Opioids Hydrocodone metabolizing into hydromorphone

I'm on probation and take monthly drug tests. I am prescribed hydrocodone for severe pain and take the regularly. My PO has said that my drug tests has shown positive for hydrocodone and hydromorphone everytime. I've never taken hydromorphone. I do understand somewhat that hydrocodone does metabolize into hydromorphone.

My main question is:
Does hydrocodone metabolize into hydromorphone automatically or is there a certain amount and length of time taking hydrocodone in order for it to change into hydromorphone?

Sorry for my ignorance on this topic. My PO scares the shit out of me.

Thanks

bump

Google it , it'll become clear , most drs don't understand that some shit metabolizes different I different people

Cliffy78 said:

Google it , it'll become clear , most drs don't understand that some shit metabolizes different I different people

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I've googled it but can't find the answer on how long you have been taking hydrocodone for it to metabolize into hydromorphone. I know it depends on body type amongst various factors. But is there an estimate?

Yeah it does, but not sure how long it takes to convert. I think it happens very soon after depending on the persons metabolism.

Why does it matter?

I think gonna have a hard time finding an answer cuz there isn't one lol. If I had to guess I'd say as soon as its metabolized, like within a couple hours or so.

The answer is as fast as your liver can metabolize it..

Does your liver automatically metabolize hydrocodone into hydrmorphone when ingested? Or does it take a significant period of taking hydrocodone for it to finally metabolizee into hydromorphone?

My PO keeps saying I test positive for both, even though I haven't taken hydromorphone and I need to know how much hydrocodone it takes in order for the body to start metabolizing it into hydromorphone. Thanks for the input guys.

This is a borderline drug testing thread but anyways read this http://jat.oxfordjournals.org/content/36/4/257.full

If you can't understand that paper then there's nothing I can say to help you.

It seems 5%-6% converts. It's in the intro.... Very good read. I'm assuming one can aim to induce/inhibit certain enzymes to promote/prevent hydromorphone from being created. Thank you for the informative link post!

I was prescribed Valium before & when I was tested, my doctor said I tested positive for both Valium & Oxazepam & I got onto my phone & googled it & it showed thst valium metabolizes into Oxazepam & i showed my doctor & he was like, oh yeah, I knew that......lol!

I think he did know it but maybe he was testing me with the questions.........

Hydrocodone is metabolized into hydromorphone by the enzyme cyp2d6. There's a lot of variation in the expression of this enzyme in different people: some people are cyp2d6-deficient, and some people are cyp2d6 ultra rapid merabolizers.

Some hydrocodone will metabolize into hydromorphone in all people, but if you're producing an abnormal amount, that means that you're probably a cyp2d6 ultra rapid metabolizer.

This isn't your fault, and you can tell your PO this. However, you can also inhibit the function of cyp2d6 with quite a few commonly-available items, including grapefruit juice.

Either way, it's important that you are very aware of this differerence. Hydromorphone is dilaudid. Also, codeine is metabolized into morphine by cyp2d6. It's very possible that a prescribed dosage of an opiate could kill you through respiratory depression if more of it is being metabolized into an active metabolite than doctors are expecting.

Please take care,
InterestingFACT

I read on drug-forum that the inhibition of that enzyme was believed to be a myth. I gathered this note from it, but I'll look for the link and edit it in.

CYP3A inhibition
Prevents conversion into inactive counterpart leaving more available to convert. Less codeine to norcodeine

Edit: here's reference http://www.drugs-forum.com/forum/showthread.php?t=32404

tacodude said:

I read on drug-forum that the inhibition of that enzyme was believed to be a myth. I gathered this note from it, but I'll look for the link and edit it in.

CYP3A inhibition
Prevents conversion into inactive counterpart leaving more available to convert. Less codeine to norcodeine

Edit: here's reference http://www.drugs-forum.com/forum/showthread.php?t=32404

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I shouldn't have mentioned grapefruit juice because there's debate about that. But it's proposed mechanism was through cyp3a4 inhibition and therefore cyp2d6 induction. I believe it inhibits both 3a4 AND 2d6, which is why it doesn't have a significant potentiating effect--though I don't have a source offhand so don't take my word for it.

