I've been taking extremely high doses of diclofenac (~800mg) with codeine every day

[Costa Rican]

I didn't bother to research it beforehand because what addict would. I can easily taper myself off of these, but how much damage have I realistically done to myself, especially knowing that I have a tolerance and I have rarely ever exceeded a daily dose of 800mg. And even on those days that has never been all at once; usually separated in doses of 400mg by 10-12 hours. I have spent literally days googling and the most I can find is that many people are prescribed 200mg a day and that over 150/200mg a day for sustained periods of time can cause a slight risk of heart attack.

Ironically, I take omeprazole for acid reflux (a problem I've had since before I started using the codeine/diclofenac combo) which apparently aids in diclofenac's ability to break down the stomach wall.

Can anyone point me towards anything definitive on this drug? Do I have permanent damage of any kind? I don't feel bad aside from the occasional stomach cramping if I miss a dose; otherwise, I feel fine normally. Basically they are 50mg/50mg codeine/diclofenac pills and I take 8 at a time typically knowing the liver's ceiling for codeine is ~400mg.

 

[Costa Rican]

I'm CT tonight. I can do it, I wasn't taking more than 400-800mg of codeine a day and I have a bunch of immodium and valium too which saved my ass when I was using H 7 years ago. Anyway, any responses are appreciated. Obviously I won't know how fucked I am permanently until I go to a doctor, which I cannot afford right now, but I'm hoping I can curb the damage through taking good care of myself. If anyone has ever done this and survived, I guess they'll respond with some tips. Anyone with medical training or access to docs to pose this question, I would greatly appreciate the help.

As of now, I've doubled my dose of omeprazole for the next 2-3 days (twice a day instead of once), am drinking my full body weight in fluid ounces of water to try and flush out my kidneys. Apparently this drug is hardest on the stomach lining and the kidneys.

 

[Kittycat5]

NSAIDs, besides doing real damage to GI mucosa have been shown to increase the risk for CV disease even in relatively small and short term doses. Please stop.

 

[Costa Rican]

Believe me. I'm done. I'm not even going to take a single more—to be honest, I'm in another country and I didn't even realize it was an NSAID. I feel like a dumbass for not researching it. I've stopped. Last dose was ~10 hours ago. Please pray for me, that I haven't done any long term damage and that I can get through this CT without too much trouble.

I used to use close to a g of heroin a day, so if I could CT that, I can CT this.

Any further medical advice would be welcome. I knew about CV; I'm actually more concerned that I've put myself at risk for acute renal failure in the near future.

 

[Costa Rican]

I am a pharmacist, not a physician. Good news is the cardio and nephrotoxic effects take time to develop but you are pushing your luck. A GI bleed is a real risk so keep taking that omeprazole. Get checked. Why did you take so much if you dont mind me asking? I mean I get junkie logic but NSAID logic? Lol. Sorry. I shouldnt make fun.

Kittycat5, it won't let me respond to your PM, it says I have to wait 3 hours so I figured I would respond here. I took it because they are 50 mg codeine pills bound with 50 mgs of diclofenac potassium, and I was chasing the codeine high. I haven't been able to get a connect for any other opiate down here. I didn't realize it was an NSAID when I started taking them, and I'm an idiot and didn't bother to look it up because I thought it was just potassium or something. I'm glad to hear I can recover from this with hopefully no long-term serious repercussions. If getting checked out by a doc is not an option, what should I be on the lookout for and what other drugs should I avoid for awhile other than obvious NSAIDs.

And yeah, you should make fun. I'm a complete dumbass. The spanish name for diclofenac is literally diclofenaco. It would've taken me 2 seconds to look up, but at first I wasn't concerned (only taking 3-4 at a time) and then I started to take more and the other day when I really noticed I had a habit of taking this stuff now for several months I decided to investigate more.

 

[Kittycat5]

Ah, I see. Well that makes more sense. Stay hydrated. Eat well. Exercise but not excessively. Any pain or dark stools or changes in urination, you need to be seen.

 

[Costa Rican]

Ah, I see. Well that makes more sense. Stay hydrated. Eat well. Exercise but not excessively. Any pain or dark stools or changes in urination, you need to be seen.

Will do. What changes in urination? Since doing my research today I've had about 3L of water and my pee is literally clear; not even tinted yellow. Good? The stools are going to be harder to manage; I have IBS and other bs from being a huge fat teenager (~300 lbs) and now I'm 160.

 

[Kittycat5]

Clear is good. I think a doctor visit still is in order but I understand if you cant.

 

[Costa Rican]

I'll go as soon as I'm able to. I'll be paying out of pocket; what kind of doc do you recommend I see or just a general physician. Also, I'm assuming tapering off of this is a bad idea as that involves more NSAIDs, and from what I see there is no way to CWE successfully. Can I take immodium for the W/Ds I'm sure to face at least over the next few days? Valium?

 

[Kittycat5]

Im a huge opponent of loperamide. Valium + opiates = danger as well. Taper. Quickly. Few days max.

 

[Costa Rican]

Will loperamide damage my GI tract more than the taper? Why are you a huge opponent? I was able to kick H only because of that so that's part of my curiosity. I think I can manage a taper from ~600, to ~400, to 200, to 100, to 50, then nothing.

