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What is the difference between Percocet and Vicodin?

Carli Simmonds, Author

Carli Simmonds

What is the difference between Percocet and Vicodin

Percocet and Vicodin are two commonly prescribed medications used to manage pain. Both are combination drugs that include an opioid and acetaminophen, but they differ in the specific opioid component, strength, potential side effects, and risk profiles. Understanding the distinctions between these medications can help patients and doctors make informed decisions about pain control.

Active ingredients

The most fundamental difference between Percocet and Vicodin lies in the type of opioid each contains:

  • Percocet combines oxycodone with acetaminophen.
  • Vicodin combines hydrocodone with acetaminophen.

Oxycodone is generally considered more potent than hydrocodone. This means that, milligram for milligram, Percocet typically has a stronger effect on discomfort than Vicodin.

What is Percocet?

Percocet is a prescription opioid drug used to relieve moderate to severe pain. It combines oxycodone with acetaminophen. Oxycodone targets opioid receptors in the brain and central nervous system to block pain signals and produce a calming effect. Acetaminophen enhances the pain-relieving effects of oxycodone. Percocet is typically prescribed after surgery or injury, or when other pain medications are not effective. It is available in immediate release formulations and comes in various strengths depending on the severity of pain being treated.

Percocet belongs to the opioid analgesics class of drugs. It is classified as a Schedule II controlled substance due to its high potential for abuse. Healthcare providers may prescribe Percocet when less potent treatments have failed or after surgeries that require strong pain management. On the street, it is known as “percs,” “blues,” “buttons,” or “30s.” These slang terms often disguise illicit drug use. Street Percocet may be counterfeit and contain fentanyl, significantly increasing overdose risk.

What are Percocets used for?

Doctors prescribe Percocet for short-term relief of acute pain, including pain from surgical procedures, dental work, or physical trauma. It is not typically used for chronic pain unless other treatment options have failed. The drug is intended for short periods, and the prescribed dose should be followed exactly. Taking more than prescribed can lead to dependence, opioid overdose, and symptoms of withdrawal.

What do Percs do?

When taken as directed, Percocet reduces the perception of pain and creates a sense of calm or mild euphoria. Some users experience drowsiness or dizziness, especially when first taking the medication. These effects come from the action of oxycodone on the central nervous system. Percocet may also cause cough suppression, a common side effect of opioid drugs. People using oxycodone for longer periods may develop tolerance, meaning higher doses are required to achieve the same effect.

How strong is Percocet compared to other Opioids?

Percocet is stronger than medications like Tylenol #3 (which contains codeine) and hydrocodone-containing drugs like Norco or Lortab. It is not as potent as long-acting opioids such as OxyContin or fentanyl, which are used for chronic or cancer-related pain. Oxycodone, the active opioid in Percocet, is among the most commonly prescribed and studied opioids for acute and short-term pain.

What is Vicodin?

Vicodin is a prescription opioid drug that combines hydrocodone and acetaminophen. Like oxycodone, hydrocodone acts on opioid receptors in the brain to relieve pain. Both drugs belong to the class of opioid analgesics and are considered prescription opioids. Vicodin was widely prescribed before being discontinued in its original form in the U.S., although hydrocodone is still available under other brand names.

What does Vicodin do?

Vicodin changes how the brain interprets pain. It may cause mild euphoria and sedation. It is effective for managing pain that is not controlled by less potent drugs. Vicodin can also slow breathing, cause low blood pressure, and lead to constipation.

Comparing Percocet and Vicodin

Both Percocet and Vicodin combine an opioid with acetaminophen. Vicodin contains hydrocodone, while Percocet contains oxycodone. Oxycodone is generally considered stronger than hydrocodone and may offer more effective pain relief in some cases. Both are classified as opioid analgesics and are used to treat moderate to severe pain.

Vicodin was discontinued from the U.S. market but is still referenced in discussions about prescription medications. It remains a subject of comparison because hydrocodone is still prescribed under other brand names. Common side effects of both drugs include drowsiness, lightheadedness, nausea, and constipation. Both can cause respiratory depression, physical dependence, and increased risk of overdose, particularly when combined with other medications.

Which is stronger, Vicodin or Percocet?

Percocet is usually stronger because oxycodone is more potent. Some patients find Percocet brings faster relief. But effectiveness depends on the person, the dose, and health history. Doctors consider many factors before prescribing either.

Side effects and risks

Both medications can cause:

  • Drowsiness
  • Nausea
  • Constipation
  • Dizziness
  • Respiratory depression

Since Percocet is more potent, its sedating effects may be more pronounced at equal doses. Long-term use may lead to dependence and withdrawal symptoms.

Withdrawal symptoms and substance use disorder

Continued opioid use may cause withdrawal when the drug is stopped. Symptoms include restlessness, anxiety, chills, and nausea. Stopping should be done with medical help. Treatment may be needed to avoid relapse.

Prescription opioids, misuse, and overdose risks

Prescription medications such as Percocet and Vicodin are commonly used to relieve pain, particularly after injury or surgery. While effective for moderate to severe pain, these medications carry a high potential for misuse, especially when taken in higher amounts or for longer than intended. Over time, individuals may develop physical dependence, requiring higher doses to achieve the same effect. This cycle increases the likelihood of addiction, which can involve compulsive drug use even when it causes harm.

