Vicodin and Percocet are both opioid medications that contain acetaminophen. While Vicodin contains the opioid hydrocodone, Percocet contains the opioid oxycodone.

Vicodin and Percocet are brand names of different drugs. Percocet is available as both a brand name and a generic form. Vicodin is only available as a generic form, which some people may refer to as Vicodin in conversation.

The two drugs work similarly, with comparable side effects and a high risk of addiction with long-term use.

Both Vicodin and Percocet have black box warnings. A black box warning is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be severe.

Below, we outline the differences between Vicodin and Percocet. We also describe directions for use, dosage information, and the possible side effects of each drug.

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Percocet and Vicodin are both opioid pain relief medications. They help ease moderate to severe pain, such as pain caused by surgery or a car accident. They also help alleviate some forms of chronic pain.

The key difference between the two drugs is that Percocet contains the opioid oxycodone, while Vicodin contains the opioid hydrocodone.

Both also contain acetaminophen. The amount of acetaminophen in Percocet or Vicodin varies, depending on the formula.

Percocet is available in formulas containing 325 milligrams (mg) of acetaminophen, while Vicodin may contain 300 or 325 mg of acetaminophen.

These doses of acetaminophen are similar to that of extra-strength Tylenol, which comes in 500-mg caplets. An adult may safely take a maximum of two of these caplets every 6 hours. People should be sure to read the instructions that come with the product, as different products have different instructions.

To use Vicodin or Percocet safely, follow the doctor’s instructions carefully. It is also crucial to:

  • Take the lowest effective dosage: Take as little as needed to relieve the pain, and never exceed the maximum dosage.
  • Use the drug for its intended purpose: A doctor prescribes Vicodin or Percocet to help treat specific symptoms. Only take the drug for this purpose. Do not reuse it later or lend it to a friend.
  • Follow the instructions on packaging exactly: A person should not:
    • cut the pills in half
    • take the pills early
    • increase the dosage
  • Let the doctor know about any other medications or supplements: Vicodin and Percocet can interact with other substances. Before receiving a prescription for either, a person should tell their doctor if they are taking or using:
    • other medications
    • vitamin or herbal supplements
    • any recreational drugs, including alcohol
  • Be aware of possible interactions: Never combine Vicodin and Percocet or take either with anything else containing acetaminophen. Doing so can cause severe and potentially fatal liver damage.
  • Take steps to avoid constipation: Opioids can cause constipation. To help prevent this:
    • drink plenty of water
    • eat high-fiber foods
    • exercise regularly
    • consider taking a stool softener
  • Seek prompt treatment for symptoms of addiction or overdose: If a person may be becoming addicted to an opioid or may be experiencing an overdose, it is vital that they receive immediate medical care.

The right dosage of Vicodin or Percocet depends on the formula the doctor selects. Generally, doctors recommend taking opioids only as needed, rather than continually.

Maximum daily dosage

People typically take Percocet and Vicodin every 4–6 hours, or less frequently if there is less need.

While taking either drug, avoid any other products that contain acetaminophen. According to the FDA, the current maximum adult dosage of acetaminophen is 4,000 mg per day.

To help avoid taking too much acetaminophen, the makers of extra-strength Tylenol have lowered their maximum daily dose to six pills, which works out as 3,000 mg per day.

Overdose risk

The United States is experiencing an epidemic of fatal opioid overdoses. In 2018, 67,367 people died of drug overdoses, and around 9.9% of these deaths involved a synthetic opioid other than methadone.

Both Vicodin and Percocet can be highly addictive and very dangerous at high doses. The acetaminophen in these drugs makes them even more dangerous — taking more than the maximum daily dosage of 3,000–4,000 mg of acetaminophen can cause fatal liver damage.

Both Percocet and Vicodin may interact with any drug that slows down activity in the central nervous system, including:

Do not take Percocet or Vicodin with any other drug containing acetaminophen. It is also important to note that birth control pills, beta-blockers, and some other drugs may intensify the effects of acetaminophen.

In addition, acetaminophen may reduce the effectiveness of loop diuretics, drugs that people typically take to treat high blood pressure or edema.

Also, both Vicodin and Percocet may interact with an enzyme in the body called cytochrome P450 3A4. This interaction can either increase or decrease how fast the body breaks down the drug. The result may be an increased risk of side effects.

Both drugs have black box warnings. These concern the high risk of addiction and the:

  • Increased risk of accident and injury: Both Vicodin and Percocet can cause sleepiness and poor concentration, increasing the risk of accidents and injuries. Do not try to drive or operate heavy machinery while using either drug until it is clear that this can be done safely.
  • Increased risk of severe hypotension: In some people, opioids dangerously lower blood pressure. Tell the doctor about any history of low blood pressure or blood pressure-related treatment.
  • Increased risk of liver damage: High doses of acetaminophen can severely damage the liver. Even without life threatening levels of hydrocodone or oxycodone in the body, an overdose of acetaminophen can be fatal.

The side effects of Vicodin and Percocet are similar. The most common side effects of these and other prescription opioids may include:

Serious side effects

Severe side effects are more common when people take very high doses of either opioid or use either for long periods. Some of the most serious side effects may include:

A healthcare provider should describe the possible side effects and other risks thoroughly before writing a prescription.

The Centers for Disease Control and Prevention (CDC) emphasize that doctors should monitor and follow up with all patients taking opioids, especially those using these drugs in the long term for chronic pain. Anyone taking opioids should see their doctors for routine monitoring.

Beyond routine follow-up visits, a person should receive medical attention if:

  • They experience serious side effects.
  • They no longer get relief from the prescribed opioid dosage.
  • They begin craving opioids or develop other symptoms of addiction, such as:
    • rapid mood changes
    • erratic behavior
    • irregular sleeping patterns
    • a loss of interest in hobbies and activities
    • avoiding time with family and friends

A person should receive emergency medical care if they experience any of the following:

  • symptoms of a severe allergic reaction, such as:
    • a rash
    • swelling of the lips, tongue, or throat
    • difficulty breathing, such as shortness of breath
    • dizziness or fainting
    • stomach or abdominal pain
    • vomiting or diarrhea
    • an impending sense of doom
  • other severe side effects
  • a suspected overdose

Vicodin and Percocet are powerful opioids. They alleviate moderate to severe pain, such as that following an accident or surgery.

Percocet is available in both a generic and a branded form. The brand name form of Vicodin has been discontinued, however, and so it is only available as a generic.

Like other opioids, both Vicodin and Percocet pose a high risk of addiction. To avoid this, only take an opioid according to the doctor’s instructions and visit the doctor for routine monitoring.

Both Vicodin and Percocet can cause severe side effects and interact with other medications, supplements, and recreational drugs, including alcohol.

If a person feels unwell while taking either drug, they should contact their doctor. Anyone who experiences severe side effects or may have taken an overdose should receive immediate medical care.