Lortab vs Percocet: How These Two Opioid Painkillers Compare

How Lortab and Percocet compare, what each contains, the difference between hydrocodone and oxycodone, their shared opioid and liver risks, and why both must be used with the caution any opioid demands.

Clinically reviewed by Dr. Ponlawat Pitsuwan, Physician and Addiction Medicine Specialist, Phuket Island Rehab.

Lortab and Percocet are both prescription opioid painkillers that combine an opioid with acetaminophen, and they are more alike than different. The key difference is the opioid each contains: Lortab combines hydrocodone with acetaminophen, while Percocet combines oxycodone with acetaminophen. Both treat moderate to moderately severe pain, both act on the brain’s opioid receptors, and both carry the same opioid risks of tolerance, physical dependence, addiction, withdrawal, and dangerous slowed breathing in overdose, as well as a shared risk of liver damage from their acetaminophen content. Oxycodone, the opioid in Percocet, is generally considered somewhat stronger than hydrocodone, the opioid in Lortab, so Percocet is often regarded as the more potent of the two milligram for milligram, though both are powerful and both are controlled substances. Neither is safer to misuse, both should be taken only exactly as prescribed, never with alcohol or sedatives, and never stopped abruptly after regular use.

Two combination opioids compared

Lortab and Percocet are two of the most commonly prescribed opioid painkillers, and people often want to know how they compare. The most important thing to understand is that they are fundamentally similar: both are combination medicines that pair a powerful opioid with acetaminophen, also known as paracetamol, both are used for moderate to moderately severe pain, and both are controlled substances carrying the full range of opioid risks. They belong to the same broad category of opioid-acetaminophen combination painkillers, of which Vicodin is another well-known example, and they are more alike than different.

The main difference between them is which opioid each contains. Lortab combines hydrocodone with acetaminophen, while Percocet combines oxycodone with acetaminophen. Hydrocodone and oxycodone are both potent opioids, closely related, but with some differences in strength. Understanding how Lortab and Percocet compare, in their ingredients, their relative potency, and their shared risks, helps make sense of why a doctor might prescribe one rather than the other, and underlines that whichever is used, it is a powerful opioid that must be treated with real caution. Neither should be regarded as the mild or safe option.

What each one contains

Both Lortab and Percocet are combination medicines with two ingredients, an opioid and acetaminophen. In Lortab, the opioid is hydrocodone, a semi-synthetic opioid that provides the main pain relief and carries the opioid risks. In Percocet, the opioid is oxycodone, another semi-synthetic opioid, somewhat more potent, that does the same job. In both products, acetaminophen, a non-opioid pain reliever, is added to enhance the pain-relieving effect. So the structure of the two medicines is identical, an opioid plus acetaminophen, and they differ only in which opioid is paired with the acetaminophen.

This shared structure means both carry not only the opioid risks of their respective opioid but also the same risk from the acetaminophen component, which is toxic to the liver in excessive amounts. With both Lortab and Percocet, taking more tablets to get a stronger opioid effect also means taking more acetaminophen, which can cause severe, sometimes fatal liver damage. This hidden hazard applies equally to both products and is an important reason neither should ever be taken above the prescribed dose, and why other products containing acetaminophen should be avoided while taking either one.

Feature	Lortab	Percocet
Opioid ingredient	Hydrocodone	Oxycodone
Non-opioid ingredient	Acetaminophen	Acetaminophen
Relative opioid strength	Potent	Generally somewhat stronger
Used for	Moderate to moderately severe pain	Moderate to moderately severe pain
Controlled substance	Yes	Yes
Opioid risks	Tolerance, dependence, addiction, overdose	Tolerance, dependence, addiction, overdose
Liver risk	Yes, from acetaminophen	Yes, from acetaminophen

The difference: hydrocodone vs oxycodone

The practical difference between Lortab and Percocet comes down to hydrocodone versus oxycodone. Both are potent opioids that work the same way, on the opioid receptors in the brain and spinal cord, but oxycodone is generally considered somewhat stronger than hydrocodone, milligram for milligram. This means Percocet is often regarded as the more potent of the two, and it may be chosen when stronger pain relief is needed, though the actual effect depends on the specific doses in a given tablet, since both come in various strengths. In practice, the difference in strength is real but modest, and both are firmly in the category of powerful opioids.

