Hydrocodone and codeine are both opioids commonly prescribed for pain with similar side effects. However, hydrocodone is stronger than codeine to treat severe pain.
A serious crisis is occurring in the U.S. when it comes to opioid abuse. Opioids are responsible forthousands of deaths each year, and it’s important for individuals to understand what these drugs are and what their effects can be before they are prescribed to them. The following provides an overview of two opioids in particular: codeine and hydrocodone.
Article at a Glance:
- Codeine and hydrocodone are both opioids that can be prescribed for pain.
- Hydrocodone is considered a more potent opioid than codeine.
- Both drugs are controlled substances that carry a risk of abuse and addiction.
Codeine vs. Hydrocodone
| Codeine | Hydrocodone | |
|---|---|---|
| Drug Class | Natural opioid | Semi-synthetic opioid |
| Drug Schedule | Schedule II to Schedule V, depending on the product | Schedule II |
| Uses | Pain, cough | Pain |
| Dosage | Can vary; a sample dose is 15 to 30 mg every 4 hours as needed | Can vary; a sample dose is 10 mg every 12 hours |
| Side Effects | Constipation, nausea, and sedation | Constipation, nausea, and sedation |
| Warnings | Carries an FDA Black Box Warning for addiction, overdose, and drug interactions with central nervous system depressants | Carries an FDA Black Box Warning for addiction, overdose, drug interactions with central nervous system depressants, and a warning against drinking alcohol with the long-acting form of the drug |
| Drug Interactions | Avoid with other central nervous system depressants, including benzodiazepines | Avoid with other central nervous system depressants, including benzodiazepine |
Similarities Between Codeine & Hydrocodone
Codeine and hydrocodone have many similarities:
- Both are classified as narcotic or opioid pain relievers that change the perception of pain in the user, and both are available only by prescription.
- Both codeine and hydrocodone affect the same areas of the brain and can create a high in the user, although this happens at lower doses with hydrocodone in most people.
- Both codeine and hydrocodone are central nervous system depressants with similar side effects.
- Most side effects from codeine and hydrocodone usually subside over time, although how side effects impact people can vary between individuals.
- Both may be habit-forming and can lead to physical dependence.
- Both can have dangerous interactions with many of the same substances. This includes central nervous system depressants like benzodiazepines, for which both drugs carry an FDA Black Box Warning. Because opioids are central nervous system depressants, combining them with other depressants may increase the risk of overdose and death.
Important Warning
A risk of abuse and addiction exists with both codeine and hydrocodone. However, these risks may be more significant with hydrocodone since it’s consideredmore potentthan codeine.
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Physical Dependence & Withdrawal Symptoms
Both codeine and hydrocodone can cause physical dependence. This occurs when someone’s brain and body become used to the presence of these drugs. When you are physically dependent on a drug, you will go through uncomfortable withdrawal symptoms if you suddenly stop taking them.
If a doctor has prescribed codeine or hydrocodone and the patient wishes to stop, they will usually put patients on a tapering-down schedule where they use less and less until they stop completely to lessen or prevent withdrawal symptoms from occurring. If a person struggles with codeine orhydrocodone addiction, amedical detoxprogram followed byinpatient rehabmay be the best option to come off the medication.
Opioid withdrawal symptoms are similar in codeine and hydrocodone andinclude:
- Nausea and vomiting
- Anxiety
- Trouble sleeping
- Hot or cold flashes
- Sweating
- Muscle cramps
- Watery discharge from eyes or nose
- Diarrhea
Differences Between Codeine & Hydrocodone
Despite their similarities, codeine and hydrocodone have many differences:
- Codeine is a naturally occurring opiate, while hydrocodone is synthetic.
- Hydrocodone is considered more powerful than codeine, so it can be used for moresevere pain, while codeine is usually prescribed formoderate painrequiring an opioid.
- Codeine is available as an immediate-release medication, while hydrocodone is available in both immediate-release options and extended-release tablets.