In any case, other food items believed to be 2d6 inhibitors include garlic. Also, SSRIs such as prozac and I believe some of the tricyclics also bind heavily to 2d6.

You seem to know more than me I just learned this todau :D Didn't know it was a whole debate. I did find that article looking into 2d6 induction and seeing someone suggest Valerian, st johns wort, and something else.... I couldn't stand the way I felt after a couple weeks of a st johns wort and cannabis tincture and actually ended up tossing it once I noticed that effect. Just throwing it out as a stronger effect isn't always worth the trade off.

tacodude said:

You seem to know more than me I just learned this todau :D Didn't know it was a whole debate. I did find that article looking into 2d6 induction and seeing someone suggest Valerian, st johns wort, and something else.... I couldn't stand the way I felt after a couple weeks of a st johns wort and cannabis tincture and actually ended up tossing it once I noticed that effect. Just throwing it out as a stronger effect isn't always worth the trade off.

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I only know what I've read--not that much.

In any case, my point was that some people have an extra copy of the gene that codes 2d6, and those people get a stronger effect from opiates. I don't think playing with cytochrome enzymes is really worth it for trying to potentiates anything, but I was throwing that option out there as a possibility to reduce the hydromorphone in the OPs system.

I share that same philosophy except I never know, but only understand. I was pointing out both possibilities although I completely agree that there's no reason to play with enzymes like that.

I take oxycodone and I only get the bigboy gc/ms test, every single time I test positive for oxymorphone and oxycodone, my dr explained that this is a common thing as oxy codone metabalizes as oxymorphone. Google again good luck btw

tacodude said:

You seem to know more than me I just learned this todau :D Didn't know it was a whole debate. I did find that article looking into 2d6 induction and seeing someone suggest Valerian, st johns wort, and something else.... I couldn't stand the way I felt after a couple weeks of a st johns wort and cannabis tincture and actually ended up tossing it once I noticed that effect. Just throwing it out as a stronger effect isn't always worth the trade off.

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It's not a debate, you're right; at least with hydrocodone, 2d6 deficiency has little effect. 3a4 inhibition reduces metabolism, increasing hydrocodone plasma levels, blah blah blah.

WGJ potentiates hydrocodone at large doses, but, around 50% of hydrocodone metabolism is via non-P450 mechanisms(reliable phase 2 metabolism) and, anecdotally, the effect of inhibitors on hydro isn't as drastic as with other opioids that are P450 substrates.

However, it is true that ultra-rapid metabolizers could have a more dramatic effect, though with a shorter duration.

I realize this was posted a while back but I will put my 2¢ in anyways. When you take a hydrocodone pill (Vicodin, norco, lortab, etc) your liver metabolizes part of it into the more active metabolite hydromorphone. That is good that you have both in your system. I to am prescribed hydrocodone and when I am tested at my doctor they check for both. If I didn't have any hydromorphone in my system it would mean that I'm not taking it like I am supposed to (selling it or whatever) I just took a pill before the test to pass it. That's what hydromorphone is, the active metabolite of hydrocodone. Have a problem with my cyp2d6 enzyme but I'm not a rapid metabolizer. My body doesn't metabolize as much hydromorphone as it should. Therefore I need much stronger doses that the average person. Hydromorphone and oxymorphone (duladid, opana) both were created for people like me who can't metabolize hydrocodone and oxycodone it's just a pill that's already metabolized so your body doesn't have to do it. Morphine is the same way to an extent. Codiene metabolizes into morphine. If your PO tries to get you in trouble for having hydromorphone don't let him take that shit to court if you have to. I am not a doctor but all of this information has come straight from my doctor or in the genetic testing papers given to me by my doctor explaining my condition. Hope this helps. Best of luck.