How Long Does Vicodin Stay in Your System?

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Vicodin is a powerful pain reliever for moderate to severe pain. It is a combination product that includes the opioid narcotic hydrocodone bitartrate along with the nonnarcotic pain reliever acetaminophen.

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 others
  • Muscle relaxants
  • Sedatives
  • Sleeping pills
  • Tranquilizers
  • Other 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:

  • Erythromycin
  • Ketoconazole
  • Ritonavir
  • Rifampin
  • Carbamazepine
  • Phenytoin

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.

Discuss all of your prescription, non-prescription, and over-the-counter medications, supplements, and vitamins with your doctor or pharmacist before taking this medication. It is important to review the drugs you are currently taking as well as any you will be adding or stopping.

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:

  • Anxiety
  • Insomnia
  • Muscle aches
  • Nausea
  • Diarrhea

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 breathing
  • Slowed or stopped breathing
  • Excessive sleepiness
  • Spasms of the stomach or intestinal tract
  • Dizziness
  • Fainting
  • Limp or weak muscles
  • Liver damage from acetaminophen
  • Narrowing or widening of the pupils
  • Cold, clammy skin
  • Seizures
  • Slowed heartbeat
  • Blueish color of fingernails and lips
  • Loss 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).

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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.

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.

9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. U.S. Drug Enforcement Association. Narcotics (Opioids).

  3. MedlinePlus. Hydrocodone and Acetaminophen Overdose. Updated October 8, 2020.

  4. MedlinePlus. Hydrocodone Combination Products. Updated September 28, 2019.

  5. MedlinePlus. Acetaminophen overdose. Updated October 8, 2020.

  6. Depriest AZ, Puet BL, Holt AC, Roberts A, Cone EJ. Metabolism and Disposition of Prescription Opioids: A Review. Forensic Sci Rev. 2015;27(2):115-145.

  7. American Addiction Centers. How Long Do Opiates Stay in Your System? Updated October 19, 2020.

  8. American Addiction Centers. Vicodin Withdrawal Timeline, Symptoms and Treatment. Updated April 17, 2020.

  9. Rzasa lynn R, Galinkin JL. Naloxone dosage for opioid reversal: current evidence and clinical implications. Ther Adv Drug Saf. 2018;9(1):63-88. doi:10.1177/2042098617744161

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.