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Cocaine

Follow one dose of cocaine from the moment it enters the body until the last of it leaves.

CocaineactiveBenzoylecgonineinactive, via esterasesNorcocainevia CYP3A4+ alcohol: cocaethyleneactive, longer-lastingUrinekidney

The clock, on a log scale

Each bar runs from the dose to about five half-lives, roughly when 97% of that molecule has been converted or cleared. The scale is logarithmic so minutes and days fit on one line.

  1. secondsonset

    Dose enters the body

    smoked/IV: secondssnorted: ~5 min

    Onset ranges from seconds to minutes. Snorted cocaine narrows the blood vessels in the nose, which delays its effects by about five minutes.1 About 60–80% of a snorted dose is absorbed.1

  2. minutesblood and liver

    Cocaine → benzoylecgonine

    hCE-1 (liver)hCE-2 (liver)pseudocholinesterase (blood)benzoylecgonine is inactive

    Pseudocholinesterase in the blood and two liver carboxylesterases quickly break cocaine's ester bonds.2 Benzoylecgonine is made in the liver by carboxylesterases and is pharmacologically inactive.3 CYP3A4 makes a smaller amount of norcocaine.1

    Drug tests: benzoylecgonine is what most cocaine urine screens look for.3 Wikipedia marks this "citation needed"
  3. ~1 hcocaine half-life

    Half the cocaine is gone

    half-life 0.7–1.5 heffects 20–90 min

    Cocaine's half-life is about 0.7–1.5 hours, and effects last 20–90 minutes. They last longest when snorted, at 60–90 minutes.1

    Redosing: the effects end well before the drug and its metabolites are gone, which is why people redose. TripSit rates opioids with cocaine as Dangerous, since the stimulant can wear off before the opioid does.4
  4. with alcoholdetour

    Cocaine + alcohol → cocaethylene

    liver carboxylesterasecocaethylene is active

    When cocaine and alcohol are in the blood together, the liver enzyme that normally breaks cocaine down swaps part of it into cocaethylene instead.5 Cocaethylene lasts about 2 hours, against about 1 hour for cocaine.5

    Higher risk: the combination has been linked to an 18–25-fold higher risk of immediate death than cocaine alone. Much of the extra risk may come from alcohol slowing cocaine's breakdown.5 TripSit rates cocaine with alcohol as Unsafe.4
  5. daysexit

    Out through the kidneys

    kidney

    Cocaine and its metabolites leave through the kidneys.1

Sources

  1. Wikipedia, Cocaine (infobox and pharmacology), CC BY-SA
  2. Kamendulis LM et al. Metabolism of cocaine and heroin is catalyzed by the same human liver carboxylesterases. J Pharmacol Exp Ther 1996;279(2):713–7. PubMed 8930175
  3. Wikipedia, Benzoylecgonine, CC BY-SA
  4. TripSit combination chart (combos.json, read 2026-10-24)
  5. Wikipedia, Cocaethylene, CC BY-SA

Half-lives vary between people, doses and routes. This page explains what the body does with a drug. It is not dosing advice.