How Long Does Lortab Stay in Your System?

Lortab in Your Blood, Urine, Hair, & Saliva

Older man taking a whit pill

Mladen Zivkovic / Getty Images

Lortab is a combination drug prescribed to relieve moderate to severe pain. It combines the opiate hydrocodone with acetaminophen (Lortab) or with aspirin (Lortab ASA). Similar hydrocodone-acetaminophen combination products include Anexsia, Anolor DH, Lorcet, Norco, Vicodin, and Zydone. The main difference between these medications is the amounts of hydrocodone and acetaminophen contained in one dose.

Combination drugs with less than 15 milligrams of hydrocodone per tablet like Lortab are classified as Schedule II drugs, meaning they are considered to have a high potential for misuse, with use potentially leading to severe psychological or physical dependence.

While this medication is in your system, you are at risk for drug interactions and overdoses. Knowing how long Lortab is present in the body can help you understand and avoid these risks.

How Long Does Lortab Stay in Your System?

Blood: Up to 24 hours

Urine: Up to three days

Saliva: Up to three days

Hair: Up to 90 days

How Long Does It Take to Feel Effects?

Lortab is taken as an oral tablet, so the drug must first pass through the digestive system before it takes effect. The acetaminophen component of Lortab is absorbed rapidly from the gastrointestinal tract and start having pain-relieving effects within 30 minutes. The hydrocodone in Lortab acts more slowly, but usually begins working within 30 to 60 minutes of ingestion.

The package insert for Lortab suggests that following a 10mg oral dose, the hydrocodone component reaches peak blood concentration levels 1.3 hours after ingestion.

The pain-relieving effects usually last between four and six hours.

How Long Does Lortab Last?

Determining exactly how long Lortab is active or detectable in the body depends on many variables. The acetaminophen in Lortab has a half-life in the blood of about one and a quarter to three hours. This is the time in which half of it is no longer acting in your system. The exact half-life can vary depending on a number of factors, including how well your liver function.

Hydrocodone is processed by the liver and broken down into metabolites including hydromorphone and dihydrocodeine. Approximately 85% of a single dose is eliminated through urine within 24 hours.

Hydrocodone has a half-life of about four hours; it takes five to six half-lives to eliminate most of the drug from your system. That said, hydrocodone can be detected in the urine for up to three days.

If you take a urine drug screen while you are taking Lortab, it is likely to test positive for opiates. Be sure to disclose your medications to the testing laboratory so they can interpret your test accurately.

Urine

Lortab will show up on the standard drug screenings that are commonly administered in employment, forensic, and medical settings. It is detectable by urine tests for up to three days after last use, although individual detection windows can vary depending on factors including metabolism and frequency of use.

Blood

Blood tests are used less frequently than urine screenings. While the detection windows are much shorter, blood tests may be used in some cases to help confirm an unexpected positive result on a urine test. Blood tests can usually only detect the presence of hydrocodone for up to 24 hours after the last dose.

Saliva

Hydrocodone is detectable in oral fluid for up to three days after the last dose of Lortab. Like urine tests, saliva tests are fairly non-invasive and inexpensive to administer. However, Lortab can also cause side effects such as dry mouth, which can impact the ability to collect an adequate sample.

Hair

As with other substances, the hydrocodone component of Lortab is detectable through a hair follicle test for as long as 90 days. Hair tests are not normally part of a standard drug screen but may be used in some cases to evaluate past drug use.

False Positive Testing

While a useful, simple, and inexpensive tool, immunoassay urine drug screens can return false-positive results. Quinolone antibiotics such as levofloxacin and ofloxacin can cause a false-positive opiate screening.

The consumption of poppy seeds can cause a false positive test result for opiates. While only present in trace amounts, poppy seeds do contain enough codeine and morphine to show up on enzyme immunoassay (EIA) tests that are often used in workplace and medical drug screenings.

Certain medications, including allergy drugs containing diphenhydramine and doxylamine, can also produce false positives for opiates. Tell the testing lab about any medications that you are currently taking or if you have consumed poppy seeds in any form so that they are able to accurately interpret your test results.

Factors That Affect Detection Time

It is important to remember that the above detection windows are just estimates. There are a number of different variables that can influence how long Lortab will remain in your system.

Age

The prescribing information for Lortab suggests that there is not enough research on whether the drug affects the elderly differently. However, since the drug is excreted primarily by the kidneys and because older adults are more likely to have decreased renal function, this may mean that the drug stays in an older person's system for a longer period of time. 

Metabolism

Overall metabolism plays a critical role in determining how long a substance remains in the body. People with faster metabolisms tend to process substances more quickly, while those with slower metabolisms may have slower clearance rates.

Fluid Intake

Because Lortab is excreted primarily by the kidneys, the amount of fluid you take in can impact how quickly the drug is flushed out of your body. It can also impact how detectable substances are by diluting the amount that is in your urine.

Liver and Kidney Function

Hydrocodone and acetaminophen are both processed by the liver and excreted by the kidneys, so decreased hepatic or renal function can extend how long these substances remain in your system.

Dosage and Duration of Use

The amount of Lortab you are taking and how long you have been taking it also plays a major role in how long it can be detected in your body. It takes longer for higher doses to clear your system. If you have been taking Lortab for a while, it may build up in the tissues of your body, making it detectable for a longer period of time.

