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Subutex Abuse and Addiction

How Long Does Lortab Stay in Your System?

Lortab is the brand name given to a medicine composed of two active ingredients, one is a synthetic opioid and other is a non-synthetic analgesic. Hydrocodone bitartrate is the opioid component and Acetaminophen is the non-opioid component. Lortab is prescribed for managing the pain of moderate to severe intensity. Hydrocodone functions by binding to the opioid receptors (mu-opioid receptor) in the central nervous system. The effects are initiated by the release of neurotransmitters like dopamine, acetylcholine, GABA, substance P, and norepinephrine. Mood enhancement, euphoria, reduced anxiety, and feelings of relaxation are some of the effects generated by the action of Lortab. The drug is not considered as favorable for the long-term treatment. It is associated with many adverse effects such as dependence, impaired vigilance, and addiction. The drug continues to produce harmful effects as long as it stays in the system.

How long does Lortab stay in your system?

The disuse of Lortab is associated with many agonizing symptoms. Additionally, there is a high likelihood that the adverse effects of the drug intake continue for a much longer duration after the last dose. The combination of lingering symptoms and discontinuation effects make a person question as for how long the body will take to get completely rid of the drug. For this, it is important to understand the half-life of the drug.

The half-life of Lortab is about 3.8 hours +/- 18 minutes. It means that the whole drug will take about 21 hours to get out of the system. However, many other sources have reported the half-life of about 3-9 hours. If the half-life falls towards the end of this range, that is 9 hours, so Lortab will take about 2 days to clear from the system. Lortab also has another component, acetaminophen. The half-life of acetaminophen is about 1-4 hours. Within 22 hours, acetaminophen component will get out of the system. Acetaminophen has a faster metabolism than Hydrocodone component of Lortab. Hydrocodone breaks down into various metabolites like Hydromorphone and Norhydrocodone, which can take up to 2 days or 48 hours.

Factors that influence how long Lortab stays in your system:

The clearance of drug from the body is subjected to a number of variations. Variables that cause such discrepancies include individual factors, co-administration of drugs, doses, frequency, and duration of drug abuse.

Individual Factors:

Theoretically, two individuals consuming a same dose of drug will eliminate it at different intervals. This is as a result of following factors.

  • Age:The elderly people have a diminished clearance rate as a result of reduced hepatic and renal function, and an overall poor physiologic health of the body.
  • Body size and fat content:A larger body size is associated with a faster metabolism in comparison to a smaller body size. Lortab is a hydrophilic compound, which means it doesn’t accumulate in the fat tissues. Moreover, individuals with high-fat content tend to eliminate the drug more quickly.
  • Genetics:Some of the individuals have a genetic makeup that facilities the faster metabolism of Lortab. This is due to a set of efficient enzymes that tend to speed-up the rate of metabolism. On the other hand are the poor-metabolizes that require more time to metabolize the drug.
  • Glutathione levels:NAPQ1 is a toxic metabolite of Acetaminophen. It gets detoxified by conjugation with Glutathione. So it is speculated that individuals having higher levels of Glutathione can excrete Acetaminophen at faster rates.
  • Hepatic and renal functions: These are the two major organs involved in metabolism and excretion of Lortab. Any degree of impairment will affect these processes. People with liver cirrhosis have reported a much-delayed excretion of the drug. Any kidney dysfunction will lead to an accumulation of drug and thus, a slower excretion process.

Co-administration of drug:

There are many drugs that can interfere with the metabolism of Lortab due to same set of enzymes acting on them. Codeine, Amiodarone, Citalopram, Yohimbine, Sertindole, Perphenazine, Paroxetine, Methadone, Fluoxetine, and Delavirdine act as the inhibitors and slow-down the speed of Lortab metabolism. On the other hand, if an inducer medicine is administered, it will augment the rate of hepatic metabolism.

Frequency of use and duration:

The higher frequency and prolonged duration of use lead to a much slower clearance of the drug from the body. It happens due to multiple factors like a heavy concentration of enzymes needed for metabolism and excretion of high amounts of Lortab and its metabolites.

