How long does Hydrocodone stay in your Urine & Blood-Get it out of your System
You have heard the famous Vicoden, Norco, Lorcet, Lortab brands that have been prescribed for pain management. You have also probably heard of their misuse and addiction associated with long-term intake. If you haven’t yet, then this article digs into one component, hydrocodone, its uses, how long it stays in your system, how to get it out and tests.
What is Hydrocodone and what is it used for?
What is hydrocodone? It is a semi-synthetic opioid modified from morphine’s chemical structure. An opioid is generally the generic term referring to all substances whether exogenous or endogenous with morphine-like properties.
It is a µ-opioid receptor agonist that is severally more potent than codeine. When compared to codeine, a 10mg dose is as effective as 60 mg of codeine in the treatment of post-partum pain as investigation findings by Hopkinson J (1978).
Beaver W and McMillan D (1980) among other research findings have confirmed this. However, morphine is more potent but since it is only available as compound preparations, hydrocodone is widely used as an alternative.
Since Hydrocodone is a narcotic analgesic, it is indicated for pain management in various circumstances including moderate to severe pain along with medications with the same benefit. Pain is unpleasant and sensory in origin and can be associated with emotional experience serving to alert you to actual or potential tissue damage.
The indications of hydrocodone are not different from those of codeine and like codeine it is available in combination doses only such as with aspirin and paracetamol. The pain referred to herein is that experienced after parturition (birth), a chronic condition such as cancer, injuries of surgeries.
To add, it has also been used in relieving cough by suppressing certain areas in the brain involved with the cough reflex. You may also find it in cough medications in combination with antihistamines such as Chlopheniramine. It should be noted that the dose used for the antitussive activity is sub-therapeutic which means that the dose is relatively lower than that that causes Central Nervous System depression or euphoria.
Note that since hydrocodone is an opioid, it has been linked to causing both physiological and psychological dependence. This property is much higher than its generic alternative, oxycodone.
It is more abused than any other opioid in most countries and this has led to restriction is some counties such as those in Europe. You might associate Vicodin abuse by Dr. House in the medical series, Dr. House. In this case, Dr. House takes Vicodin every day and as a result, got addicted to the drug.
How long does hydrocodone stay in your urine?
How long does 5mg hydrocodone stay in your urine?
This is a matter of understanding the pharmacokinetics of hydrocodone. Pharmacokinetics refer to what your body does to the drug once it has been administered. While in the urinary tract, this marks the end of the elimination stage of a drug by the body.
he other prior stages include absorption into the blood stream, distribution from the site of administration to other parts of the body and elimination by metabolism.
According to the kinetics of hydrocodone, it will take about 3.8 hours within a range of 0.3 hours from the mid-line for a 10 mg dose to reduce to half its original concentration. Hence the half-life of hydrocodone is 3.8 hours. If we are dealing with a 5 mg dose, then it will take about 20 hours for the drug to taper off from the blood.
This means that until this time, you have significant levels of hydrocodone and its metabolites in the blood and so does the urine. Opioids are greatly metabolized and less than 10% of the dose is eliminated unchanged in the urine with the exception of hydrocodone among a few others which are pH dependent.
Therefore, when the pH is acidic, elimination is much faster. However, stick to the fact that it may take you 2-3 days to eliminate from the urine. The most detectable metabolite of hydrocodone, norhydrocodone is the main reason why detectability in urine streams longer than if it is hydrocodone itself.
Hydrocodone levels in your system may be one of the medical examinations that you have to undergo in your new job. Employees are particularly interested in whether you use opioids which may deter you from pursuing normal duty and efficiently. Safety and drug free workers are a priority after an occupational accident to identify the cause.
It is important to note that hydrocodone drug test is very sensitive. This means that a slight concentration in the system tests positive. The reason this is so? There are passive users who may test for a false negative whereas, they indeed should test positive. Beware of this drug test as it has a large detection window.
The reduction of a drug in the system is due to elimination processes that occur via the liver and the kidney. Now, this explains why the dose effects of hydrocodone take longer to completely diminish and that you may experience long lasting withdrawal symptoms of about 48 – 72 hours after the last dose considering the dosage of the drug you took.
Apart from hydrocodone levels in the urine, there are known and documented values for hydrocodone levels in the blood, sweat and even the hair. These are discussed in the subsequent sections of this material.
How long does hydrocodone stay in your Blood?
According to Tjorvi E. Perry and Charles D. Collard (2013) in Pharmacology and Physiology for Anesthesia, there are genetic variations in the how fast opioids are metabolized. This indicates that there may be a wide range of plasma concentration possibilities and hence different elimination windows for hydrocodone.
Hydrocodone like other weaker synthetic opiates, oxycodone, codeine, tramadol and dihydrocodeine, is metabolized into the more potent opioids, hydromorphone and morphine. There are poor, extensive (normal) and ultra-rapid metabolizers.
For instance, it is known that in ultra-rapid metabolizers, it takes a short time for hydrocodone to get metabolized and hence concentration to reduce in blood. Extensive metabolizers excrete only 6-9% of the dose of hydrocodone administered as unchanged hydrocodone. Slow metabolizers eliminate about 18-20% of the drug unchanged.
However, it will also still be ‘present’ in the form of its more active and potent metabolites such as hydromorphone and norhydrocodone.
Therefore, to eliminate the percentages of hydrocodone mentioned previously, it will require you to know the dose of drug ingested and possibly any drug taken that may interact with hydrocodone.
