If your doctor has prescribed hydrocodone to you to take, you may have a number of questions about how long it will remain in your system.
How soon will you feel its effects? When do those effects peak? How long will they last? What is hydrocodone's half-life? When is it safe to take another dose?
In this article, I will set out to answer all of those questions in detail so that you can take this painkilling medication safely and effectively.
What is Hydrocodone?
Hydrocodone is an opioid. Opioids are taken to provide powerful pain relief.
The National Institutes of Health (NIH) describes hydrocodone as ( 1), "a semisynthetic derivative of codeine or thebaine."
Codeine and thebaine in turn are natural alkaloids which come from poppy seed resin.
By binding to the µ opiate receptor in your body and acting as an agonist, it is able to relieve moderate to severe pain.
Why is Hydrocodone Prescribed?
Most often, hydrocodone is prescribed for pain relief, usually in a combination form which includes acetaminophen.
Sometimes hydrocodone is also combined with anticholinergic or antihistamine substances. In these forms, it is a cough treatment.
Hydrocodone is not casually prescribed to patients. It can be addicting, and patients are prone to abusing it (more on that in a bit).
Most of the time, hydrocodone will only be prescribed under these types of circumstances:
- A patient has just come out of surgery, and needs a treatment for the severe, acute pain.
- If a patient has a severe, acute injury, hydrocodone may be temporarily prescribed to manage the pain.
- A patient has severe chronic pain from a condition such as arthritis, cancer, or a structural issue that is not responding to more moderate pain management measures.
If a doctor can prescribe something else to treat pain, he or she probably will. Opioids are a "last resort" measure in chronic pain scenarios.
Common Forms of HydrocodoneAs already mentioned, hydrocodone is available in a variety of forms. Here are some of the medications which contain it:
- Lorcet® (hydrocodone/acetaminophen)
- Lortab®(hydrocodone/acetaminophen).
- Lortab ASA® (hydrocodone/aspirin)
- Hycomine® (hydrocodone/chlorpheniramine/phenylephrine/acetaminophen/caffeine)
- Vicodin® (hydrocodone/acetaminophen)
- Vicoprofen® (hydrocodone/ibuprofen)
You might also be prescribed an extended-release hydrocodone drug. A couple of examples are:
Why Is It Harder to Get Hydrocodone Than It Used to Be?
It was never "easy" to get doctors to prescribe hydrocodone, but you may have noticed it has become even harder to get a prescription over recent years.
The reason for this is the "war on opioids" which is now in full swing in the United States.
As The Guardian explains ( 2),
"The US is facing what many are describing as an opioid crisis, with growing numbers of deaths associated both with opioid medications and overdoses on heroin - 19,000 in 2014 linked to opioids alone."
The CDC states ( 3), "On average, 130 Americans die every day from an opioid overdose."
Obviously, this is a grave matter, which has led the government to taking action to try and prevent further fatalities.
This article ( 4) explains,
"In response to concerns for drug abuse and overdose, the Drug Enforcement Agency rescheduled HCPs [hydrocodone combination products] to Schedule II in October 2014, with the intent of limiting overprescribing and increasing awareness of their abuse potential."
Between tightening federal restrictions and changing cultural perceptions, doctors are far less likely to prescribe hydrocodone than they were in the past.
Indeed, there have been many stories which have surfaced since the changes went into effect about patients with devastating chronic pain who were thrown off their prescriptions overnight.
There are of course two sides to this issue.
On one hand, it is true that using hydrocodone and other opioids can lead to addiction, and it is true that misuse of opioids can lead to death.
On the other, some patients literally have no other recourse for treating their pain.
Without their opioids, they truly are not functional, and may consider suicide their only viable alternative.
Patients in this situation whose opioids are taken away are being abandoned (and arguably condemned) by the system.
Regardless, if you are prescribed hydrocodone or any other opioid, all of this should drive home the message that is very important to make sure you are not misusing the medication.
Remember, not all misuse is deliberate. Oftentimes, patients simply time their dosages incorrectly or make other mistakes.
The information in this article should help you prevent that.
What Does It Feel Like Being on Hydrocodone?
The most marked effect of hydrocodone is intense pain relief. Some people also report it may produce numbness, drowsiness, a reduction in anxiety, and euphoria.
I have experience with Vicoprofen, which was prescribed to me following a surgery.
Incidentally, during that same time period, I was experiencing intense chronic pain.