Lortab absorption, metabolism, and excretion

Following the oral ingestion of Lortab, Hydrocodone component gets efficiently absorbed from the gastrointestinal lining. When a 10 mg dose is administered, peak levels of Lortab are reached within 1.3 hours. About 19% – 45 % of Lortab gets bound with the plasma proteins.

After getting absorbed, a number of hepatic isoenzymes act on the drug to form various metabolites. The O-demethylation of the Hydrocodone component occurs to produce Hydromorphone. Another enzyme causes the oxidation via the N-demethylation to produce Norhydrocodone. Additional metabolites that are formed include 6-beta Hydrocodol and 6-alpha Hydrocodol.

The hepatic enzymes act on the Acetaminophen component to convert it into Acetaminophen sulfate and Acetaminophen Glucuronide through the process of Sulfation and Glucuronidation. A small percentage of a metabolite NAPQ1 is also formed and some of the drug is excreted in an unchanged form.

Approximately 90% of Acetaminophen gets excreted in the urine. The APAP-sulfates and APAP-glucuronides are the excretory products of Acetaminophen. In the case of Hydrocodone, 6 to 20% is excreted as unchanged Hydrocodone, 2 to 14% as Norhydrocodone, and 5 to 6% as Hydromorphone. Some of the other metabolites of Hydrocodone that appear in urine include isodihydrocodeine, dihydrocodeine, isodihydromorphone, and dihydromorphone. The Hydromorphone metabolite eliminates faster than its parent chemical. Females have a better demonstration of Hydrocodone metabolites in their urine samples as compared to males.

Different types of Lortab drug tests:

There are many tests that can be utilized to detect Lortab in the body. Most common include urine tests, blood tests, hair tests, and salivary analysis. Salivary tests are becoming more popular nowadays although urine tests are more in routine use due to a longer window of detection of metabolites.

  • Urine Tests:

For the urine tests, samples of fresh urine are collected and sent to the laboratory. As the Lortab components are excreted in the urine so they remain detectable for longer durations. Hydrocodone remains identifiable in urine samples for about 48 hours. The metabolites of Hydrocodone like Norhydrocodone remain detectable for even longer, about 4 days. More Norhydrocodone is formed in women as compared to men due to a variation in an action of hepatic enzymes.

  • Hair Tests:

This is another reliable method for detection of Lortab. Hair follicles are collected from the scalp of a person. Hydrocodone remains identifiable for about 3 months after the last dose. The large window of detection is provided by hair samples. The precise amount of drug can be analyzed with the help of ELISA (enzyme linked immunosorbent assays) and GC/MS (gas chromatography/mass spectrometry). The results of hair testing are accurate and correlate with the ingested amounts of Lortab. Moreover, they are capable of detecting even minute quantities, up to picograms per milligram.

  • Saliva Tests:

Oral samples are analyzed by High-performance liquid chromatography (HPLC). Saliva tests are more feasible and convenient in comparison to other modalities. However, these tests are not relied upon solely due to a shorter window of detection. Even in the long-term users, the drug components don’t remain recognizable on the 4th day of last ingestion. The detestability stays strongest on the first day of ingestion. The oral fluid will contain Norhydrocodone and Hydrocodone in the users of Lortab.

  • Blood Tests:

This modality of testing is mostly used in the hospitalized patients. Blood samples can accurately determine the levels of drug. It is a most useful test in case of intoxication or overdose. The drug becomes readily detectable within an hour and stays detectable for up to 24 hours. Due to a shorter window of detection and invasiveness, they are mostly employed in hospital settings and for research purposes.

Tips to clear Lortab from the system faster:

There are many ways that can expedite the excretion of Lortab. However, their medical safety has not been determined accurately and should be implemented after the doctor’s consultation.

  • The first step is to refrain from the use of drug and completely stop the usage of Lortab.
  • The use of activated charcoal doesn’t allow the drug accumulation in the body by preventing its absorption.
  • Calcium-D-Glucarate aids the kidneys to eliminate the toxins rapidly from the body.
  • Glutathione is an important supplement to convert NAPQ1 to less toxic metabolites. In the absence of normal Glutathione levels, accumulation of NAPQ1 can cause significant damage to the liver.
  • Acidification of urine is another useful method to enhance the excretion of Lortab.