What’s the Difference Between Oxycodone and OxyContin?

What’s the Difference Between Oxycodone and OxyContin? Get the Facts

OxyContin is the extended-release version of oxycodone. While OxyContin contains oxycodone as its active ingredient, it is specifically formulated as an extended-release tablet, unlike immediate-release oxycodone formulations. This difference significantly affects how the drug is absorbed and its duration of action in the body.

Both names refer to oxycodone; labeled use is for pain severe enough to require an opioid and for which alternatives are inadequate. These drugs are highly addictive and considered controlled substances by the DEA. While primary care clinicians can prescribe oxycodone when benefits outweigh risks, clinical guidelines recommend considering pain or addiction specialist consultation—especially for patients at high risk for misuse, those requiring long-term opioid therapy, or those with complex comorbidities.

What Is Oxycodone?

IR oxycodone is indicated for the management of acute pain severe enough to require an opioid and for which alternative treatments are inadequate; use for chronic pain is off-label and generally reserved for select cases under specialist supervision. OxyContin can be initiated in opioid-naïve patients at appropriate starting doses (e.g., 10 mg every 12 hours) with careful titration; higher starting doses require opioid tolerance. Because of its classification as a highly addictive opioid, doctors may try non-opioid analgesics as a first-line treatment for pain management before prescribing oxycodone or similar opioids.

Immediate-release oxycodone may be dosed every 4–6 hours as needed; extended-release OxyContin is taken every 12 hours and is not for ‘as-needed’ use. FDA labeling indicates oxycodone for pain severe enough to require an opioid analgesic when alternative treatments are inadequate.

Oxycodone is the active ingredient in several other opioid painkillers, including OxyContin, Percocet, Roxicodone, and RoxyBond. These drugs can cause a feeling of relaxation and euphoria, which is why they are frequently misused. Street names for oxycodone may include hillbilly heroin, kicker, OC, Ox, Roxy, Perc, or Oxy. [1]

The U.S. Drug Enforcement Administration (DEA) has classified oxycodone in all of its forms, including OxyContin, as a Schedule II controlled substance. Illegal possession, diversion, distribution, or prescription fraud carries legal penalties.

What is OxyContin?

OxyContin is the extended-release form of oxycodone. Label dosing is typically every 12 hours; in rare cases, clinicians may individualize intervals (e.g., every 8 hours). Do not change frequency without the prescriber’s direction. Oxycodone exists as IR and ER formulations; IR can be used for acute or chronic pain when appropriate, and ER (OxyContin) is reserved for severe, persistent pain requiring around-the-clock dosing.

OxyContin comes in tablet form and is only available by prescription from healthcare providers. ER tablets come in various strengths; per-tablet mg may exceed some IR tablets, but overdose risk is determined by total daily dose, patient tolerance, and tampering—not ER status alone. Even when appropriately selected and dosed for tolerant patients, ER/LA opioids are associated with a higher risk of unintentional overdose early in therapy compared to IR opioids, per FDA and observational data, due to sustained systemic exposure and greater total opioid load per dose.

Safety Guidelines for Oxycodone/OxyContin

People who take oxycodone or OxyContin must take extreme precautions when prescribed this opioid pain medication. The risk of addiction and physical dependence with these drugs is very high.

Under the Opioid Analgesic REMS, education is made available (strongly encouraged, not universally mandated), and a Medication Guide must be provided at dispensing; counseling requirements vary by state. Here are some of the guidelines for oxycodone/OxyContin typically provided to patients: [2]

