Codeine Potentiation - Answers wanted once and for all? Please read and contribute..

[pally pete]

I know what you are thinking.... either.. This question has been asked and answered a million times/it should belong in 'The Opiate Potentiation MegaThread'

But as we all know, the Megathreads are many pages long, and often questions/answers get overlooked/ignored/not answered. Also, specific questions often have multiple answers that contradict each other.

So after much searching using Google etc... and being brought back and forth to the usual drug forums and not having my answer(s) specifically answered without contradiction, I have one simple(ish???) Question -

Below I have copy 'n' pasted one of my posts from this thread - http://www.bluelight.org/vb/threads/815584-Codeine-tolerance-sucks

" As for potentiators... Well all I ever read is just pure contradiction! Cytochrome P450 has an awful lot to answer for??? Is it better to inhibit or induce CP3A4..?? Same goes for CYP2D6.. Induce or inhibit? If so, when? Before consumption of said Opiate? After consumption? Taken with/at the same time? I know Codeine has slightly different rules to follow compared to most the other Opiates...

But please somebody clear it up once and for all.................? I know there are countless potentiation threads and Megathreads. But these just add to the confusion 8(

Thanks. Somebody.... "

 

[fermonos]

'I know there are countless potentiation threads and Megathreads. But these just add to the confusion'

So you make another one to add more confusion. Nice.

Anyway, I would just say have a glance through google and try what you read and see what is best for you.

 

[pally pete]

'I know there are countless potentiation threads and Megathreads. But these just add to the confusion'

So you make another one to add more confusion. Nice.

Anyway, I would just say have a glance through google and try what you read and see what is best for you.

I was going to reply with an equally pointless and sarcastic comment but...

The rest of what I've written still stands.


" As for potentiators... Well all I ever read is just pure contradiction! Cytochrome P450 has an awful lot to answer for??? Is it better to inhibit or induce CP3A4..?? Same goes for CYP2D6.. Induce or inhibit? If so, when? Before consumption of said Opiate? After consumption? Taken with/at the same time? I know Codeine has slightly different rules to follow compared to most the other Opiates...

 

[Kittycat5]

You would want to induce 2D6 to convert codeine to morphine as morphines affinty for MOR is vastly higher than codeine or norcodeine, the metabolite formed from 3A4.

https://www.pharmgkb.org/pathway/PA146123006

As far as the above comment, it was slightly out of line, but not the worst. I dont think the poster meant all that much harm, but if it escalated, I will deal with it.

 

[swilow]

I think 2D6 inducers can also speed up metabolism of morphine though. Is this correct?

Fwiw, I've used a fuckload of codeine and morphine and I don't think they are the same.

 

[Kittycat5]

No, morphine does not undergo metabolism via CYP enzymes to any appreciable degree, rather glucoronidation (phase II metabolism) handles it. Of course drugs can hit multiple targets and be acted upon by multiple enzymes but afaik, there arent many classic pharmacokinetic interactions that speed or slow the breakdown of morphine.