Edited to add: or is that too slow? 600 to 300 to 150 to 50? And I could give a rat's ass about getting high right now; honestly the concern for my health is way more prevalent. Do you think taking the doses separated out will be better? Like the dya I take 300 try to start with 1 pill, then if that doesn't work 1 more?

 

[fermonos]

Codeine CT is nothing bro, don't sweat over it.

I've went from 300mg a day every day for months to literally nothing and worst I get is a killer fucking headache but some paracetamol fixes that. Sometimes get a horrible ache in my lower back but I'm not entirely sure that is linked to withdrawals. Anyway just don't worry about it, make sure to keep yourself busy and eat and drink a lot. After 3 days you'll be back to normal.

also taking anything over 300-400mg is pointless. It has a ceiling effect codeine, and usually needs at least 24 hours in between doses but I feel like 36 is best. Anyway don't worry haha codeine withdrawals are none-existent. The worst, at least for me is just thee craving to get high but like I said it all passes after 3 days you'll start to feel normal again completely.

About the NSAID I know a little about them but not enough to comfortably give you advice on them.


But the advice I would give is if you are quitting don't bother tapering just for codeine. You're better off just stopping completely especially since you are taking harmful medication with the codeine, tapering usually just makes you way more open to 'keep taking' smaller doses because it's not as bad as the higher doses and you are happy with not getting any negative withdrawals etc.

 

[Costa Rican]

I've went from 300mg a day every day for months to literally nothing

I'm taking ~800mg daily split into two doses, 1 AM and 1 PM. Hence the 50/50, hence the 800mg of diclofenac a day. That ceiling effect is true, but it does not need 24 hours, as I will tell you I've dosed 400mg at 8 AM and gotten high and 400mg at 8 PM and gotten high. The PM high is always a little more subdued. I still think I can do it CT—if I quit a g of heroin a day with just immodium I can do this CT or with a little MJ and valium.

ETA: I am now at 8:30 PM and missed my second dose; have taken nothing tonight (I took my 400/400 in the AM). I will see if I can take a valium, smoke a joint and just go to bed.

 

[fermonos]

Listen, 300mg and 800mg is no difference, it's stupid if anything and a waste. Maybe a longer high but you only have so much enzymes in your liver to produce the morphine from codeine. From my experience anyway, and what many others have said. I have tried 1.2g codeine split into two doses. 6 hours apart because someone posted it on here and I felt it was such a waste of drugs.

you aren't going to get any serious withdrawals from 800mg codeine daily. I was also doing 400mg twice daily of Tramadol for around 2 month posing a serious seizure risk I know but I also quit that stone dead after running out of Tramadol and again. No serious withdrawals, I just don't think you can get harsh withdrawals from such weak opiates. Just chill out dude, no point tapering or substituting other drugs in replace of another.


As for the 24 hours that's just my body, everyone else's is different. But whenever I do codeine 24 hours apart it feels really lacklustre compared to waiting a bit longer, say 36 hours.

 

[Costa Rican]

I used to mix tramadol and codeine. That actually feels close to heroin if you get it right.

 

[Costa Rican]

So it's almost 9 AM, and I absolutely can feel the W/Ds. I've had worse. I'm going to try smoking a joint and having a shower and walking to work—will try not to take any today. I'd really like to just CT this whole bs.

 

[Costa Rican]

I caved and took 300/300. Thankfully I made it through all of yesterday only dosing once at 8 AM (400/400), and I was able to hold out and work and have meetings in my office like a normal human. Until about 11 and I caved; I was getting too many chills and had a meeting with the boss I didn't want to fuck up.

I'm trying to look at the bright side of this—I cut my usage by more than half in less than 24 hours with no cravings for more. I still took double the technical max daily dose of Diclofenac, which has made me extremely angry at myself, but I'm determined to cut this shit out of my life. If I'm going to waste my money on pills, they should be pills that aren't going to kill me from fucking nephrotoxicity or CV, especially if I'm chasing an opiate high.

If anyone has any method for harm reduction—CWE for this (I've heard it's difficult as diclofenac is water soluble) or anything that could aid me in reducing harm to my body as I taper off of this. I've started taking 2 doses of prilosec a day (20 mg AM, 20 mg PM, to help with potential GI damage) as well as drinking a lot of water to help clear the kidneys out.

 

[fermonos]

Why don't you just buy from the darkweb? Or even buy pure codeine in cough syrup form? that's what I do.

 

[TensionClown]

Diclofenac is terrible. I'm also taking prilosec for stomach issues and was prescribed this a while ago for pain associated with some pinched nerves and a herniated disc in my back. Two days in I got stomach cramps and severe nausea. I wonder why my doctor even gave me that since he knew I have stomach problems. After that experience someone recommended I take bromelain. I was hesitant because it's an all natural anti-inflammatory derived from pineapples, but it has worked great for the pain. Just an idea, hope everything works out ok for you.

 

[Costa Rican]

Today it's 8 AM and saturday, I don't have to work. I'm not sure if it's because I dosed later in the day yesterday, but I have 0 withdrawals this morning.