Codeine and hydrocodone are two prescription drugs, both of which fall into the classification of opioids, and both of which are controlled substances. So other than that, what are the similarities and the differences seen when looking at codeine vs. hydrocodone?

The following provides an overview of codeine vs. hydrocodone, as well as specific information like the codeine vs. hydrocodone cough syrup conversion.

What Is Codeine?

Codeine is an opioid that’s prescribed for the treatment of mild pain and cough, but as compared to most other prescription narcotics, it’s relatively low-strength. While someone who takes codeine will experience an increased tolerance to pain, they will likely know the pain is still there, which is why it’s often combined with other things like acetaminophen for more effectiveness. Codeine is converted back to morphine when it reaches the brain of the user, where it then binds to opioid receptors and slows the activity of the central nervous system.

While it is less potent than a lot of other opioids, there is still a risk of overdose as well as addiction and physical dependence when someone takes codeine.

What is Hydrocodone?

Hydrocodone is also an opioid pain medication that’s often used in combination with acetaminophen.Hydrocodone is relatively potent among prescription painkillers, and it’s important for people to be aware of this when they take it. It binds to opioid receptors in the brain, and like codeine it slows the central nervous system, but in a more powerful way.

This is why people overdose on opioids. They slow the activity of the central nervous system to the point where respiration can be slowed or even stop.

Hydrocodone is also addictive, and the development of physical dependence isn’t uncommon with this drug.

Hydrocodone, along with its medical uses, can also be abused to get high. When someone takes larger doses of hydrocodone, they may first feel euphoric, or other pleasurable sensations, and then they would become very tired and relaxed.

Codeine vs. Hydrocodone

Both codeine and hydrocodone are opioids that stimulate the opioid receptor sites located in the central nervous system. They are both used to treat pain as well as suppress the cough reflex in the brain.

However, there are differences seen with the two drugs. For example, they have a different chemical structure. Originally, hydrocodone was synthesized from codeine, however. Because of the differences in their chemical structure, some people may not get any effect from codeine. If they lack a certain liver enzyme that makes codeine into morphine, they won’t feel effects, but this isn’t the case with hydrocodone.

Codeine is also derived from opium plants, while hydrocodone is synthesized.

Hydrocodone is significantly stronger than codeine, has more sedative effects, and is more effective for treating severe pain.

Codeine vs. Hydrocodone Cough Syrup

Both codeine and hydrocodone can be prescribed to treat a cough. However, there are differences seen in codeine vs. hydrocodone cough syrup. First, codeine cough syrup is considered pretty mild, and in some states cough syrups with low amounts of codeine may be available over-the-counter. This isn’t the case with hydrocodone cough syrup.

Hydrocodone cough syrup is often used in patients who have not only a cough but severe pain. One example is patients with a cough from lung cancer. Hydrocodone cough syrup tends to be more effective not just for pain, but also cough than codeine, but it also has a higher risk of abuse and addiction.

Some of the brands of hydrocodone cough syrup available include Tussionex, Tussicaps, and Hytan.

Drug Allergy & Allergy-Like Side Effects

First, people frequently believe they’re having an allergic reaction to codeine that can include symptoms like nausea and itching. What it usually turns out to be is that they’re just experiencing the normal symptoms of codeine, and true codeine allergies are rare. This is because codeine activates a histamine response that’s similar to what happens when you do have an allergic reaction.

This can happen somewhat with hydrocodone as well, but usually to a lesser extent. More powerful opioid medications tend to have fewer allergy-like side effects as compared to milder drugs like codeine.

Many patients who do have a codeine allergy can also tolerate hydrocodone better.

Codeine vs. Hydrocodone Conversion

When it comes to a codeine vs. hydrocodone conversion, people should realize that hydrocodone is a lot more powerful than codeine. This makes it more effective for pain relief, and it means fewer allergy-like side effects, but it also increases the risk of things like addiction and overdose.

To provide a general overview of the codeine vs. hydrocodone conversion, a 120 mg dose of codeine would be equal to about 3 to 6 mg of hydrocodone.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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