Some people respond differently to the two opioids, finding one more effective or better tolerated than the other, which is another reason a doctor might choose between them, sometimes switching if one is not working well. There can also be small differences in side effects for some individuals. But these are differences of degree, not of kind. It would be a mistake to think of Lortab as a safe, mild option and Percocet as the only dangerous one, or vice versa. Both carry a serious risk of dependence and addiction, both can cause fatal overdose, and both share the acetaminophen liver risk, so the differences should not lead anyone to underestimate either.

The risks they share

Whichever of the two is prescribed, the opioid risks are essentially the same and must be respected. Both Lortab and Percocet can cause tolerance, where more is needed for the same effect, and physical dependence, where the body adapts so that stopping suddenly causes withdrawal. Both carry a real potential for misuse and addiction, particularly when taken in larger doses, more often than prescribed, or for their euphoric and calming effect rather than for pain. And both, like all opioids, can suppress breathing dangerously in overdose, a risk that rises sharply when combined with alcohol, benzodiazepines, or other sedatives, and which can be fatal.

Both also share the acetaminophen liver risk and the opioid withdrawal syndrome. Stopping either drug after regular use produces withdrawal, with cravings, aches, sweating, agitation, nausea, and insomnia, which while rarely directly life-threatening is intensely unpleasant and drives continued use. For all these reasons, neither Lortab nor Percocet should be stopped abruptly after regular use, both should be taken only exactly as prescribed, and both should be treated as the powerful opioids they are. The choice between them is a medical one based on the level of pain relief needed and individual response, not a matter of one being safe and the other not.

When use has become more than the prescription

Because both Lortab and Percocet are opioids, both carry a real risk of dependence and addiction, and recognising the warning signs with either is important. They include taking more than prescribed or more often, taking the medication for its calming or euphoric effect rather than for pain, feeling unable to stop, running out of a prescription early, seeking it from more than one source, experiencing withdrawal such as aches, sweating, agitation, and nausea between doses, and combining it with alcohol or other substances. With both drugs, escalating use also carries the added danger of acetaminophen-related liver damage, making a developing problem especially hazardous.

If you or someone you love has become dependent on Lortab, Percocet, or any opioid, help is available, and stopping is safest done with medical support rather than suddenly and alone. A medically supervised opioid detox can manage withdrawal safely and comfortably, and for opioid addiction, medication-assisted treatment with buprenorphine or methadone is highly effective, alongside counselling and ongoing support. Opioid dependence and addiction are treatable, and recovery is realistic. Anyone who has been taking high doses of either drug also needs assessment for any liver harm from the acetaminophen. Reaching out for help is a positive and potentially life-saving step, regardless of which opioid was involved.

Summary

Lortab and Percocet are both prescription opioid painkillers that combine an opioid with acetaminophen, and they are more alike than different. The key difference is the opioid each contains: Lortab combines hydrocodone with acetaminophen, while Percocet combines oxycodone with acetaminophen. Both treat moderate to moderately severe pain, both act on the brain’s opioid receptors, and both carry the same opioid risks of tolerance, physical dependence, addiction, withdrawal, and dangerous slowed breathing in overdose, as well as a shared risk of liver damage from their acetaminophen content. Oxycodone, the opioid in Percocet, is generally considered somewhat stronger than hydrocodone, the opioid in Lortab, so Percocet is often regarded as the more potent of the two, though both are powerful and both are controlled substances. Neither is safer to misuse, both should be taken only exactly as prescribed, never with alcohol or sedatives, and never stopped abruptly after regular use. Opioid dependence and addiction are treatable, and help is available.