The pain was otherwise intractable during the initial months, responding to no other treatment measures.
But I do remember that right after the surgery, I mistakenly thought the surgery might have fixed the problem causing the intractable head pain.
In reality, the Vicoprofen was so potent that it provided relief not just for the surgery pain, but for the (ultimately worse) head pain.
It did make me ridiculously sleepy (which was also helpful, since the only times I wasn't in pain in general were when I was unconscious).
Oddly enough, at the same time, in some ways I felt more energetic (pain sucks a lot of life out of a person, and relief gives it back).
As for "euphoria," I can attest to that as well, though I'm not sure that it was from the drug or simply from the relief at pain relief.
I also recall it making me feel indifferent and apathetic toward much of what was going on around me.
There was also a kind of perception of "floating."
This wasn't in a literal sense - it was just that in an associative sense, Vicoprofen felt like resting on a cloud.
I can't even tell you how horrible it was running out of pills from the surgery.
In any case, the fact that even I couldn't get opioids for my intractable pain should tell you how hard it is to get a hydrocodone prescription.
Thankfully, things got better for me, though it took a longtime and a lot of anguish.
Over the years, I've learned enough about pain disorders to know that at the time, I actually probably was a reasonable candidate for a hydrocodone prescription to manage my intractable pain, which definitely was "moderate to severe" at all times.
Regardless, doctors tended to blow me off as an addict looking for a fix-pretty ironic since I have a fairly strict no-drugs policy in my life outside of pain meds (I don't even drink).
How Quickly Does Hydrocodone Provide Pain Relief?
Because hydrocodone comes in a tablet form, it takes some time to digest and make its way into your bloodstream.
You should start to feel pain relief inside of an hour. Your mileage may vary, but some patients say that they can feel the effects of hydrocodone within just 20 minutes.
Product packaging for hydrocodone states that it takes around 1.3 hours for it to peak in your bloodstream.
What is the Half-Life of Hydrocodone?
The half-life of hydrocodone depends on the type of medication you are taking as well as a few other factors (more on that shortly).
In most cases, it is around 3.5 hours.With some hydrocodone-based medications however, the half-life can be as long as 9 hours.
If you are not familiar with the concept of medication half-life, the half-life is how long it takes your body to breakdown and purge half the dosage you took.
How Long Does a Dose of Hydrocodone Provide Pain Relief?
You should be able to enjoy the positive effects of hydrocodone for anywhere from 4-8 hours.
If you have an extended release formula, the effects could last for up to 12 hours.
How Long is Hydrocodone Detectable in Your System?
Hydrocodone remains detectable in the body long after the effects wear off.
How long it remains detectable depends on the type of body tissue which is being screened.
- Blood: Up to 24 hours.
- Saliva: Up to 36 hours.
- Urine: Up to four days.
- Hair: Up to 90 days.
Medications Which Interact With Hydrocodone
Quite a few different types of medications and drugs can potentially interact with hydrocodone. Some of these include:
- Alcohol
- Narcotics
- Antihistamines
- Antidepressants
- Anti-anxiety meds
- Antifungal medications
- Antibiotics
- Protease inhibitors
- Benzodiazapines
- Carbamazepine
- Cimetidine
- Muscle relaxants
- Tranquilizers
- Sedatives
- Phenytoin
- Rifampin
- Nausea medications
- HIV medications
- St. John's Wort
- Tryptophan
This is not an exhaustive list. It is vital that you tell your doctor all drugs you are taking (whether they were prescribed to you or not) so that you can prevent dangerous interactions.
Alcohol and Hydrocodone: A Deadly Combination
We have already talked about how opioids can be habit-forming. Unfortunately, alcohol can be as well.
This makes it very hard for some patients to resist taking hydrocodone and alcohol together.
This may even be a challenge for those who are not alcoholics, but simply enjoy a drink now and again, and do not want to give that up.
They may think, "Surely I can sneak just a little bit."
But the American Addiction Centers warns ( 5),
"With so many people struggling with opioid and alcohol abuse, it is likely that these two conditions will overlap. This form of polydrug abuse is extremely risky and puts the person at great risk of death from overdose."
Indeed, over 20% of deaths from opioid overdose have been associated with alcohol ( 6).
Since you obviously do not wish to put yourself at "great risk of death," you should never mix hydrocodone and alcohol - no exceptions.
Other Factors Which Affect How Long Hydrocodone Stays in Your Body
Previously, I mentioned that the formula of hydrocodone you are taking is not the sole factor which impacts how long it remains detectable in your body.
Below are some other factors which can have an influence:
How old you are:
Younger patients will breakdown and eliminate hydrocodone and other medications more rapidly than older patients, on average.
This is because organ efficiency is usually higher.
Tolerance
The longer you use hydrocodone, the more tolerance you may build to it. With increased tolerance comes slower processing in the body.
That means the pain relief effects may kick in more slowly, and the drug may remain detectable in your body for longer too.
History of opioid use
If you have used other opioids in the past, that could also impact how long hydrocodone remains in your system.
Your body type
While your doctor will write you a prescription which is optimized to your weight, fat distribution and height insofar as he or she can, your dosage probably will not be perfectly optimized.
You might be assigned the same dosage as another patient with a slightly different height or weight than you, and you may each take a slightly different amount of time to break down the medication.
Kidney and liver function
The more efficiently your kidneys and liver are working, the more quickly they will purge hydrocodone from your body.
Metabolic rate
A quick metabolism will speed up the process of elimination for hydrocodone (along with any other medications you use, food you consume, etc.).
Genetic factors
Your genetic profile may cause you to break down and eliminate hydrocodone more or less quickly than other patients.
Interactions with other medications
Certain other medications you take may have an influence on how quickly or slowly your body breaks down hydrocodone.
Interactions with other health conditions
Health conditions might influence the rate at which your body eliminates hydrocodone as well.
Other drug use
Using alcohol or other drugs might change the breakdown rate of hydrocodone in your system (reminder: do not mix alcohol and hydrocodone).
What Happens If You Go Into Hydrocodone Withdrawal?
Whether you miss a dose of hydrocodone and go into withdrawal or you are deliberately trying to quit, you may experience withdrawal symptoms.
Note that you do not necessarily need to be addicted to hydrocodone to experience the symptoms of withdrawal.
Hydrocodone is a powerful drug, and your body becomes adapted to it being in your system after a while.
When you abruptly stop taking hydrocodone, your body needs time to adjust.
Before it does, you will likely experience withdrawal symptoms.
Here are some of the ways withdrawal can manifest:- Achy muscles
- Watering eyes
- Runny nose
- Cramping in the abdomen
- Diarrhea
- Nausea
- Vomiting
- Fatigue
- Insomnia
- Night sweats (or sweats at other times of the day)
- Chills
- Irregular heartbeat (usually rapid)
- Rapid breathing
- Headaches
- Restlessness
- Depression
- Anxiety
- Concentration problems
- Cravings
- High blood pressure
- Suicidal thoughts
At best, these symptoms can be extremely unpleasant. At worst, they may be dangerous.
That is why if you have been using hydrocodone for two weeks or longer, you should not jump right into trying to quit hydrocodone cold turkey.
You should instead speak to a medical professional about your goal of quitting hydrocodone.
A professional can guide you through a program for detoxification, cutting down your dosages in a controlled fashion in order to keep withdrawal symptoms to a minimum.
There are some other benefits of working closely with your doctor on your taper as well:- You can be assured of getting the timing right. The exact process for safely and effectively tapering hydrocodone varies from one individual to another. A doctor can help you to taper on a customized schedule which is right for you.
- Your doctor can monitor your vitals throughout the process to ensure that you are safe.
- If the side effects of the withdrawal become overpowering, your doctor may be able to prescribe some other medications to help you manage them.
- If you still have pain (the pain you were trying to treat with hydrocodone), your doctor may also be able to give you other safe prescriptions to help keep that pain in check.
- The doctor can answer questions you might have. Withdrawal symptoms can be scary. If you are all on your own, you might panic. But with a doctor on your side, you do not have to struggle with unnecessary fear and uncertainty.
- You will have some emotional support. It can be tough to stay the course with a withdrawal. Your doctor can help to bolster your confidence and determination.
What if it has only been two weeks or less since you started taking hydrocodone?
You should not need to worry about tapering. You can just stop taking the medication once you no longer need it.
If you are not trying to quit your medication and have simply missed a dose, you should start feeling better after you return to your regular dosing.
How Long Does It Take to Recover from Hydrocodone Withdrawal?
Just as some peoples' bodies take longer or shorter time periods to eliminate hydrocodone, there are also variations on how quickly people recover from withdrawal from the medication.
On average, you can expect the first 72 hours to be the roughest. You should then notice (hopefully) a reduction in your symptoms.
