Oxycodone vs. Tylenol With Codeine for Pain: Important Differences and Potential Risks.

Key takeaways

Oxycodone (Oxycontin, Roxicodone) is a prescription medication that treats severe pain that isn't relieved by non-opioid pain medications. Acetaminophen / codeine (Tylenol #3) also contains an opioid, but it’s prescribed for mild-to-moderate pain. All opioids are controlled substances and have side effects such as sleepiness, dizziness, and constipation. More seriously, they can lead to misuse and overdose. However, these serious risks are more likely with oxycodone than they are with acetaminophen / codeine.

Oxycodone

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Tylenol with Codeine

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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

Common Side Effects for Oxycodone

Nausea
Constipation
Vomiting
Itching
Headache
Dizziness
Weakness
Sleepiness
Trouble sleeping

Warnings for Oxycodone

Potential for addiction and misuse
Dangerously slow breathing (respiratory depression)
Risk for opioid overdose
Difficulty concentrating and extreme sleepiness
Drug interactions
Harm to newborn babies
Physical dependence and withdrawal
Low blood pressure
Low adrenal hormone levels
Seizures

Summary for Tylenol With Codeine

Prescription only

Tylenol with Codeine (acetaminophen / codeine), also known as Tylenol #3, is a combination opioid medication. Both acetaminophen and codeine treat mild-to-moderate pain by blocking pain signals in the body. This medication is taken by mouth, typically every 4 hours as needed. Tylenol with Codeine is available as a tablet and liquid. Like other opioids, Tylenol with Codeine can cause common side effects like sleepiness, dizziness, and constipation. It also has a warning for dangerous breathing problems and risk of dependence and misuse.

Indications for Tylenol With Codeine

Treatment of mild-to-moderate pain that isn't relieved by non-opioid pain medications alone

Pros and Cons for Tylenol With Codeine

Pros

Works well for treating mild-to-moderate pain
Combines 2 medications with different modes of pain relief into a single pill
Available in a liquid form for people who have trouble swallowing tablets
Available as a generic medication

Cons

For short-term pain relief only
Can be habit-forming
Not recommended to take with other medications containing acetaminophen, since it can raise the risk of liver damage
Liquid solution contains alcohol