I've been taking around 30mg-40mg of Loperamide daily to manage withdrawal symptoms related to quitting a 150mg a day oxy addiction as well as a Kratom addiction (not at the same time, I bounce between the two). It's now day 4. I read this entire thread plus many others on Loperamide (and its dangers).
Lolwhatz- I saw that you posted quite a bit and appear knowledgeable on the topic. The Loperamide has helped me TREMENDOUSLY. I take it an hour after 800mg of Tagamet. I missed the Tagamet once and it seemed to make a noticeable difference. My question here is if you feel I'm taking an unsafe amount. Usually it's 20-24mg in the AM and another 10-12mg at night. I want to start tapering in 2 days, which will be day 6 of withdrawals. I know it has a long half life and don't want to have it inadvertently build up to unsafe levels in my body. Any thoughts would be appreciated.
Personally I never use tagamet, so there's that. I had a tolerance to oxycodone similar to that and that seems like a safe amount. I always found that while I would require a dosage higher than that the first day (up to 100mg) I could easily take only 20-35mg the next day and subsequent days. It takes a very long time for it to be absorbed fully, and since loperamide has a pretty long half life I always need less than half the second and later days.
So, no you're not taking an excessive amount - as I don't take tagamet I'm not sure how much it increases peak plasma, but even if it doubled the strength you wouldn't be in acute danger, it just isn't a good idea to take such dosages for a extended duration (some of the people here have taken 100-200mg it every day for years and doses several times that, not saying what they're doing is safe in the slightest just that you specifically are very likely ok). Doing exactly as you're doing it is fine, especially if you stick to the tapering you mentioned.
Personally I would take the smaller dosage in the morning, and the larger dosage 2-5 hours (depending on your experience) before you go to bed. Loperamide, as I mentioned, takes a while to build up in your system (about 4-5 hours or a little more for me before maximum effects are reached) and many people feel that it increases lethargy and fatigue, it is best to position those maximum side-effects of the larger dosage at night. Also, since the peak effect of the larger dosage will be achieved while sleeping, when you wake in the morning rested it may be easier to taper that lower dosage in the morning first while taking the same amount at night until you're not taking any in the morning. I've never found a need to take loperamide more than once a day, though when I was tapering it I would do that with two equal smaller dosages and reduce them both instead of one large and one small.
Happy to help if you have any more questions or need input regarding my subjective experience with the stuff. It can be a real life saver when used correctly, and definitely increase your chances of stopping opioid use due to the lack of horrible physical symptoms (I'd much rather be fatigued, than dead fucking tired and unable to sleep at all 0 yuk, but what I hate the most is the pain and the temperature instability - sweating while shivering is the worst fucking thing ever). I successfully got down to 2mg a day but had to go and fuck it all up. I'll be starting over in a few days tapering again with low doses of etizolam to manage the anxiety. It should, hopefully, be easier now that I've done it once. Don't take the etizolam or related drugs if you might suddenly relapse and reach for opioids or if you have a hard time controlling benzo/thienodiazipine intake (IE you take them too much/become amnesic, you don't seem to feel them work so take more often, you can't control your dosage or must use it daily). I have never come close to dependency on these drugs and haven't done any etizolam (or any benzos/thienos) for a few months so I feel comfortable in adding 1-3mg max daily/as needed (it's half the strength of clonazepam(klonipin)/alprazolam(xanax) to help.
I found it helped a whole lot to create an excel spreadsheet with the columns (each
underlined set is a column):
Date/Hour/Dosage in Pills/Dosage in mg
And use a formula just to multiply the dosage in pills by to in the mg column.
[=cell number*2]
(the formula is in between the brackets, the brackets aren't part).
Keeping track of the exact time and dosage you're taking is important, and helps you keep track of where you are, where you were, and where you want to be. You can even fill in the rows of future dates ahead of time to make a plan and say cross them through if you take more or less to see where you had predicted and where you are.
Doing this helps a lot for sure! Taking pills and trying to remember what you took three days ago at what times isn't feasible.
I wish you much luck, it is very doable if you're determined, just
stay away from people who have or are doing opioids for a good long time while and after tapering to 0. Heeding this previous sentence will save you a lot of failed effort and a lot of beating yourself up and a lot of pain. My downfall was realizing how low my tolerance was (Wow! I can get high on 2$ worth of dope!), having a friend that offered me some and fooling myself that I could somehow control myself and be a "weekend warrior," It's amazing how fast after hard work you go from an enlightened person getting sober to an idiot going: weekend, weekend, DAY DAY HOURS HOURS HOURS HOURS ad infinitum. Also, despite how low your tolerance has gotten, after going back to daily for just a week or two your previously high tolerance (after abusing opioids for awhile your body will never react like the first time you became dependant taking a long time to build up tolerance to 150mg of oxycodone, this is extra sucky because if it didn't do this you might at least be able to stop while you're... behind, nope.) is right back to where you started and so are the withdrawals.
Hope that helps!
PS, also after you get past the first 5-7 days, are only on loperamide and the oxycodone is out of your system you should stabilize, be less lethargic, have a bit more energy and motivation to continue. It helps to try and be active, accomplish something/exercise, something to be proud of that will make you realize what a great decision you've made and make you healthier. It's hard, and I will have much trouble practicing what I'm preaching in this paragraph.
PS2 (not the game console)
If you're not defecating daily you might be taking too much, if withdrawal is too painful to reduce right then take an oral laxative (not for more than a day if taking a stimulant laxative, it's always best to start with the polyethylene glycol laxative before ever taking a stimulant laxative, I've never needed either) and try and reduce as quickly as possible. I've always had a bowel movement daily and not gotten that stopped up YMMV. It helps to eat fruits, vegetables and grains for the fiber and even take a fiber supplement especially if you can't eat a lot of those things especially the first two. Green giant has steamer bags of good veggies that are quick to make and tasty. This fiber is especially important, and the vegetables and fruits especially especially important. I also drink lots of whole milk which the lactose gives me gas and helps move stuff along. Sorry if that's TMI.
