Hydrocodone is a popular pharmaceutical drug commonly prescribed for the treatment of severe pain, and in some cases as an antitussive agent to mitigate chronic coughing. It is a semi-synthetic drug in that it is synthesized from codeine (an opioid alkaloid derived from opium poppy). Upon ingestion of hydrocodone, it facilitates analgesic effects via binding to mu-opioid receptors, as well as delta-opioid receptors (to a 6-fold lesser extent).
As a result of its substantial opioidergic effect (particularly on the mu-receptors), ingestion of hydrocodone can elicit feelings of euphoria, relaxation, and pleasure. For this reason, hydrocodone has a high potential for abuse and dependence and is classified as a Schedule II controlled substance in the United States. It is also associated with rapid onset of tolerance, meaning users quickly become habituated to their dosing and require regular dosage increases to derive ongoing therapeutic benefit.
Despite the fact that many people attain necessary analgesic benefit from taking hydrocodone, it is not meant to be used over a long-term. Long-term ingestion of hydrocodone can impair endogenous opioid production and trigger a host of unwanted neurophysiological effects such as: mood swings, vomiting, drowsiness, dizziness, and impaired motor skills. To avoid these deleterious long-term complications, many people discontinue the drug and hope to clear it from their body (i.e. system) as soon as possible.
How long does hydrocodone stay in your system?
In order to ensure that hydrocodone fully leaves your system, you’ll need to first discontinue usage. This typically means facing a multitude of potentially horrific (but inevitable) hydrocodone withdrawal symptoms. Understand that the discontinuation process should always be monitored by a medical doctor to avoid unnecessary complications and dangers (e.g. blood pressure changes, seizures, etc.).
Assuming you’ve completely ceased ingestion of hydrocodone, you’re probably wondering how long it will take your body to completely excrete the drug. Research has shown that the elimination half-life of hydrocodone is an average 3.8 hours. In other words, it will take just under 4 hours for your body to excrete 50% of the hydrocodone.
This means that the average hydrocodone will fully excrete hydrocodone from their system in 20.9 hours. Other sources suggest that there could be more variation in half-life of the drug, ranging from 3.3 hours to 4.1 hours. This indicates that certain users may be able to clear the drug from their system quicker (18.15 hours), while others may have slightly prolonged systemic clearance periods (22.55 hours). Most users should have cleared the drug from their system within 1 day, but may not clear the metabolite norhydrocodone for up to 2 days.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/856847
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/hydrocodone
Factors that influence how long Hydrocodone stays in your system
There are many factors that can influence clearance rates of hydrocodone, ultimately determining how long the drug (and its metabolites) stay in your system. Influential factors to consider when contemplating clearance time include: individual factors (e.g. age/genetics/liver), dosage, regularity of ingestion, and whether other drugs were administered simultaneously.
It is important to consider the fact that two individuals could’ve taken a single-dose of hydrocodone at the same strength (mg) and time, yet one may eliminate the drug quicker from his/her system than the other. A variety of individual factors that may dictate rate of clearance include: a person’s age, body mass, genetics, liver functionality, and urinary pH.
Age: Compared to younger individuals, the elderly (aged 65+) often metabolize and excrete drugs at slower rates. In part, this may be due to the fact that their organs (e.g. liver/kidneys) may be functioning suboptimally and/or internal blood flow to the liver may be reduced. Further, elderly are often on other medications and face a variety of other health problems – all of which could delay excretion of hydrocodone. Know that if you are younger, you should clear hydrocodone quicker than an older individual.
Body height / weight / fat: It is necessary to account for a person’s height, weight, and fat when estimating how quickly they are likely to eliminate the drug from their system. A person who is tall/heavy should theoretically clear a 5 mg dose of hydrocodone quicker than a short/lightweight individual. This is due to the fact that the smaller the dose of the drug you ingest proportionate to your body size (height/weight/fat), the quicker the clearance; vice-versa also applies.
Genetics: Various genes are known to influence our ability to metabolize drugs, including hydrocodone. Genetic variants that regulate CYP450 liver enzymes such as CYP2D6 may dictate whether someone metabolizes hydrocodone at a quicker (or slower) rate than average. Based on genetics, certain individuals are thought to be “rapid metabolizers,” while others are considered “poor metabolizers.” This may result in different effects of the drug, but also variability in clearance rates.
Food intake: It is thought that taking hydrocodone with food (especially carbohydrates) can slow the absorption, whereas taking it on an empty stomach results in expedited absorption. Differences in absorption time could influence rate of clearance from your body. Among those that ingest a high-carbohydrate meal along with hydrocodone, it may slightly delay clearance.
Liver/kidney function: Since hydrocodone is metabolized by enzymes in the liver, impaired functionality of the liver may could extend half-life and prolong clearance. For example, someone with cirrhosis may take hours longer to clear hydrocodone from their system compared to an individual with a healthy liver. In addition, renal (kidney) impairment may also delay drug clearance.
