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Taking Hydrocodone Regularly And It Is Not Detected In Urine And Blood Test. What's Causing This??

Posted on Sat, 23 Feb 2013

Question: I have been on hydrocodone APAP 5/325 for almost two years now and every time I go in for a drug screen to get my refill, the medicine does not show up in my urine. Doesn't matter if I take the pill two hours of 1/2 hour before, it still is not detected by the clinic's test. I have even gone as far as to have them test my blood and even that comes back negative. What is happening in my body that these tests are NOT picking up my medicine? HELP!!!

Answered by Dr. Ganesh Sanap (1 hour later)

Hi, welcome and thanks for writing in.
Hydrocodon is therapeutic drug with half life of 3 hours. It means half of dose get completely metabolised. The drug gets converted to active metabolites known as hydromorphone .
Hydrocodone may be quantitated in blood, plasma or urine to monitor for misuse, confirm a diagnosis of poisoning or assist in a medicolegal death investigation. Blood or plasma hydrocodone concentrations are typically in the 5-30 µg/L range in persons taking the drug therapeutically, 100-200 µg/L in abusers and 0.1-2.0 mg/L in cases of acute fatal overdosage.
It looks your dose is below that level so it is not getting detected yet.

Can you please explain exact reason why you want to get it detected in body fluids.?

Hope it will work for you. Looking forward for your response.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ganesh Sanap (1 hour later)

Because I am on a pain contract with my doctor which means I have to have a urinanalysis each time I go in for my refill and it has to show up on the drug screen. It has NOT been showing up and I am very frustrated as to why it hasn't been. I was told by my doctor that I could be metabolizing the medicine to quickly so I would wait at least a 1/2 hour before my appointment but it still doesn't show up. Yesterday (1/31/13) I had an hour in between the time I took my pill until I went in to take my urine test.

Answered by Dr. Ganesh Sanap (1 hour later)

Hi, welcome back.
There are two possibilities for such incidence. First one , your dose is less than level which is detected in blood. Second, you belong to ultra-rapid metabolizers group which is seen in up to 7% of Caucasians and up to 30% of Asian and African populations.
I think it is important that whether you are pain free or not on present drug schedule. If you are pain free then I think test is of low significance.
It will be better if you discuss this issue in detail with your treating doctor. It will clarify exact nature and course of management.

Hope I have answered your query. If you have further concern, please let me know.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar