Last reviewed by Editorial Team on September 4th, 2018.
What is Hydrocodone? What is Hydrocodone used for?
Hydrocodone is a Generic name for an opioid pain reliever medicine. Chemically hydrocodone is also known as dihydrocodeinone. It is semi-synthetic opioid medicine that is synthesized from codeine.
Hysingla ER and Zohydro ER are hydrocodone’s extended-release forms that are used for around-the-clock treatment for moderate to severe pain treatment. Extended-release form of hydrocodone is not for use on an as-needed basis for pain. Hydrocodone is also commonly used in liquid form as an antitussive/cough suppressant.
How does Hydrocodone works?
Hydrocodone works as an opioid agonist of opioid receptors in the brain. This drug blocks pain perception in the cerebral cortex of the brain. Hydrocodone reduces synaptic chemical transmission in the brain, which then inhibits pain sensation into the higher centers of the brain. Agonist actions at the μ and k receptors cause analgesia, decreased body temperature and miosis.
Agonist activity at the μ receptor may also cause the opiate withdrawal suppression, while antagonist activity can result in precipitation of withdrawal. Hydrocodone acts at several areas within the brain by involving several neurotransmitter systems to produce pain relieving, but the precise mechanism has not been fully yet understood.
Hydrocodone can also produce inhibition at the chemoreceptors through μ-opioid receptors and in the medulla through μ and δ receptors which can lead to dose-related respiratory depression.
Hydrocodone side effects
Common hydrocodone’s side effects that usually do not require medical attention include:
Side effects that patients have to report to their doctor or health care professional as soon as possible as it can be very serious include:
- breathing difficulties, wheezing
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- light headedness or fainting spells
How long does Hydrocodone stay in your system?
Studies have been shown that the elimination half-life time of hydrocodone is an average 3.8 hours. This means that, it will take under 4 hours for your body to excrete 50% of the administrated hydrocodone dose. This means that the body will fully excrete hydrocodone from its system for 20.9 hours. However, other findings suggest that there could be more difference in drugs half-life time ranging it from 3.3 hours to 4.1 hours.
This indicates that some patients may be able to eliminate the drug much quicker for 18.15 hours, while others may have prolonged systemic clearance time with 22.55 hours). In most patients hydrocodone should be cleared from the body within 1 day, however, it may not clear hydrocodone’s active metabolite named norhydrocodone for up to 2 days.
There are many factors that may have influence on how long will hydrocodone and its active metabolites stay in your system. Those factors can be internal or individual such as: age, genetics, body mass, liver and kidney function etc. Also external factors such as: frequency of hydrocodone use and other medicines taken at the same time can also have the influence.
How long does Hydrocodone stay in your urine?
In normal situations, Hydrocodone itself should be detectable in urine after 24 hours of last dose administration, but its active metabolite norhydrocodone can stay in urine up to 2-3 days.
How long does Hydrocodone stay in your blood?
In normal situations, Hydrocodone should be detectable in blood for one day after last dose administration.
How long does Hydrocodone stay in your hair?
Hydrocodone can be detectable in hair up to 90 days.
How long does Hydrocodone stay in your saliva?
In saliva, hydrocodone can be detectable for up to 1 day after administration, while norhydrocodone could remain detectable for up to 2 days.
How long does Hydrocodone stay in your system if you snort it?
If hydrocodone is snorted, it will pass in your system more quickly than after ingestion. There is no time to lose on absorption of the drug. The effects are almost immediate. Depending on how much of hydrocodone is taken, it will approximately stay in the body for 12-24 hours after administration.
How the age affects Hydrocodone elimination?
The elderly (aged 65+) compared to younger individuals often metabolize and eliminate drugs by much slower rates. Their organs such as liver or kidneys may have lower function and/or their internal blood flow is reduced to the liver. Further, elderly are often on many other medications and some of them could delay hydrocodone metabolism or excretion.
How body height / weight / fat affect Hydrocodone elimination?
Patient’s height, weight, and fat amount when can have impact on how quickly body eliminate the drug from the system. In theory, taller and heavier patients should clear a 5 mg of hydrocodone quicker compared to shorter and lightweight individuals. This is because of the fact that the smaller the dose of the drug is taken proportionate to your height/weight the quicker the elimination, vice-versa also applies.
How genetics affects Hydrocodone elimination?
Different genes are known to have the influence on drug metabolism, including hydrocodone. Genes that regulate CYP450 liver enzymes such as CYP2D6 may have strong influence whether some patient metabolizes hydrocodone in a quicker or slower rate than average.
Based on genetics, certain patients are classified as “rapid metabolizers,” while others are “poor metabolizers.” This may result in different drug effects, but also variability in clearance rates.
How food affects Hydrocodone elimination?
Food like carbohydrates may slow hydrocodone absorption if they are taken together. However, taking hydrocodone on empty stomach may increase absorption this drug. Absorption time differences could influence rate of drug clearance from the body. Those who ingest a high-carbohydrate meal along with hydrocodone, clearance may be delayed.
How liver or kidney function affects Hydrocodone elimination?
Since hydrocodone is metabolized in the liver, liver issues and impaired liver function may extend half-life time and prolong hydrocodone elimination. For example, someone with cirrhosis or hepatitis may take hours longer to metabolize and eliminate hydrocodone from their system compared to healthy individuals. In addition, kidney impairment may also delay drug clearance.
How urinary pH affects Hydrocodone elimination?
Patients with more acidic urine may clear hydrocodone and it metabolites more efficiently than those with highly alkaline urine. Alkalinity of urine is known to promote drug reabsorption prior to their elimination, and thus slowing the clearance.
How frequency of Hydrocodone use affects its elimination?
Single dose users (patients that use hydrocodone only once) are more likely to clear the drug faster from the body than those who regularly used the drug for a long period of time. This is likely to be caused because of the fact that when hydrocodone is used frequently for several days, hydrocodone and its metabolites will accumulate in the body until the “peak” is reached. Once the “peak” is reached the clearance time will be prolonged.
Single-dose, infrequent, users will less likely accumulate hydrocodone compared to frequent users. Such patients should be able to excrete the drug efficiently from the body in under 2 days. However, long-term users who are on chronic hydrocodone therapy could take longer than 2 days to fully eliminate hydrocodone.
How other drugs affect Hydrocodone elimination?
Since hydrocodone is metabolized by cytochrome 450 isoenzyme CYP2D6, all drugs that affect CYP2D6 may reduce or prolong hydrocodone’s half-life time. Drugs classified as CYP2D6 inhibitors are known to impair body’s ability to eliminate hydrocodone from the body. CYP2D6 inhibitors are: SSRI drugs (such as paroxetine, citalopram, fluoxetine etc.), Codeine, Methadone, Amiodarone, Serindole, Yohimbine and more.
Certain inhibitors of CYP2D6 may slow metabolism to a greater level than others and that dosing often plays a role. There are also drugs known as CYP2D6 “inducers” such as Dexamethasone and Rifampin which may enhance metabolism of hydrocodone. These drugs enhances metabolism of hydrocodone, thus resulting in quicker clearance from the system.
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