Metabolic rate: A person’s basal metabolic rate (BMR) is thought to influence metabolism speed of drugs. Someone with a faster-than-average BMR may metabolize and excrete hydrocodone quicker than someone with a slower-than-average BMR. While BMR is largely determined by genetics – factors such as diet, exercise, drugs, and supplements can also influence it.
Urinary pH: Though it is unknown as to whether urinary pH has a significant impact on clearance of hydrocodone (and its metabolites), it may play a role. Individuals with more acidic urine may clear hydrocodone more efficiently than those with a highly alkaline urine. Alkalinity of urine is known to promote reabsorption of drugs prior to their elimination, slowing the clearance.
- Source: https://www.ncbi.nlm.nih.gov/pubmed/22205192
Frequency of use
A person who used hydrocodone just once (e.g. a “single dose” user) is more likely to clear the drug quicker from his/her system than a person who regularly used the drug for years. This is likely due to the fact that when ingested frequently over the course of several days, hydrocodone (and its metabolites) are thought to accumulate within the body until they reach a “peak.” Once they reach a “peak,” the clearance time will be extended for a longer duration.
Infrequent or single-dose users are less likely to accumulate as high of hydrocodone levels within their system as frequent users. A single-dose user should be able to clear the drug efficiently from his/her system in under 2 days. On the other hand, frequent/long-term users could take longer than 2 days to fully eliminate hydrocodone; resulting in a positive urinalysis (e.g. failed drug test) for much longer than 2 days.
Frequent users may also take a second dose of the drug before their body is able to metabolize and excrete the first dose. To use an analogy, they are essentially adding more wood (hydrocodone) to a fire that hasn’t finished burning (metabolizing) the initial wood (hydrocodone). It is also important to consider that levels of hydrocodone metabolite “norhydrocodone” may accumulate in frequent users; prolonging clearance.
Taking other drugs
If you take other drugs or supplements along with hydrocodone, it could alter the speed by which your body is able to metabolize and excrete it. Since hydrocodone is metabolized by CYP450 (cytochrome 450) isoenzyme CYP2D6, drugs that affect CYP2D6 may reduce or extend half-life. Drugs classified as “inhibitors” of CYP2D6 are known to impair your body’s ability to clear hydrocodone from your body.
Examples of such CYP2D6 inhibitors include: SSRIs (Citalopram, Fluoxetine, Paroxetine, etc.), Methadone, Amiodarone, Codeine, Deiavirdine, Perphenazine, Serindole, Yohimbine, and more. Talk to your doctor if you suspect that you may be taking a CYP2D6 inhibitor and discuss how it will affect how quickly you’re able to metabolize hydrocodone. Realize that certain CYP2D6 inhibitors will slow metabolism to a greater extent than others and that dosing often plays a role.
There are also drugs known as “inducers” of CYP2D6, which enhance metabolism of hydrocodone. Examples of such CYP2D6 inducers include: Dexamethasone and Rifampin. These agents should expedite metabolism of hydrocodone, thereby resulting in quicker clearance from your system.
How Hydrocodone is Absorbed, Metabolized, and Excreted (Details)
Following oral administration of hydrocodone, it is efficiently absorbed by the gastrointestinal (GI) tract. Research has shown that upon administration of a 10 mg tablet, peak serum levels (of 26.3 ng/ml) are attained after approximately 1.3 hours. The drug is metabolized primarily by CYP450 isoenzymes, namely: CYP2D6 and CYP3A4.
CYP2D6 facilitates O-demethylation of hydrocodone, resulting in the formation of metabolite hydromorphone. CYP3A4 catalyzed oxidation (N-demethylation) is responsible for generating the metabolite norhydrocodone. Other hydroxymetabolites of lesser significance include: 6-alpha-hydrocodol and 6-beta-hydrocodol.
Greater than 50% of hydrocodone clearance is facilitated by CYP2D6 and CYP3A4 pathways, whereas upwards of 40% of clearance is done via non-CYP pathways. Though orally administered hydrocodone has an elimination half-life of approximately 3.8 hours, the half-life of metabolite norhydrocodone is thought to be 8 hours. This means that norhydrocodone could remain in the body for up to 2 days (~1.83 days) before 100% clearance.
For this reason, norhydrocodone is often detectable in urinary drug tests for a longer duration than hydrocodone. The other metabolite hydromorphone has a half-life of 2.3 hours, and is therefore excreted at a quicker rate than hydrocodone itself (in under 13 hours). Urinary excretion following orally ingested hydrocodone consists of: hydrocodone unchanged (6%-20%), norhydrocodone (2%-14%), and hydromorphone (5%-6%). Other metabolites excreted in urine include: dihydrocodeine, isodihydrocodeine, dihydromorphone, and isodihydromorphone.