As Dr. Ponlawat Pitsuwan, addiction medicine specialist at Phuket Island Rehab, puts it, “Patients ask me which is stronger, Lortab or Percocet, and the answer is that the oxycodone in Percocet is generally a bit more potent than the hydrocodone in Lortab, but that distinction matters far less than people think. Both are serious opioids, both can lead to addiction, and both carry that hidden acetaminophen risk to the liver when people take extra. The rules for either one are identical: take it exactly as prescribed, never with alcohol, and never stop suddenly.”

Frequently asked questions

What is the difference between Lortab and Percocet?

Both are combination opioid painkillers that pair an opioid with acetaminophen and treat moderate to moderately severe pain. The key difference is the opioid: Lortab contains hydrocodone, while Percocet contains oxycodone. Oxycodone is generally considered somewhat stronger than hydrocodone, so Percocet is often regarded as the more potent. Otherwise the two are very similar in structure, use, and risks, both being controlled substances that carry the same opioid and acetaminophen-related dangers.

Which is stronger, Lortab or Percocet?

Percocet is generally regarded as the stronger of the two, because oxycodone is somewhat more potent than hydrocodone milligram for milligram. However, both come in various strengths, so the actual effect depends on the specific doses in a given tablet, and the difference is real but modest. Both are powerful opioids, and neither should be underestimated; the choice between them is a medical decision based on the pain relief needed and individual response.

Are Lortab and Percocet both addictive?

Yes. Both contain a potent opioid and carry a real risk of tolerance, physical dependence, and addiction, particularly when taken in larger doses, more often than prescribed, or for their euphoric effect rather than for pain. Neither is the safe option. Warning signs include needing more, taking it for its mood effects, running out early, and feeling unable to stop. Dependence and addiction to either are treatable, and stopping is safest done with medical support.

Do Lortab and Percocet both contain acetaminophen?

Yes. Both are combination products in which an opioid is paired with acetaminophen (paracetamol) to enhance pain relief. This means both share the risk of liver damage from acetaminophen if too much is taken, which is a particular danger when people take extra tablets to get a stronger opioid effect. With both, the dose should never be exceeded and other products containing acetaminophen, common in cold and pain remedies, should be avoided.

Can you switch between Lortab and Percocet?

Only under medical guidance. Doctors sometimes switch a person from one to the other, for example if one is not providing adequate pain relief or is not well tolerated, since some people respond differently to hydrocodone and oxycodone. The doses are not directly equivalent given the difference in potency, so any change must be managed by a prescriber. Switching or adjusting these opioids on your own is dangerous and should never be done without medical advice.

Are Lortab and Percocet dangerous with alcohol?

Yes, very. Combining either with alcohol is dangerous for two reasons: alcohol adds to the opioid’s suppression of breathing, raising the risk of fatal overdose, and both alcohol and acetaminophen stress the liver, increasing the risk of liver damage. The same applies to combining either with benzodiazepines or other sedatives. Neither Lortab nor Percocet should ever be taken with alcohol or other depressant substances, which is one of the most important safety rules for both.

Sources

Food and Drug Administration (FDA). Hydrocodone and Oxycodone Combination Products Prescribing Information. https://www.fda.gov/drugs

National Institute on Drug Abuse (NIDA). Prescription Opioids DrugFacts. https://nida.nih.gov/publications/drugfacts/prescription-opioids

Drug Enforcement Administration (DEA). Hydrocodone and Oxycodone Drug Fact Sheets. https://www.dea.gov/factsheets

National Library of Medicine (MedlinePlus). Opioid Combination Pain Medicines. https://medlineplus.gov/

Substance Abuse and Mental Health Services Administration (SAMHSA). Medication-Assisted Treatment. https://www.samhsa.gov/medications-substance-use-disorders

World Health Organization (WHO). Opioid Overdose. https://www.who.int/news-room/fact-sheets/detail/opioid-overdose

Lortab vs Percocet — key entities and related terms

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