Hydrocodone Levels Too High

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So i take hydrocodone 10/325 and have for a long time. I had my bi monthly apt and my doctor said my levels were way to high. He said i had to be getting more from somewhere. I told him i don't get extra from anywhere and i only take 3 a day. That's what i am prescribed. He did not tell me what the levels were but i am livid that he called me a liar. I take Baclofen 20 mg on top of that and a .5mg alprazolam. My fluid intake usually consists of only soda and coffee, but i have recently stopped almost all of the coffee. I was being honest my Dr. and i now get called a liar. What could be causing the high levels here?

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1

Hello, Kim! How are you?

If you have cut down on your fluid intake, your levels could be showing up higher due to dehydration. It can cause such a medication to become more concentrated in your urine sample. (NDC for more medication information 52544-539).

The FDA warns that it carries the risk of being habit forming and may cause side effects, such as nausea, dizziness, headache, constipation, and dry mouth.

How much fluid do you take in each day?

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Re: Verwon (# 1) Expand Referenced Message

Dont drink hardly anything and was only drinking soda. Have started drinking water and only drinking 2 bottles a day right now and im always tired to

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3

A lot of times these high readings can be due to other medications, whether they are OTC or prescribed. Certain medications can mess with the metabolism of other medications. This could make a particular medication build up in your system as it is not being metabolized fast enough. This could result in a higher than normal reading.

For example, grapefruit/grapefruit juice is known as a cytochrome P450 3A4 (CYP3A4) inhibitor. This is the same enzyme that breaks down xanax for example, among many other prescription drugs. There are many other drugs that inhibit CYP2D6/CYP3A4 as well; such as tagamet (cimetidine), clarithromycin, telithromycin, nefazodone, itraconazole, ketoconazole, atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir among many others.

Although only a small percentage of Baclofen is metabolized by the liver it could be enough to inhibit either liver enzymes CYP2D6/CYP3A4 just enough to cause a build up in your blood/plasma. However, I'm not a doctor or pharmacist but I have read a lot about drug/food interactions and how they can relate to how liver enzymes can increase or decrease the amount of a drug in your system.

Bottom line is that CYP2D6/CYP3A4 enzymes are the first line of metabolism against Hydrocodone. If you're taking anything that may inhibit these enzymes it could result in delayed clearance of hydrocodone from your system.

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4

You can get a copy of your medical records and read the lab report.

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5

BL (# 3) --

Ok im gonna try that. Thank you very much. Do i tell the Dr i need copies or who do i tell?

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6

Re: Kim (# 5) Expand Referenced Message

You can call your doctors office and ask to speak to the person in charge of medical records. They can charge you a fee for copying the records. Federal Law governing patients access to their medical records is at the link below.

Your Medical Records-
hhs.gov/hipaa/for-individuals/medical-records/index.html

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7

Re: BL (# 6) Expand Referenced Message

Ok. Thank you very much. I was very upset when he may as well told me i was a liar. His words were the only reason they are too high is because you have to be getting them from someone else :(

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