What is hydrocodone?

Hydrocodone is an opioid drug used to relieve moderate to severe pain. It’s only used to treat people who need pain relief and who can’t be treated with other medications.

Hydrocodone may be prescribed following an injury or a major surgery or to treat other types of severe pain, like cancer pain or arthritis.

Hydrocodone is derived from codeine, a natural alkaloid that comes from the resin of poppy seeds. Once in the body, hydrocodone binds to and activates the mu opiate receptor to block the feeling of pain.

When combined with acetaminophen or ibuprofen, hydrocodone goes by the brand names:

  • Vicodin
  • Lortab
  • Lorcet
  • Norco

There are also several extended-release formulations of hydrocodone, including:

  • Hysingla ER
  • Zohydro ER

Hydrocodone comes with many warnings due to its high potential for abuse and addiction. For this reason, it’s classified as a federal controlled substance (C-II). Extended-release formulations of hydrocodone are specifically formulated to be difficult to crush, break, or dissolve in order to prevent abuse.

If you’ve been prescribed hydrocodone, you may be curious as to how long the effects will last in your body and how long the medication may show up on a drug test.

Hydrocodone is taken by mouth (orally) and has to pass through your digestive system before you begin to feel its effects. You should start feeling the effects of hydrocodone in under an hour.

According to the package insert, a 10-mg oral dose of the medication reaches peak concentrations in the bloodstream in roughly 1.3 hours following ingestion.

People who take hydrocodone often will build up a tolerance to the drug over time. For these people, it may take longer to feel pain relief or the relief may not feel as strong.

When this happens, your doctor may want to increase your dose or switch you to a different type of pain medication. Don’t take a larger dose of hydrocodone without first speaking to your doctor.

One way to find out how long a drug will last in the body is to measure its half-life. The half-life is the time it takes for half of the drug to be eliminated from the body.

Hydrocodone has an average half-life of roughly 3.8 hours in healthy adult males. In other words, it takes 3.8 hours for the average healthy male to eliminate half of the dose of hydrocodone.

However, it’s important to note that everyone metabolizes medications differently, so the half-life will vary from person to person.

It takes several half-lives to fully eliminate a drug. For most people, hydrocodone will fully clear the blood within a day, but it can still be detected in the saliva, urine, or hair for much longer than that.

According to the American Addiction Center, hydrocodone can be detected in:

  • saliva for 12 to 36 hours after the last dose is taken
  • urine for up to four days after the last dose is taken
  • hair for up to 90 days after the last dose is taken

You will likely stop “feeling” the pain relief of hydrocodone long before it fully clears your body. This is why your doctor may have you take a single tablet of hydrocodone every four to six hours while you’re in pain.

Extended-release formulations last a bit longer, so they are usually taken every 12 hours in order to control pain.

A number of factors can influence the time it takes for hydrocodone to clear the body. These include:

  • weight
  • body fat content
  • metabolism
  • liver function
  • how long you’ve been taking hydrocodone
  • if you’ve taken opioids before
  • dosage
  • other medical conditions
  • other medications
  • alcohol

Alcohol and hydrocodone taken in combination have a synergistic effect on one another. This means that the effects of hydrocodone are increased if you consume alcohol. It will take longer to clear hydrocodone from your body.

Combining alcohol with hydrocodone can also lead to dangerous side effects, including the possibility of a fatal overdose.

Hydrocodone is cleared by your body through a pathway known as cytochrome P450 3A (CYP3A). Drugs that inhibit CYP3A4 make it more difficult for your body to break down hydrocodone.

Combining hydrocodone with the following could result in serious problems, including potentially fatal respiratory depression:

  • macrolide antibiotics, such as erythromycin
  • azole antifungal agents
  • protease inhibitors

Other medications that have been shown to interact with hydrocodone and increase its effects include:

  • other narcotics
  • antihistamines
  • anti-anxiety agents (like Xanax)
  • tricyclic antidepressants
  • antidepressants known as MAO inhibitors

You shouldn’t stop taking hydrocodone abruptly without consulting your doctor because you can have serious withdrawal symptoms. These may include:

  • restlessness
  • widened pupils
  • irritability
  • inability to sleep
  • muscle cramps
  • joint pain
  • vomiting
  • sweating
  • chills
  • fast breathing
  • fast heartbeat

Your doctor may reduce your dosage gradually over time to prevent withdrawal. This is called tapering. It’s recommended that the dose is decreased gradually, by 25 to 50 percent every two to four days, while monitoring carefully for signs and symptoms of withdrawal.

If you do experience withdrawal symptoms, they can be classified as mild, moderate, or severe. Everyone experiences withdrawal differently.

In general, symptoms begin to improve within 72 hours and significantly decrease within a week. Your doctor can help you manage your symptoms.

The pain relief effect of hydrocodone will wear off within four to six hours. But the drug may still be detected in the saliva for up to 36 hours, in urine for four days, and in the hair for 90 days after the last dose.

There are also a number of factors that could alter the time it takes for hydrocodone to clear the body, including age, metabolism, weight, dose, and other medications.

You shouldn’t drink alcohol or take other street drugs while taking hydrocodone as these will increase your risk of experiencing serious side effects. Be sure to also tell your doctor if you’re taking any other prescription or nonprescription medications.

Never take more than your prescribed dose of hydrocodone, even if you feel that the medicine is not working as well. It’s possible to overdose on hydrocodone. You should seek emergency medical care if you experience any of the following symptoms after taking hydrocodone:

  • unusual dizziness
  • slowed breathing
  • unresponsiveness
  • extreme sleepiness
  • lightheadedness
  • hallucinations
  • nausea
  • vomiting
  • chest pain

Although they are prescription drugs, opioids such as hydrocodone have been associated with serious health issues and have led to a series of overdoses and deaths across the nation.

In 2015, more than 20,000 people died from opioid prescription-related overdoses in the United States, according to the American Society of Addiction Medicine.

It’s important to only take your prescribed dose of hydrocodone and to do it under your doctor’s supervision. Read the information contained in the Medication Guide before you begin treatment with hydrocodone. Speak to your doctor if you have any questions or concerns.