For instance, the drugs paroxetine and fluoxetine which are antipsychotics, may reduce the rate at which it is metabolized into Hydromorphone and hence retain plasma levels in blood for longer.
Ideally and overall, it will require between 12 and 24 hours to eliminate hydrocodone from your plasma with regard to all the factors influencing its plasma levels.
To add 3.8 hours is the elimination half-life of an orally administered hydrocodone. Taking a look at its metabolite norhydrocodone, its half-life is 8 hours hence you could be looking at 2-3 days before its cleared completely.
What factors will determine how long it last in your body?
Well, this section should have come way before the previous sections so as to make you understand why the pharmacokinetics associated with hydrocodone may be estimates with an appreciable uncertainty level. There are many factors that determine how long it will take to eliminate hydrocodone from your body. Fortunately, this applies to all other opioid drugs. These include:
Idiosyncrasy (Individual factors)[1]
As mentioned earlier, individuals are different in the way they metabolize opioids inclusive of hydrocodone.
Polymorphisms:
There are slow, normal and ultra-rapid metabolizers due to genetic variation known as polymorphisms of the liver enzymes responsible for metabolizing hydrocodone.
The two enzymes responsible are the CYP2D6 and CYP3A4 that result in the production of hydromorphone and norhydrocodone respectively. Race, ethnicity and mutations are reasons for this. For instance, 65-80% of Caucasians are extensive metabolizers of hydrocodone and codeine.
Age:
You can never over-estimate age as a factor influencing kinetics of all drugs. The elderly, above 65 years of age have slowing down organs and hence metabolize hydrocodone slower than younger individuals. Sub-optimal functioning of organs, weaker pumping of the blood and increased viscosity of blood are reasons for this not forgetting that they have morbidities and are taking drugs that may interact with hydrocodone.
Body mass:
The administration of hydrocodone is mass-dependent. For instance, in pediatric anesthesia, 0.05 to 0.1 mg/kg is the recommended dosage. It is equally pertinent for one to consider the metrics of height and fat as these are factors affecting how fast the drug will be eliminated. It is shown that shorter individuals have a slower elimination of hydrocodone than taller people.
Morbidity:
Ill individuals may have organs charged with elimination such as the liver and the kidney malfunctioning and so are they on drugs too. Liver functionality determines the rate of metabolism and kidney, the filtration of hydrocodone and its metabolites from the blood.
Urinary pH:
Acidic pH of urine results in a faster elimination of hydrocodone. There are individuals who have slightly less acidic urine and the otherwise is true for such a group. In addition, alkaline urine, perhaps due to a bacterial urinary tract infection will increase reabsorption of hydrocodone than promote its clearance (Crews, K. R., et al., 2012).
The number of times you use hydrocodone
If you are a frequent user of hydrocodone, then you may have suffered accumulation of the drug in your system making elimination process slower.
Metabolites also build up and are consistently in the system. This is unlike use by an individual for the first time or first few times. This individual will find it much easier to eliminate hydrocodone faster.
It could take you longer than 3 days for the hydrocodone concentration in blood, urine or the hair to wear off. You may even fail a hydrocodone drug test when you are comfortably off the drug for a period of time.
Interaction with other drugs
Since hydrocodone is metabolized by the liver enzymes, it is possible that a number of drugs being metabolized by the same enzymes may lead to either an increase or decrease in systemically available hydrocodone.
This is due to the ability of other drugs to either inhibit or induce the action of the drug. A good example is concurrent administration of opioids.
Since they are both metabolized by CYP2D6, then the enzyme may be depleted of its catalytic sites and result in a high concentration of one of the drugs.
Paroxetine, fluoxetine, amiodarone, delavirdine among many others inhibit CYP2D6. Inducers of this enzyme include the corticosteroid dexamethasone and the anti-tuberculosis and anti-brucellosis drug, rifampin.
Hydrocodone urine test detection times Hair & Urine
Hair sampling is one of the tests used to determine presence of hydrocodone in your body. A 3-6 cm of hair follicle is sent for analysis. This test is particularly good for detecting presence of ingestion in the past. When the hair sample is longer, the test is more selective.
In an article published in 2006, Disposition of hydrocodone in hair by Christine Moore et al., (2006)[2], hydrocodone may accumulate in hair cells and this has been used in the determination of a correlation between self-reported intake of hydrocodone and finding in hair. Hydrocodone levels in hair are detectable for up to 90 days after cessation of intake.
How to get hydrocodone out of your system
You can get hydrocodone out of your system by drinking plenty of water to enable elimination through renal excretion. This is the best way that you could do so. Then make sure that you respond to calls in order to clear your bladder.
The other option is to ensure that you do not take any other dose while you are trying to detox. With drugs that bind to tissues more strongly than in blood, it will take long to completely
References
[1] Crews, K. R., Gaedigk, A., Dunnenberger, H. M., Klein, T. E., Shen, D. D., Callaghan, J. T., … & Skaar, T. C. (2012). Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for codeine therapy in the context of cytochrome P450 2D6 (CYP2D6) genotype. Clinical pharmacology & Therapeutics, 91(2), 321-326.
[2] Christine Moore, Michael Feldman, Edward Harrison, Sumandeep Rana, Cynthia Coulter, David Kuntz, Alpana Agrawal, Michael Vincent, James Soares; Disposition of Hydrocodone in Hair, Journal of Analytical Toxicology, Volume 30, Issue 6, 1 July 2006, Pages 353–359,