Taking more than the prescribed dose, missing a dose, or combining opioids with other substances can trigger symptoms such as nausea, muscle pain, chills, restlessness, or anxiety. For patients taking opioids over an extended period, doctors often monitor with urine tests, adjust dosages, and evaluate treatment options to prevent escalation.

Opioid overdose and accidental overdose

An opioid overdose can happen quickly and without warning. It may be caused by high doses, drug interactions, or diminished tolerance after a period of stopping. Symptoms include shallow breathing, slow breathing, pinpoint pupils, blue lips, unconsciousness, and clammy skin. The most serious outcome is respiratory depression, which can lead someone to stop breathing, causing brain damage or death. Immediate medical attention is critical.

An accidental overdose may occur even when taking a medication as prescribed. This is more common in individuals with sleep apnea, those using other CNS depressants, or patients with complex medical problems. Healthcare providers frequently warn patients about the increased risk of overdose and provide safety guidance, particularly when combining opioid medications with other drugs like benzodiazepines or muscle relaxants.

Monitoring and interactions

To reduce the risk of overdose and drug interactions, doctors may:

  • Limit high doses
  • Recommend alternative treatment options
  • Use urine tests to assess compliance
  • Monitor for signs of opioid misuse
  • Avoid prescribing with other CNS depressants

Patients should mention all medications, including antidepressants. Some drug combinations can cause harmful interactions.

Other opioids and interactions with other substances

Other opioids like morphine, tramadol, or fentanyl differ in strength and form. All can interact with each other and with other drug types. Mixing opioids with alcohol, tranquilizers, or relaxants raises the risk of slow breathing.

Serotonin syndrome and increased risk with other drugs

Combining opioids with certain antidepressants, such as SSRIs, can lead to serotonin syndrome, a potentially life threatening condition. It involves elevated serotonin levels that affect mood, behavior, and body temperature. Symptoms include confusion, agitation, muscle rigidity, and rapid heart rate. A doctor may review your health background and current medications to reduce the risk of this dangerous interaction.

Treatment options for opioid dependence

Treatment for opioid dependence or addiction from a healthcare professional may involve several stages, including medically supervised detox, medication-assisted treatment, and behavioral therapies. Detox helps manage withdrawal symptoms, such as anxiety, muscle pain, and insomnia.

Medications like buprenorphine or methadone may reduce cravings and lower the risk of relapse. Long-term treatment often includes counseling, cognitive-behavioral therapy, and relapse prevention. Treatment options vary based on the individual and should be discussed with a healthcare professional. Contact our treatment center for more information on treatment programs, insurance coverage and more.

Other important safety considerations

Long-term use of opioids increases the likelihood of dependence. A doctor may adjust the dose or recommend an alternative if a patient develops tolerance or side effects. Liver damage is a serious concern with medications containing acetaminophen, especially when combined with alcohol or taken at high doses. Patients with sleep apnea or respiratory issues are at higher risk for overdose. Regular urine tests, counseling, and check-ins with healthcare professionals can help ensure safety while managing pain.

Taking Oxycodone

Oxycodone is the opioid component of Percocet. It is stronger than codeine and hydrocodone and can cause significant sedation, especially when used in high doses. Oxycodone can relieve pain effectively, but it may also cause sleepiness, dizziness, and breathing problems. Individuals with a history of sleep apnea or other respiratory conditions may be more likely to experience complications.

Which should you take?

The choice between Percocet and Vicodin depends on various factors, including a patient’s pain level, health history, sensitivity to opioids, and risk of misuse. Some may do better with a lower-strength hydrocodone product, while others may require the potency of oxycodone.

Using Percocet and Vicodin safely for pain relief

Percocet and Vicodin remain important tools in the treatment of moderate to severe pain. While effective, these drugs are not without risk. Understanding the differences between oxycodone and hydrocodone, the signs of opioid overdose, and the importance of using opioids exactly as prescribed can help prevent life-threatening complications. When in doubt, speak with a healthcare provider about safer pain management and treatment options.

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About the content

Last updated on: Jun 23, 2025
Jodi Tarantino (LICSW)

Written by: Carli Simmonds. Carli Simmonds holds a Master of Arts in Community Health Psychology from Northeastern University. From a young age, she witnessed the challenges her community faced with substance abuse, addiction, and mental health challenges, inspiring her dedication to the field.

Jodi Tarantino (LICSW)

Medical reviewed by: Jodi Tarantino, LICSW. Jodi Tarantino is an experienced, licensed Independent Clinical Social Worker (LICSW) and Program Director with over 20 years of experience in Behavioral Healthcare. Also reviewed by the RRR Editorial team.

Red Ribbon Recovery is committed to delivering transparent, up-to-date, and medically accurate information. All content is carefully written and reviewed by experienced professionals to ensure clarity and reliability. During the editorial and medical review process, our team fact-checks information using reputable sources. Our goal is to create content that is informative, easy to understand and helpful to our visitors.

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