Grapefruit Juice w/ Methadone....does it potentiate?

[rachamim18]

I am back...everybody clap...thank you...

O.K. You are confusing two issues...but it is a common error. While grapefruit juice does contain a substance that does potentiate opiate/opioid metabolisation it also contains vitamin c [in a big way] which unfortunately negates any of this potentiating effect in methadon usage by lowering [again in a big way] a user's methadone plasma level.

I do not have my notes with me as I am not at home but just did a cursory check via "Google" and came up with one bonafide that should satisfy you. The Addiction Treatment Forum mentions it in their journal. The one I just checked was the spring 97 issue but any reputable source on the substance will mention it.

I have tried to include a url for the above mentioned source but it did not fly. Simply do a search for "vitamin c effecting methadone plasma levels," etc.

 

[Paregoric Kid]

dammit, never thought of that. it's very misleading that people say it "potentiates" methadone. good thing I have tagamet handy

 

[rachamim18]

You are right...

You have it. The thing is, people usually latch onto one thing without considering the other possible consequences.

 

[Paregoric Kid]

I am reading that you'd need to be ingesting something like 4grams of vitamin c to decrease methadones effects and that it is decreased because it changes the ph. what if you took baking soda or something else to neutralize it?

 

[paradoxcycle]

Originally posted by RoboticOpiateMaster
No, it's tang.

tastes like sunny delight.

Tang IS sugar and food coloring.

 

[Technical User]

grapefruit juice and any drugs that have an effect on P450 cytochrome enzyme can either increase serum level or decrease serum levels so while being a potentiator or not: is this the best thing to do for daily MMT.

I am going to do more research on this, because I am quite interested in the tagament reply . I have been thinking about this for a couple weeks now..

I am thinking that if you load up on tagament say if you know you are going to miss a dose or say if your heroin dealer is going to be gone till the evening, that the effects on the enzyme would equal a way less painful sickness..

any info on that^^^

 

[twgburst]

I have taken xanax on methadone for almost 2 years now, it may shorten the effects in the long run, but who gets high off of methadone for 24 hours? If you take your dose and alprazolam your dose will kick in stronger and you will get high longer. Overall though, if methadone and xanax were such a bad combo I don't see how come almost half of the clinics i've gone to the people had street benzo habbits or used benzos on the weekends. I always thought that it varied from person to person, but I know I didn't notice any difference when I used xanax vs when I didn't prior to my habit except the meth made me nod for 2 hours.

 

[Paregoric Kid]

not to bump the thread again but here is something interesting and relevant:
Effects of grapefruit juice on the pharmacokinetics of the enantiomers of methadone.

Benmebarek M, Devaud C, Gex-Fabry M, Powell Golay K, Brogli C, Baumann P, Gravier B, Eap CB.

Service of Medicine and Penitentiary Psychiatry, University Department of Adult Psychiatry, Lausanne, Switzerland.

BACKGROUND AND OBJECTIVES: Cytochrome P450 (CYP) 3A4 is the main CYP isozyme involved in methadone metabolism. We investigated the influence of grapefruit juice, which contains inhibitors of intestinal CYP3A, on the steady-state pharmacokinetics of methadone. METHODS: For 5 days, 8 patients undergoing methadone maintenance treatment received 200 mL water or grapefruit juice 30 minutes before and again together with their daily dose of methadone. Blood sampling for R-, S-, and R,S-methadone plasma determination was performed over a 24-hour period. CYP3A activity was determined by measuring the plasma 1'-hydroxymidazolam/midazolam ratio. RESULTS: A decrease in the midazolam ratio was measured in all patients after grapefruit juice (mean +/- SD before grapefruit juice, 9.3 +/- 5.9; mean +/- SD after grapefruit juice, 3.9 +/- 1.2; P <.05). Grapefruit juice led to a mean 17% increase in the area under the curve extrapolated to 24 hours for both enantiomers of methadone (range, 3% to 29% [P <.005]; range, -4% to 37% [P <.05]; and range, 1% to 32% [P <.01]; for R-, S-, and R,S-methadone, respectively). A similar increase in peak level and decrease in apparent clearance were measured with grapefruit juice, whereas time to peak level, terminal half-life, and apparent volume during the terminal phase of R-, S-, and R,S-methadone were not affected by grapefruit juice. No symptom of overmedication was either detected by the clinical staff or reported by the patients. CONCLUSIONS: Grapefruit juice administration is associated with a modest increase in methadone bioavailability, which is not expected to endanger patients. However, it cannot be excluded that a much stronger effect may occur in some patients, and thus grapefruit juice intake is not recommended during methadone maintenance treatment, in particular in patients initiating such a treatment.

 

[RoboticOpiateMaster]

Originally posted by RoboticOpiateMaster
No, it's tang.

tastes like sunny delight.

Tang IS sugar and food coloring.

And Dr.Pepper is syrup and carbonated water, but wouldn't you ask for it by name rather then its contents?

 

[johnnyb420]

hydroxyzine seems to potentiate methadone for me also known as vistril, atarax i take 100mg per day with my methadone

 

[xxanxx]

I have never noticed grapefruit juice to potnentiate any opiate. It sure doesn't seem to take away from the high, but definitely doesn't increase effect or duration. I consume a fairly large amount of vitamin c/fruit juices and use methadone frequently(prescribed for pain), and have never noticed any effect either way....
Obviously, it varies from person to person. Interesting post paregoric, thanks...

 

[fastandbulbous]

The flavanoid naranjin that is present in grapefruit juice is an inhibitor of cytochrome 3A4, which according to the info posted by Paregoric Kid, is responsible for the metabolism of methadone to nor-methadone.

Against this is the fact that grapefruit juice (or any citrus fruit juice) contains relatively high levels of organic acids (it's not just vit C involved. In fact, that's a minor consideration as it's mostly present as the unionized form), such as citric and tartaric acid (and a few others). These encourage the equilibrium between methadone in its ionized and unionized form towards the ionized form (eg methadone citrate), and in the ionized state, the body excretes more of the methadone into the urine. You can increase the half life of methadone by the use of alkalinizing agents like sodium bicarbonate.

The equilibrium mentioned above is the principal behind forced acid diuresis, to clear the blood of a drug in cases of overdose.

As for which is of the greater importance in methadone's half life, cyp 3A4 vs increased acidic diuresis, you'd need a textbook on pharmacokinetics and a calculator to wrk out!

 

[iloveoxycontin]

check this out...

after a little searching on the web for different drugs that might potentiate opiates, methadone specifically, i found this on good ol' erowid....

"However, many people are unaware that both enhanced effectiveness of narcotic analgesics AND prevention or reversal of tolerance is readily achievable through the oral use of up to 200-250 mg of Proglumide [(DL)-4-Benzamido-N,N-dipropylglutaramic acid]. [See Ott 1999; Watkins et al. 1984]"

from http://www.erowid.org/chemicals/opiates/opiates_info3.shtml

I'd never heard of this Proglumide before, but this definitely sparks my interest. Let me know if any of you have any info on this, and please, dont post facts unless you have references.