Most patients recovering from hydrocodone withdrawal notice that they begin feeling much better after around a week has passed.
What Happens if You Overdose on Hydrocodone?
On the flipside, if you take too much hydrocodone, or if hydrocodone interacts with another medication, you can also experience side effects.
Indeed, you already know that this can be incredibly dangerous, and may even be deadly.
You might also be aware however that hydrocodone has common side effects as well.
In order to help you to tell the difference between common side effects and dangerous side effects, I am sharing a couple of lists with you from the American Addiction Centers ( 5).
The following are common side effects of hydrocodone:- Dry mouth
- Headache
- Backache
- Constipation
- Nausea
- Vomiting
- Stomach cramps
- Tight muscles
- Urinating more frequently
- Urination being painful
- Sleep disturbances
- Tinnitus
- Swollen feet and legs
- Fatigue
- Difficulty waking up in the morning
- Shaking
The American Addiction Centers notes that these symptoms can occur to anyone, but they are more probable if you abuse your mediation (deliberately or otherwise).
That in itself should be good incentive not to take more hydrocodone than you should.
The following are signs of overdose:- Intense confusion
- Severe challenges with memory
- Skin which is pale, clammy and/or cold
- The lips and fingernails may appear bluish
- Stumbling
- Slowed heartbeat
- No heartbeat
- Vomiting
- Gurgling noises
- Slow breathing
- No breathing
- Falling asleep and not waking up
Obviously if you are overdosing, there is a possibility that you will not even be aware of what is happening until it is too late.
Even if you are, you may collapse before you are able to get medical assistance.
So be extra careful when you are timing your doses. Do not risk taking too much hydrocodone at one time.
And do not risk a hydrocodone dose dangerously overlapping with another medication or substance in your body.
Summary
So now you know in detail about the half-life of hydrocodone, and you know how long it takes to work, how long it stays in your system, and what symptoms signify withdrawal or an overdose.
Let's quickly summarize what we have learned.- Hydrocodone comes in a variety of forms.
- The half-life of hydrocodone can vary, but it is usually around 3.5 hours.
- It can take up to an hour to feel the effects of hydrocodone, but some people get effects within just 20 minutes.
- Effects usually continue for 4-8 hours.
- Some extended release formulas may work for up to 12 hours.
- A wide variety of factors impact how long hydrocodone takes to clear your system.
- A large number of medications, supplements, and other substances may interact with hydrocodone.
- Even if you are not an addict, you can go into withdrawal if you stop taking hydrocodone suddenly.
- Withdrawal symptoms typically are at their worst for the first 72 hours, and improve a lot after a week or so.
- Taking too much hydrocodone at a time can lead to an overdose.
- An overdose can also result from a dangerous interaction.
- Overdosing on hydrocodone can be lethal.
- Blood: Up to 24 hours.
- Saliva: Up to 36 hours.
- Urine: Up to four days.
- Hair: Up to 90 days.
- Before you start taking hydrocodone, give your doctor a full list of all medications, supplements and other substances you might be using.
- Make sure your doctor is aware of all health conditions which affect you.
- Take the exact dosage prescribed to you on the exact schedule the directions tell you to. Do not deviate from this schedule or take more than the directions specify.
- Do not attempt to quit hydrocodone cold turkey. Taper it instead under a doctor's watch.
- If you have been using other substances which interact with hydrocodone, make sure they are out of your body before you take hydrocodone (that means you will need to look up how long those substances remain in your system too).
- If you still have hydrocodone in your system, refrain from using other drugs or supplements which might interact.
- Especially make sure you do not take sleeping pills or sedatives with hydrocodone.
- Do not give into the temptation to drink alcohol while you are on hydrocodone.
Conclusion: Hydrocodone is a Powerful Drug for Pain Relief, So Be Sure You Are Using it Properly
Even if you suffer from severe chronic pain, there is a good chance that you can get some relief from taking hydrocodone.
But because hydrocodone is so potent, it is very important to understand the timing involved with taking it.
You now know the drug's half-life, how long it takes to begin working, how many hours of pain relief you can expect, and how long it stays in your system.
This can help you to properly time your dosages.
That way you are less likely to go into withdrawal or experience an overdose or a dangerous interaction.
Use caution and work on being consistent and disciplined with your hydrocodone doses, and always follow your doctor's directions.
That way you can enjoy hydrocodone's powerful pain relief benefits without dealing with equally powerful adverse effects.