hydromorphone vs oxycodone
PlainMeds reviewed this comparison against our methodology in August 2026. It places FDA and CMS record fields side by side, without recommending either medication.
Side-by-side comparison of hydromorphone and oxycodone. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Dilaudid
OxyContin, Roxicodone
Hydromorphone (Dilaudid) is a strong pain medicine. It is used to treat severe pain when other pain medicines do not work well enough.
Oxycodone is a strong pain medicine. It is used to treat severe pain that is not helped by other treatments.
This medicine treats severe pain that requires an opioid pain medicine. It is for use when other treatments are not adequate. Do not use it for long periods unless your pain stays severe and other options are still not adequate. This medicine carries risks of addiction, abuse, and misuse.
Oxycodone is used to manage severe pain. It is for pain that requires an opioid medicine. You should only use it when other pain treatments are not enough. Talk to your doctor about other options if possible.
Hydromorphone works by binding to receptors in the brain and spinal cord. This blocks pain signals from reaching the brain. This results in a decreased feeling of pain.
Oxycodone works by changing how your brain and nervous system respond to pain. It attaches to certain receptors in the brain. This helps to block pain signals and reduce pain.
- • Lightheadedness
- • Dizziness
- • Sleepiness
- • Nausea
- • Vomiting
- • Feeling sick to your stomach
- • Constipation
- • Throwing up
- • Headache
- • Itching
- Drug Dependence 35,077
- Overdose 22,994
- Pain 22,130
- Emotional Distress 17,685
- Death 14,868
- Drug Dependence 27,480
- Pain 26,409
- Death 19,598
- Overdose 19,081
- Toxicity To Various Agents 16,253
This medicine has a boxed warning. It can cause serious and life-threatening risks. Taking too much can cause overdose and death. It can cause addiction, abuse, and misuse. It can also cause very slow or stopped breathing. Accidental intake, especially by a child, can cause a fatal overdose. Taking with alcohol or other depressants can cause coma and death. If you are pregnant, long-term use can cause withdrawal symptoms in the newborn.
Oxycodone can cause serious, life-threatening risks: * Addiction, abuse, and misuse can lead to overdose and death. Your doctor will check your risk before prescribing and during treatment. * It can cause very slow or stopped breathing, especially when you start taking it or after a dose increase. * If a child accidentally takes even one dose, it can cause a fatal overdose. * Taking it with benzodiazepines (like Xanax) or other depressants (like alcohol) can cause sleepiness, slowed breathing, coma, and death. * Using oxycodone for a long time during pregnancy can cause withdrawal symptoms in the newborn. * Taking oxycodone with certain other medicines can cause dangerous side effects.
Using this medicine for a long time during pregnancy can cause withdrawal symptoms in the baby after birth. Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may not be recommended during labor.
Using oxycodone for a long time during pregnancy can cause withdrawal symptoms in the baby after birth. Talk to your doctor about the risks if you are pregnant or plan to become pregnant. Oxycodone is not recommended during labor, as it can cause breathing problems in the newborn.
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How to Read This hydromorphone vs oxycodone Comparison
hydromorphone is classified in the Opioid Analgesic drug class, while oxycodone sits within the Opioid Analgesic class. Because both drugs share the same classification, they are often considered interchangeable in theory, but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, hydromorphone has 112,754 submissions while oxycodone has 108,821. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot represent individual circumstances. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This registry does not provide medical, treatment, substitution, or medication-change directions for hydromorphone or oxycodone.
Registry boundary: This comparison displays source-record fields and does not provide individualized medical direction.