Percocet is stronger than Vicodin on a milligram-for-milligram basis. The active opioid in Percocet (oxycodone) is roughly 1.5 times as potent as the active opioid in Vicodin (hydrocodone). That means a 5 mg Percocet tablet delivers about the same pain relief as 7.5 mg of Vicodin.
Why Percocet Is Stronger Per Milligram
Both medications combine an opioid painkiller with acetaminophen (the active ingredient in Tylenol), but they use different opioids. Percocet contains oxycodone, and Vicodin contains hydrocodone. According to the WHO’s opioid potency table, oxycodone has a relative potency of 1.5 compared to morphine, while hydrocodone sits at about 0.67. The CDC uses a similar framework called morphine milligram equivalents: oxycodone gets a conversion factor of 1.5, and hydrocodone gets 1.0. By either measure, oxycodone is the more potent drug.
In practical terms, this means the two medications come in the same tablet strengths (2.5 mg, 5 mg, 7.5 mg, and 10 mg), but at any given dose, the Percocet tablet is doing more opioid work. A 10 mg Percocet is equivalent to roughly 15 mg of morphine, while a 10 mg Vicodin is equivalent to about 10 mg of morphine.
How They Compare for Actual Pain Relief
Higher potency per milligram doesn’t automatically mean better pain relief in practice, because doctors adjust the dose to match the drug. A double-blind trial published in the journal Academic Emergency Medicine compared the two medications head-to-head in patients with bone fractures. Both groups saw meaningful pain reduction at 30 minutes (oxycodone dropped pain scores by 3.7 points, hydrocodone by 2.5 points on a 10-point scale) and at 60 minutes (4.4 versus 3.0). But when researchers analyzed the difference between the groups, it was not statistically significant at either time point. In other words, when dosed appropriately, both drugs controlled acute pain about equally well.
This makes sense. Potency just describes how many milligrams you need to reach the same effect. A less potent drug given at a higher dose can match a more potent drug at a lower dose. So “stronger” is a bit misleading if you’re wondering which one will help your pain more. At equivalent doses, they perform similarly.
How the Two Medications Feel Different
Both drugs cause the same core set of opioid side effects: nausea, constipation, drowsiness, and dizziness. Because oxycodone is more potent per milligram, some people report that Percocet feels more sedating or causes more nausea at the same tablet strength. In clinical practice, though, the side effect profiles overlap heavily, and individual responses vary quite a bit. Some people tolerate one much better than the other for reasons that are hard to predict in advance.
Hydrocodone reaches its peak blood concentration within about one hour of taking an immediate-release tablet and has a half-life of roughly four hours. Oxycodone follows a similar timeline, peaking within one to two hours with a comparable half-life. Neither one lasts dramatically longer than the other in standard formulations, so both are typically prescribed every four to six hours as needed.
Available Tablet Strengths
Both come in the same range of opioid doses paired with acetaminophen:
- Vicodin (hydrocodone/acetaminophen): 2.5 mg, 5 mg, 7.5 mg, or 10 mg of hydrocodone with 300 to 325 mg of acetaminophen per tablet. Also available as a liquid solution.
- Percocet (oxycodone/acetaminophen): 2.5 mg, 5 mg, 7.5 mg, or 10 mg of oxycodone with 325 mg of acetaminophen per tablet. Also available as a liquid solution.
Because oxycodone is 1.5 times more potent, a Percocet 5 mg tablet is not interchangeable with a Vicodin 5 mg tablet. Switching between the two requires a dose adjustment to avoid either under-treating pain or increasing side effects.
Scheduling and Abuse Potential
Both medications are classified as Schedule II controlled substances by the DEA, the most restrictive category for drugs that have accepted medical uses. This means they carry a high potential for abuse and can lead to severe physical dependence. Vicodin was reclassified from Schedule III to Schedule II in 2014, putting it on equal legal footing with Percocet. Prescriptions for either one cannot include refills and require a new prescription each time.
The acetaminophen in both drugs adds its own risk. Taking more than the recommended amount can cause serious liver damage, especially when combined with alcohol. The maximum daily acetaminophen limit from all sources is 4,000 mg for most adults, though many clinicians recommend staying under 3,000 mg to be safe. At higher opioid doses, the acetaminophen adds up quickly: four tablets of either medication at the 325 mg strength already puts you at 1,300 mg of acetaminophen per day, even before counting any other medications that contain it.
What “Stronger” Actually Means for You
If you’re comparing the two because you’ve been prescribed one and are curious about the other, the key takeaway is this: Percocet is pharmacologically stronger per milligram, but that doesn’t make it the better painkiller. It just means a smaller dose achieves the same effect. Doctors choose between them based on how you’ve responded to opioids in the past, what other medications you take, and your overall risk profile. At equivalent doses, both deliver similar pain relief with similar side effects.