• Take these medications only as prescribed by a licensed clinician authorized to prescribe controlled substances in your state (e.g., MD/DO, NP, PA, dentist). Never take more than the prescribed dose, and don’t take another dose before it’s time.
• Do not crush or chew any oxycodone tablets. Split only a scored immediate-release tablet if specifically directed by your prescriber; never chew or crush IR tablets to hasten effect.
• Avoid driving or performing other hazardous tasks until you know how oxycodone affects you; impairment varies by patient, dose, and timing.
• Never mix alcohol with oxycodone or OxyContin. This could lead to a fatal overdose.
• Tell your doctor about any other medications or supplements you’re taking, whether prescribed or otherwise, to avoid dangerous drug interactions. Concomitant benzodiazepines/CNS depressants carry an FDA boxed warning for profound sedation and respiratory depression. While serotonin syndrome risk is most associated with combining opioids and serotonergic drugs such as SSRIs, SNRIs, MAOIs, and triptans, some other antidepressants may also have serotonergic properties; clinical caution is warranted regardless.
• Naloxone should be prescribed/offered to patients at increased overdose risk (e.g., high opioid dose, concurrent benzodiazepines/CNS depressants, history of overdose or substance use disorder) and to household members/caregivers; keep it readily accessible and ensure everyone knows how to use it. Learn to use it correctly and train a family member to use it as well. If you ever need to use naloxone, call 911 immediately afterwards.
• Keep this and all other medications out of the reach of children. A high, locked cabinet is best.
• Oxycodone, including OxyContin, is generally not recommended during breastfeeding due to the risk of infant sedation and respiratory depression; if used, immediate-release formulations at the lowest effective dose for the shortest possible time are preferred, with close infant monitoring, as extended-release formulations pose a greater risk of prolonged infant exposure. Use of OxyContin during pregnancy carries risks including neonatal opioid withdrawal syndrome, and fetal growth restriction; clinicians must weigh these risks against benefits and counsel patients accordingly.
• A history of substance use disorder requires heightened caution and risk-mitigation strategies, and in most cases, specialist involvement is strongly recommended; opioid therapy is generally avoided unless benefits outweigh risks.

Common Side Effects of Oxycodone/OxyContin

Like most medications, oxycodone and OxyContin can cause side effects. Common oxycodone side effects include: [3]

• Nausea
• Headache
• Constipation
• Stomach pain
• Drowsiness
• Stomach pain
• Dizziness
• Vomiting
• Itchy or red eyes

Tell your doctor about any side effects you experience, especially if they become severe or persist for more than a day or two after starting the medication.

Dangerous Side Effects of Oxycodone and OxyContin

In addition to common side effects that may be annoying or bothersome, other, more serious side effects are also linked to oxycodone, including: [4]

• Lightheadedness or faintness
• Seizure
• Confusion
• Slow or difficult breathing (respiratory depression)
• Low cortisol levels

If you’ve taken oxycodone and experience any of these dangerous side effects, call your doctor or seek emergency medical attention.

Who Should Be Cautious While Taking Oxycodone and OxyContin?

Oxycodone is a powerful pain reliever that’s only available by prescription. Oxycodone carries a recognized risk of dependence; clinicians may use it when other therapies provide insufficient relief, balancing benefits and risks. For some people, it should be avoided entirely. Let the doctor know if you have the following if you are considering taking oxycodone: [5]

• A history of substance abuse or addiction
• Mental health problems
• Lung disease
• Sleep apnea
• Respiratory problems
• Liver or kidney disease
• Gallbladder or pancreas problems
• Thyroid disorder
• Seizures
• Head injury or brain tumor
• Adrenal disease
• Problems with urination

Be sure to inform your doctor about any other medical conditions you have or have had before they prescribe a medication.

Signs of Oxycodone/OxyContin Addiction

People who have a history of substance abuse and those who take oxycodone or OxyContin for an extended period may have a higher risk of developing an opioid addiction. Signs to watch for include: [6]

• Taking the medicine more than the prescribed dose or more frequently than prescribed
• Seeks multiple prescriptions from different healthcare providers
• Poor decision-making
• Drastic mood swings
• Spends a lot of time or effort thinking about how to get opioids
• Putting oneself or others in danger

Signs of Oxycodone/OxyContin Overdose

An overdose of oxycodone or OxyContin is considered a life-threatening emergency. Call 911 or seek immediate medical attention if you experience any of the following symptoms after taking either one of these opioid medications: [7]

• Pale, blue, or purple lips or fingernails
• Cold, clammy skin
• Pinpoint pupils
• Vomiting
• Slow heart rate
• Airway obstruction signs in overdose may include abnormal breathing sounds (e.g., snoring, gurgling)
• Weakness or limpness of the limbs
• Loss of consciousness

If you carry naloxone, administer it right away and then call 911.

It’s Best to Be Cautious when Taking Oxycodone/OxyContin

Although there are some key differences between oxycodone and OxyContin, both are highly addictive and potentially lethal opioids. Although they carry significant risks, oxycodone and OxyContin provide essential pain relief for many patients when used appropriately, and benefits may outweigh risks for select individuals under careful supervision.

Discuss potential alternatives and the relative risks and benefits, understanding that in some cases opioids offer the most effective relief despite their dependency risk.  Non-opioid therapies can reduce pain and opioid needs for many conditions, but are not universally equivalent to opioids for moderate-to-severe or cancer pain.

Frequently Asked Questions About Oxycodone vs OxyContin