Both Vicodin and codeine are opioid drugs that are typically prescribed for pain relief. Though these drugs may be similar in some ways, they have very different potencies. Vicodin is substantially stronger than codeine, but both drugs can create a variety of risks. The following overview covers the differences and similarities between Vicodin and codeine, as well as the potential risks these opioids can carry.

Vicodin and Codeine: Differences and Similarities

Both Vicodin and codeine are opioid drugs used to relieve moderate to severe pain. They work by changing how a person perceives pain, and when either drug is combined with something that affects pain in a different way, such as acetaminophen, they can be even more effective.

Vicodin is a brand-name combination drug that contains the opioid hydrocodone as well as acetaminophen. Vicodin is one of several brand-name drugs, such as Lortab and Lorcet, that include a combination of acetaminophen and hydrocodone.

Codeine is not a brand-name drug; instead, it is a generic opioid. Similar to Vicodin, it can also be combined with drugs like acetaminophen — this combination is sold under the brand name Tylenol with Codeine #3. In some cases, codeine may also be used to treat severe cough.

Vicodin and codeine share similar side effects, including:

  • Lightheadedness
  • Dizziness
  • Nausea
  • Vomiting
  • Drowsiness
  • Itchiness
  • Sedation
  • Constipation
  • Abdominal pain

Due to how they affect the central nervous system, Vicodin and codeine also carry the risk of serious side effects like slowed or stopped breathing.

Vicodin vs. Codeine: Which Is Stronger?

Codeine has only 15% of the potency of Vicodin, meaning that Vicodin is far stronger than codeine. Still, both drugs are Schedule II controlled substances that carry the risk of abuse, addiction and overdose. Physical dependence can also occur, meaning that a person will experience uncomfortable withdrawal symptoms if they stop taking either drug after using it for a period of time.

Even though Vicodin is stronger than codeine, codeine is still an opioid that should only be taken as prescribed. If you or a loved one is struggling with opioid use or a co-occurring mental health disorder, help is available at The Recovery Village. Contact us today to learn about opioid addiction treatment programs and rehab services that can work well for your needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
Sources “Tylenol with Codeine #3.” February 5, 2021. Accessed August 26, 2021. “Vicodin.” July 22, 2021. Accessed August 26, 2021. “Codeine.” October 30, 2020. Accessed August 26, 2021.

Drug Enforcement Administration. “Controlled Substances.” July 20, 2021. Accessed August 26, 2021.

American Academy of Family Physicians. “Opioid Conversion Table.” Accessed August 26, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with 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 providers.