Side Effects for Fentanyl

Nausea (41%)
Vomiting (26%)
Sleepiness (19%)
Dizziness (10%)
Trouble sleeping (10%)
Constipation (9%)
A lot of sweating (6%)
Tiredness (6%)
Feeling cold (6%)

Warnings for Fentanyl

Potential for misuse and addiction
Life-threatening slowed breathing (respiratory depression)
Risk for opioid overdose
Life-threatening risks with accidental exposure
Life-threatening risks with patch exposure to high temperatures (e.g., heat, high fever)
Difficulty concentrating and extreme sleepiness
Physical dependence and withdrawal
Harm to newborn babies
Drug interactions
Serotonin syndrome
Low blood pressure and slow heart rate
Low adrenal hormone levels
Seizures

Summary for Oxycodone

Prescription only

Immediate-release oxycodone, also known by its brand names Roxicodone and Oxaydo, is an opioid. It's used to treat pain that isn't relieved by non-opioid pain medications. Immediate-release oxycodone is available as tablets, capsules, and a liquid that are taken by mouth. Your prescriber will work with you to find the dosage for your individual needs, but it's typically taken every 4 to 6 hours as needed for your pain. Common side effects include making you constipated, sleepy, and dizzy. Oxycodone is a controlled substance because it has a high risk of misuse and dependence.

Indications for Oxycodone

Pain that isn't relieved by non-opioid pain medications alone

Pros and Cons for Oxycodone

Pros

Immediate-release oxycodone can start to relieve pain within 30 minutes
Available as a lower-cost generic (except Oxaydo)

Cons

High risk of misuse, dependence, and addiction
Must slowly lower the dose to stop the medication after long-term use to avoid withdrawal symptoms
Have special requirements to fill a prescription for it because it's a controlled substance