Vicodin is a very effective pain killer but care needs to be taken to use this drug safely. This medication can become addictive and cause side effects and/or withdrawal symptoms. Additionally, there are risks of dangerous interactions with other medications and substances you may be taking. Knowing how long Vicodin stays active in your system can help you avoid these dangerous reactions or an accidental overdose.
Understanding Drug Interactions
Vicodin contains hydrocodone, which is synthesized from codeine, one of the opioids found in the opium poppy plant. Combining hydrocodone with alcohol, other medications, or unprescribed drugs creates the risk of dangerous interactions that can cause breathing problems, sedation, falling into a coma, or death. So, it is essential not to drink alcohol or take street drugs while taking Vicodin.
Highest Risk Medications
While many drugs can have dangerous interactions with hydrocodone, the highest risks are:
Benzodiazepines, including Xanax, Librium, Klonopin, Diastat, Valium, Ativan, Restoril, Halcion, and othersMuscle relaxantsSedativesSleeping pillsTranquilizersOther medications for mental illness or nausea
Additionally, harmful interactions can occur with drugs that affect a component of liver metabolism, CYP3A4. These medications include the following CYP3A4 inhibitors and inducers:
ErythromycinKetoconazoleRitonavirRifampinCarbamazepinePhenytoin
Using, changing the dosage, or stopping these drugs can cause dangerous changes to the amount of hydrocodone in your system even if you are continuing with the same dose of Vicodin. Overdosing on the acetaminophen in the Vicodin tablet is also a potential risk. To avoid liver damage, the National Institutes of Health (NIH) recommends that adults should not exceed 3,000 mg of acetaminophen a day. If you drink alcohol, there is an even greater risk of harm to your liver. The NIH also states that an overdose and possible death can occur when taking 7,000 mg or more of acetaminophen. Many over-the-counter (OTC) products and prescription remedies contain acetaminophen, such as Tylenol. The amounts from various pills can easily add up, setting the stage for serious liver damage.
How Long Vicodin Stays Your System
A dose of Vicodin usually provides pain relief for 4 to 6 hours. This is due to both of the active ingredients—acetaminophen and hydrocodone. Your Vicodin dosage schedule is designed so the blood levels of these two drugs are constant enough to provide continuous pain relief as the body breaks down and eliminates them. The acetaminophen in Vicodin has a half-life in the blood of 1.25 to 3 hours, depending on whether a person has optimal or poor liver function. Most of it will pass out through the urine in 24 hours. Half of the dose of hydrocodone is deactivated after 4 hours in your system, and it can be detected in the urine for up to 4 days.
Withdrawal Symptoms
Vicodin can produce withdrawal symptoms if you have been taking it for several weeks and suddenly stop. These symptoms can include:
AnxietyInsomniaMuscle achesNauseaDiarrhea
The effects of withdrawal from short-acting opioids like hydrocodone usually take effect within 8 to 24 hours of your last dose. Work with your doctor to avoid withdrawal symptoms, such as tapering off the medication slowly or taking it for a shorter duration.
Drug Testing
While you are taking Vicodin, it is likely that you would test positive for opiates on a urine drug screening test for 2 to 4 days and a saliva drug test for 12 to 36 hours. A hair follicle test may show Vicodin use for up to 90 days, although such tests are uncommon. If you must take a drug screening test for employment, be sure to disclose your medications to the testing laboratory so they can interpret your test accurately.
Signs of an Overdose
Due to the potentially dangerous results of drug interactions or overtaking (intentionally or not) Vicodin, an overdose is a possibility to be aware of. The following are some of the symptoms that indicate a Vicodin overdose:
Difficulty breathingSlowed or stopped breathingExcessive sleepinessSpasms of the stomach or intestinal tractDizzinessFaintingLimp or weak musclesLiver damage from acetaminophenNarrowing or widening of the pupilsCold, clammy skinSeizuresSlowed heartbeatBlueish color of fingernails and lipsLoss of consciousness or coma
If you suspect you or someone else is suffering from a Vicodin overdose, call 9-1-1 immediately. If caught early enough, the overdose can be reversed with a treatment of Narcan (naloxone).
A Word From Verywell
While Vicodin is an effective painkiller that can help those recovering from injury or surgery, it also carries with it a number of harmful or deadly risks when not taken appropriately. The euphoric high some people get while taking the medication and its addictive properties also make addiction a danger as well. For more mental health resources, see our National Helpline Database. Always follow your physician’s orders while taking Vicodin and avoid any contraindicated medications or alcohol. Talk to your doctor if you have any concerns.