Other Medications and Substances

Alcohol and other substances can interact with hydrocodone and acetaminophen in Lortab and extend the detection time of these substances. Because your body may be trying to process multiple substances at the same time, it can slow down your body's ability to effectively metabolize and excrete each substance. In particular, drugs that affect the pathway cytochrome P450 3A (CYP3A) make it more difficult for your body to process and clear hydrocodone.

How to Get Lortab Out of Your System

There are some reasons why you might want to get Lortab out of your system more quickly, such as if you are planning to switch to different medications or taking another medication containing acetaminophen or hydrocodone. Making sure that you are well hydrated, eating a healthy diet, and getting regular exercise may help improve your body's ability to metabolize and eliminate your medications more efficiently. 

The first step to eliminating Lortab from your system is to stop taking it, but you should always talk to your doctor before you take this step. 

Symptoms of Overdose

One reason that it is important to know how long Lortab remains in the system is its potential to interact with other drugs. If the pain-killing effects of Lortab wear off, but the drug is still in the system, an overdose is possible if you take more of the drug or another drug containing the same ingredients too soon.

The following are some of the symptoms that can occur with a Lortab overdose:

  • Difficulty breathing
  • Slowed or stopped breathing
  • Excessive sleepiness
  • Spasms of the stomach or intestinal tract
  • Dizziness
  • Fainting
  • Limp or weak muscles
  • Liver failure
  • Narrowing or widening of the pupils
  • Cold, clammy skin
  • Seizures
  • Slow or stopped heartbeat
  • Stomach and intestinal spasms
  • Blue color of skin, fingernails, lips
  • Loss of consciousness or coma

If You Suspect an Overdose

Seek immediate medical help. Do not make the person vomit unless specifically told to do so by poison control (1-800-222-1222), a health care professional, or 911.

It would be helpful to provide the following information if you can. Don't delay in calling for help to gather it, however:

  • The person's age, weight, and health condition(s)
  • Name of the product taken (ingredients and strength, if known)
  • The time it was swallowed
  • Amount swallowed
  • If the medication was prescribed for the patient

Overdose Treatment

If someone experiencing a suspected Lortab overdose is taken to the emergency room, their vital signs—including temperature, pulse, breathing rate, and blood pressure—will be monitored closely and their symptoms treated as appropriate.

How well the overdose victim recovers will depend on how much of the drug they took and how quickly treatment was administered. The sooner they receive medical help, the better the prognosis.

Risk of Drug Interactions

Taking Lortab carries the risk of dangerous interactions with a number of different substances including alcohol and other prescription and over-the-counter (OTC) drugs. You must not drink alcohol, take any medication containing alcohol, or use street drugs while you are taking Lortab or you risk life-threatening reactions.

You should carefully review the list of the non-prescription and prescription drugs that you take (preferably with your doctor or pharmacist) to look for acetaminophen or paracetamol on the label.

Interactions With Hydrocodone

Some medications can interact with the hydrocodone in Lortab to produce breathing problems, sedation, or coma. You should avoid benzodiazepines, including Xanax (alprazolam), Librium (chlordiazepoxide), Klonopin (clonazepam), Diastat (diazepam), Valium (diazepam), Ativan (lorazepam), Restoril (temazepam), Halcion (triazolam), and others. Muscle relaxants, sedatives, sleeping pills, tranquilizers, and medicines for mental illness or nausea are also some of the drugs that interact with hydrocodone.

Interactions With Other Acetaminophen-Containing Drugs

While acetaminophen is found in over-the-counter products like Tylenol and some OTC cold and flu preparations, it has a narrow safety range. If you take more than 4000 milligrams in a day, you risk irreversible liver damage and even death. Often, people who have experienced this type of liver injury report that they didn't realize how much acetaminophen they were getting in aggregate from a variety of over-the-counter and prescription drugs.

Combination drugs like Lortab are now limited to no more than 325mg of acetaminophen per tablet, capsule, or dosage unit to help prevent a dangerous overdose, but you should still take care to avoid any other medications containing acetaminophen while taking Lortab.

Getting Help

Taking Lortab can lead to physical dependence, even if you take your medication as directed. When your body becomes dependent on a drug, you need to continue taking it in order to avoid experiencing unpleasant withdrawal symptoms. Always talk to your doctor if you want to decrease your dose or stop taking Lortab.

  • Runny nose
  • Muscle aches
  • Fatigue
  • Chills
  • Sweating
  • Vomiting
  • Diarrhea

These symptoms can feel like having the flu and usually lasts for about five to seven days. When stopping Lortab, your doctor may want to gradually reduce your dose, a process known as tapering, in order to minimize these symptoms. 

If you think you may be dependent or addicted to Lortab or other opioid medications, talk to your doctor about your treatment options. Your doctor can help you stop taking your medication safely, manage your withdrawal symptoms, and find other pain relief options. Inpatient and outpatient services are also available that can help support your long-term recovery.

If you need help finding treatment services in your area, reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357 or try their online treatment locator.

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Article Sources

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  1. U.S. National Library of Medicine. Label: Lortab-hydrocodone bitartrate and acetaminophen tablet. Daily Med; 2018.

  2. Activis Pharma, Inc. Hydrocodone bitartate and acetaminophen. Updated December 2016.

  3. Food and Drug Administration. Hydrocodone bitartrate 2.5 mg and acetaminophen 325 mg tablets USP. Updated August 2014.

  4. Keary CJ, Wang Y, Moran JR, Zayas LV, Stern TA. Toxicologic testing for opiates: understanding false-positive and false-negative test resultsPrim Care Companion CNS Disord. 2012;14(4):PCC.12f01371. doi:10.4088/PCC.12f01371

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