Concentrations of metabolites are subject to significant variation based on sex. Females tend to have greater norhydrocodone levels (possibly resulting from increased CYP3A4 density), whereas males tend to have greater hydromorphone levels (from CYP2D6). Research indicates that 70% of the drug is usually excreted in the first 24 hours, and the remaining metabolites are cleared within 72 hours (3 days).
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/hydrocodone
- Source: http://www.ncbi.nlm.nih.gov/pubmed/23995596
- Source: https://www.ncbi.nlm.nih.gov/pubmed/9103485
- Source: http://www.ncbi.nlm.nih.gov/pubmed/24836897
- Source: http://www.ncbi.nlm.nih.gov/pubmed/28931
Types of Hydrocodone Drug Tests
There are various types of tests that could be administered to determine whether an individual ingested hydrocodone. These tests include: urine tests, blood tests, saliva tests, and even hair tests. The most common way to test for hydrocodone is via urine tests for the simple fact that metabolites can be detected for up to 2 days after ingestion.
Urine tests: This type of testing involves collection of a urine sample followed by laboratory analysis (called a “urinalysis”). Since a majority of hydrocodone is eliminated via the urine, a urine sample is among the most effective ways to detect usage. Hydrocodone itself isn’t usually detectable in urine after 24 hours, but its metabolite norhydrocodone is detectable for up to 2 days in the urine.
If you are subject to urine testing, the sample will likely be analyzed to determine whether norhydrocodone is present. Since norhydrocodone is thought to accumulate in the body of hydrocodone users, the drug may remain detectable well beyond 2 days. Some speculate that users could test positive for up to a full week after their last ingestion via urine samples.
Urine tests are thought to be highly accurate, relatively cheap, are minimally invasive compared to a blood test. Furthermore, they provide a longer window of hydrocodone detection compared to a blood test. That said, it is important to realize that females may test positive for hydrocodone for a longer duration than males on a urine test because females have a greater propensity to form norhydrocodone; the metabolite with a longer half-life.
Hair tests: Another modality of testing for hydrocodone (and opioids) is via a hair sample. Hair samples typically consist of 20 to 50 follicles (3 cm to 6 cm) that are sent to a lab for analysis. One drawback associated with hair tests for hydrocodone is that they are incapable of detecting recent drug ingestion. This is due to the fact that the body ingests the drug, circulates it, and new hair needs to grow before the drug will show up in outgrowths.
That said, hair samples may detect opioid ingestion for up to 90 days after ingestion. The longer the sample of the hair follicles, the greater the chances of detection. Detection of hydrocodone in hair is generally confirmed with GC/MS (gas chromatography/mass spectrometry) and ELISA (enzyme linked immunosorbent assays).
The amount of hydrocodone present in hair samples seems to be directly correlated with amount ingested. Since hair tests are relatively expensive and require a lag-time between ingestion and testing for accurate results, they are seldom used. However, they are capable of detecting even small amounts of hydrocodone (pictograms per milligram).
Saliva tests: This type of testing involves collecting a sufficient amount of “oral fluid” to be analyzed. Since it is more difficult to detect the presence of hydrocodone and norhydrocodone (metabolite) in oral fluid (compared to urine), saliva tests aren’t commonly administered. That said, it is still possible to detect the presence of hydrocodone (and norhydrocodone) in salivary fluid.
Most individuals subject to a saliva test for hydrocodone will test positive within several hours of drug ingestion. Hydrocodone will remain detectable for up to 1 day after ingestion, whereas norhydrocodone (a metabolite) could remain detectable for up to 2 days. Since norhydrocodone is excreted to a significantly lesser extent in saliva than urine, the detection window may be reduced. That said, if saliva fluid is suspected to contain hydrocodone or norhydrocodone, GC/MS (gas chromatography/mass spectrometry) may be employed for confirmation.
Blood tests: Another way to determine whether someone has ingested hydrocodone is via a blood sample. Blood tests aren’t usually preferred to detect hydrocodone due to the fact that the detection window is shorter than other testing modalities (e.g. urine tests) and blood draws are highly invasive. Hydrocodone is thought to remain detectable in the blood for between 1.3 and 24 hours post-ingestion.
Blood testing is generally reserved for hospitalized patients that may have overdosed on a drug (or combination). Among hospitalized patients, a blood sample is quickly taken and analyzed to determine whether opioids (such as hydrocodone) are present. Should a medical professional conclude that an individual is suffering from hydrocodone toxicity, an appropriate agent will be administered to counteract CNS depression.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/16872564
- Source: http://www.ncbi.nlm.nih.gov/pubmed/24944068
Who could be tested for Hydrocodone?
