What Is the Connection between Oxycodone and Codeine?

Oxycodone and codeine are both medications used for pain relief that belong to the family of drugs known as opioid analgesics. Both drugs share many structural and functional similarities, but they also differ in key ways, which cause them to have related, but non-identical, medical uses. Strength, pharmacology, and bioavailability are all points of divergence between these drugs that contribute to their different uses.

Strength in terms of potency and dosage is probably the greatest area of difference between oxycodone and codeine. Oxycodone is capable of diminishing pain to a far greater degree than codeine, and it requires only about one-tenth of the dose of codeine to provide the same amount of pain relief. Therefore, oxycodone is much better suited to control moderate to severe pain. Codeine's weaker efficacy may be desirable at times, for example, to treat mild pain, or to treat pain in individuals with little to no opioid tolerance.

The human body processes oxycodone and codeine somewhat differently, meaning that the two drugs possess different pharmacologies. After ingestion, oxycodone is metabolized and excreted within a few hours. Codeine is not very active on its own, however, and must be processed by the liver into active compounds like morphine. The need for processing by the liver means that codeine must be administered orally. Any other routes of administration bypass the liver, and therefore would leave the unconverted codeine unable to affect the brain.

Bioavailability is a term that describes how effectively a substance gets into the bloodstream from a given route of administration. Both oxycodone and codeine have relatively high maximum bioavailabilities when taken orally, but codeine's varies much more wildly. For some individuals, codeine is scarcely absorbed into the blood at all. Most people absorb oxycodone at roughly the same rate, making it a more reliable medication to use in the treatment of chronic pain.

Many drugs, including oxycodone and codeine, are affected by certain compounds in grapefruit juice, which can change the way that medications work in the human body. Liver enzymes inhibited by grapefruit juice normally break down oxycodone, so combining the two can result in this drug producing a stronger effect than it normally would, and for a longer period of time. These same enzymes convert codeine into morphine and other opioids that allow codeine to exert its effects. As a result, mixing grapefruit juice with this drug can cause a reduction in its strength and duration.

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anon994715
Post 6

I had hip replacement surgery last week and was given oxycodone for pain relief both in the hospital and sent home with enough to last two weeks.

I took myself off of it after day one at home due to severe itching all over, constipation, and night sweats. I decided the pain was better than that mess!

anon992554
Post 5

Careful, careful, people. I have taken both drugs for pain relief after two surgeries, and prefer codeine over the much more potent Oxycontin. Oxycontin made me feel very ill and nauseated, not to mention very dizzy which didn't go too well being out in public.

I also suffer with a thyroid condition, which no doubt enhances its unpleasant side effects. So, unless you don't suffer with a disease that can slow down your metabolism, I would be very careful and educated on your choice of painkiller.

anon356162
Post 4

Oxycodone is the one those are about. It is synthetically created, and is very similar to morphine. Codeine is far less likely to be abused because its effects are much more minimal, and you have to take or drink a lot more of it (think chugging cough syrup). Codeine is sort of a trend in the rap community, but oxycodone is insanely abused in the US. Watch the short film "heroin hillbillies" online.

literally45
Post 3

I've been on both codeine and oxycodone in the past after injuries and my colon surgery. One thing I've noticed is that the oxycodone is very good at relieving colon spasms and pain.

So even though codeine and oxycodone are similar, I think they may be more effective for different kinds of pain.

serenesurface
Post 2

@fBoyle-- I think the risk of abuse exists with all opiates, if people choose to abuse them.

Oxycodone and codeine are both prescription drugs and the smallest effective dose is prescribed for pain relief. I think it's rare for anyone to be taking codeine or oxycodone for more than a week. I was given oxycodone after my surgery and I only took it for three days.

So, if the doctor's instructions are followed, tolerance and addiction shouldn't be a problem. But if someone has the intention of abusing the drug, then obviously, both can be addictive.

Oxycodone is probably the more dangerous drug to abuse though because it's more potent. Someone can easily overdose themselves while abusing oxycodone because even the smallest dose has a huge effect.

fBoyle
Post 1

Is the risk of dependence and abuse greater with oxycodone or codeine?

I've heard some horror stories about opioid addictions. Will both oxycodone and codeine cause increased tolerance and addiction?

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