Many people are subject to regular drug testing for opioids that metabolize into morphine. However, since hydrocodone doesn’t breakdown into morphine, it isn’t tested for on standard opioid drug screenings (e.g. SAMHSA-5 panels). That said, individuals who are suspected to be abusing prescription opioids (e.g. rehab patients) may be assessed with extensive testing that is capable of detecting hydrocodone (plus metabolites norhydrocodone and hydromorphone).
- Athletes: It isn’t very likely that athletes will be subject to drug testing that detects hydrocodone. Though the standardized drug tests administered to athletes (professional and collegiate) may detect morphine, they will not detect hydrocodone. In the event that a thorough, more extensive test is administered to athletes, the hydrocodone metabolite “norhydrocodone” is most likely to be detected.
- Drug rehab clients: Individuals in rehab are often monitored closely for relapses in drug usage. Many rehab patients will abuse whatever prescription drugs they can get their hands on, including hydrocodone. To ensure that rehab patients aren’t abusing prescription drugs during their recovery, extensive drug screenings that test for hydrocodone may be administered.
- Employees: Certain companies may require that their current and prospective employees undergo extensive drug testing. Occupations such as truck drivers, machinists, repair technicians, and any job that involves operating a motor vehicle or heavy machinery will benefit from screening for hydrocodone. This is due to the fact that hydrocodone depresses the central nervous system (CNS) and could increase likelihood of on-the-job errors, impair coordination, and lead to a potentially hazardous/fatal mistake.
- Military personnel: Those enlisted in the military are often subject to frequent, mandatory (and randomized) drug testing. Being in the military requires full alertness, attention to detail, and maximum coordination. Should an individual be taking hydrocodone, it could impair judgment, motor skills, and stamina – leading to compromised performance. For this reason, extensive drug screenings may be administered to determine whether an individual had ingested prescription opioids (e.g. hydrocodone). If hydrocodone is detected among a person in the military, he/she may be delisted without compensation.
Tips to clear Hydrocodone from your system
There are several tips to keep in mind if your goal is to clear hydrocodone from your system as fast as possible. Though some of these tips are relatively obvious and common sense, they may expedite clearance times of hydrocodone and metabolites. Understand that these tips may not benefit everyone, and that you should always consult a medical professional if you have questions.
- Stop taking it: It’s pretty easy to understand that if you want to clear a drug from your system, you probably should refrain from taking it. Unfortunately, many people do not comprehend the idea that drugs like hydrocodone typically are metabolized and excreted at a relatively predictable rate (based on the drug’s half-life) – you can’t usually speed up the process too much with sneaky tricks. The bottom line is that the longer you’ve remained hydrocodone-free, the less likely the drug (and metabolic byproducts) will remain in your system.
- CYP2D6/CYP3A4 inducers: Hydrocodone is metabolized primarily by isoenzymes in the liver CYP2D6 and CYP3A4 to form respective metabolites: hydromorphone and norhydrocodone. The metabolism can be expedited if an individual is taking a drug and/or medication to enhance activation of these enzymes. This could result in quicker overall clearance times from the body. If you’re contemplating taking any metabolic “inducers,” always talk to your doctor to verify safety and/or potential contraindications.
- Urinary pH: Though not often discussed, it is known that a person’s urinary pH can influence drug clearance times. Increasing the acidity of your urinary pH is known to speed up clearance rates of drugs like hydrocodone. Those who have highly alkaline (pH) urine tend to retain the drug for a longer duration prior to excretion because high alkalinity facilitates drug reabsorption. To maximize the likelihood of the fastest possible excretion, maintaining a sufficiently acidic urinary pH may help.
- Hydration / Diet: There is some evidence to suggest that decreased urinary output could lead to drug reabsorption. To ensure that your urinary output is adequate, you’ll want to make sure you’re drinking plenty of water. Don’t go overboard and think that drinking a “ton” of water will clear the drug faster because it won’t. That said, staying sufficiently hydrated will facilitate normative clearance whereas dehydration may prolong excretion.
- Exercise: Getting some daily exercise in the form of cardio (e.g. running) is known to enhance various physiological functions that may influence hydrocodone clearance. Exercise improves blood flow and circulation to organs (including the liver and kidneys), thereby optimizing metabolism and clearance times. Additionally, exercise increases metabolism and aids in the clearance of exogenous substances (such as hydrocodone).
Have you been drug-tested for Hydrocodone?
If you’ve been drug tested for hydrocodone, leave a comment discussing your experience. Mention the modality of drug testing you endured (e.g. urine testing) and whether you passed (i.e. tested negative) or failed (i.e. tested positive). If you failed the test, how long had hydrocodone (and its metabolites) remained in your system following your last ingestion?
If you were able to pass a drug test, mention whether you used any tricks to expedite the clearance of hydrocodone from your system. To help others better understand your situation, discuss whether you were a regular hydrocodone user, your age, whether you were taking other medications (e.g. CYP2D6 inhibitors) that may have prolonged clearance.