Opioids Loperamide (Imodium) Megathread v. 2

[Backfromthebrink]

I'm quite surprised that you can even buy 200ct+ bottles OTC in the US....especially given the recommended dose is so low and also recommended that you don't use it for more than a couple of days....and it's a fairly rare thing for the average person to use anyway.

Biggest pack you can buy OTC in ther UK is 18 usually...sometimes 30 but that's not commonplace....and thats "behind the counter OTC" from a supermarket it's either 6 or sometimes 12ct

Id sometimes buy 800 (4x200ct) from eBay just to keep in the house but id have to order them from the US...they'd take at least a week to get here and if customs noticed it they'd slap a 50% tax on it...

Selling 200ct+ bottles OTC for pennies at Wal-Mart or wherever is kind of asking for trouble.

 

[svacheme3]

Yeah I'm starting to get worried they're going to move to restrict it like pseudo... behind the counter, limited quantities... that might deter a few recreational abusers but it would be devastating to people needing it for withdrawal. It's been talked about alarmingly often. It's more drug war bullshit, "we're going to cause huge harm to 100 people to prevent 1 person from recklessly hurting themselves" and "opiates are bad, how can we be more sadistic and abusive to users to punish their immorality". They'll almost certainly set the limit so low even people who need it for IBS won't get enough. Some stores already play games... Acme only sells packs of 6 or 12 pills, for <SNIP> dollars (!). CVS has 100 and 200ct, but charges <snip> for them. If that ever happens I'm going to stock up on those <snip> 800 packs on Amazon; but hopefully sense will win out and the value of having something OTC that can completely end withdrawal will be seen, and the focus is put on educating people about protecting their heart.

 

[Backfromthebrink]

Yeah I'm starting to get worried they're going to move to restrict it like pseudo... behind the counter, limited quantities... that might deter a few recreational abusers but it would be devastating to people needing it for withdrawal. It's been talked about alarmingly often. It's more drug war bullshit, "we're going to cause huge harm to 100 people to prevent 1 person from recklessly hurting themselves" and "opiates are bad, how can we be more sadistic and abusive to users to punish their immorality". They'll almost certainly set the limit so low even people who need it for IBS won't get enough. Some stores already play games... Acme only sells packs of 6 or 12 pills, for $4 and $7 dollars (!). CVS has 100 and 200ct, but charges $28 and $40 for them. If that ever happens I'm going to stock up on those $20-30 800 packs on Amazon; but hopefully sense will win out and the value of having something OTC that can completely end withdrawal will be seen, and the focus is put on educating people about protecting their heart.

Yeah, that's what its like here...95% of places just sell 6ct.The brand name Imodium is stupid expensive but generic are usually about <snip>. Cheapest I've ever seen is <snip> for 30ct but that's behind the counter at a pharmacy...they don't take your name or anything but you can only have 1...then go to another pharmacy and buy another one. Some supermarkets restrict you to buying no more than 2 x 6ct but some don't...and you have to be over 18 for some reason to buy any medicine at a supermarket....even aspirin and paracetamol).

Amazon and eBay are the best bet...I don't know if we can discuss prices for large amounts but I think I can get away with saying that the cost per pill roughly goes down by a factor of 4 from the cheapest OTC price (but customs can put a tax on it....most the time they don't though).

In the UK if you were taking really large amounts (100 per day) and NOT buying the 800 packs online you would be trailing round dozens of different shops every day and spending a fortune...going on the average price of<snip> for 6, you would be spending around 17.00GBP per day....not exactly cheap....wouk d be cheaper to use that money to buy real opiods...

 

[svacheme3]

Honestly in the UK you shouldn't be taking lope at all; you have OTC codeine. Works a lot better and is a lot less dangerous unless your tolerance is so high the histamine release is an issue with lots of codeine-- I'd take lope over high dose codeine+antihistamine, that makes me feel weird, and without the antihistamine enough codeine the itching and burning is scratch-your-skin-off bad. And you're right on about the pricing... if someone has $40+ it would be really hard not to just spend that money on dope, especially if that's only a couple days worth of lope.

OTC items at major retailers don't fall under the no pricing rule unless it was changed very recently; thats why I had the pricing in my post.

 

[MDPV_Psychosis]

I thought price discussion is against the rules across the board whether otc, legal, illegal or whatever. Part of the reason, I thought, is because some medications can be otc in some countries while banned or controlled in other countries, therefore, it's just easier to blanket ban price discussion on everything.

I could be wrong though. Maybe we can get clarification?

 

[Jekyl Anhydride]

I thought price discussion is against the rules across the board whether otc, legal, illegal or whatever. Part of the reason, I thought, is because some medications can be otc in some countries while banned or controlled in other countries, therefore, it's just easier to blanket ban price discussion on everything.

I could be wrong though. Maybe we can get clarification?

Correct, price discussion and sourcing is only allowed for some HR materials like Micron filters or Sterifilts and even that would best be done lightly.

My edit line was referring to this:

OTC items at major retailers don't fall under the no pricing rule unless it was changed very recently; thats why I had the pricing in my post.

 

[Backfromthebrink]

Correct, price discussion and sourcing is only allowed for some HR materials like Micron filters or Sterifilts and even that would best be done lightly.

My edit line was referring to this:

Now you see that just isn't true... if my earlier post (which you may as well delete altogether as removing the prices makes the entire post just nonsense) had been in EADD that would have been allowed...pricing for all OTC items is fine there and even for illegal drugs as long as not in bulk...

In the PED forum (these are the only 2 other places I post) prices of anabolic steroids and ancillaries are fine to be discussed again as long as not bulk. Just the other day I was having a fairly lengthy discussion about UK steroid prices with one of the senior moderators of the site (CFC)

I'm not saying you're right or wrong (well actuallly I am saying that) but you can't pick and choose what the site rules are depending on which sub forum you're posting in.. It just looks stupid and directly implies that either yourself or the mods in those other 2 forums don't understand the rules..A site rule is a site rule and mods can't just pick and choose.

May I respectfully suggest taking the matter up with either admin or senior mods as people put a degree of effort into posts and deleting parts of them to the extent that the post becomes meaningless due to a supposed "site rule" that apparently changes willy nilly depending on which part of the site you are on, is completely wrong.

Just to reiterate incase tl : dr... site rule is a site rule and you can't just pick and choose if it is or not on different subforums..

 

[Backfromthebrink]

Can I reference point number 7 on the forum rules thread in the PED forum linked below....

http://www.bluelight.org/vb/threads/211091-Forum-Rules

To say that this "site rule" changes from sub forum to sub forum is just wrong man..


Point made....

I'll leave it there...

 

[Jekyl Anhydride]

BLUA rule #5: post or upload to a forum any content that violates specific rules of that forum;

http://wiki.bluelight.org/index.php/Bluelight_User_Agreement_(BLUA)


This is just a friendly reminder from your OD staff about rules and rule changes concerning price discussion.

2 ) NO DRUG PRICE THREADS/ POSTS Do not post threads asking about the price or availability of drugs. Do not list prices of any drugs anywhere in threads. Formerly we had an annual price thread where anyone could list drug prices for their location however this has been closed and NO DRUG PRICES are allowed anywhere. The only prices allowed are for harm reduction materials such as filters, bacteriostatic water and so forth.

So to be clear- absolutely no drug price discussion is allowed anywhere in OD and the only price discussion that is allowed is related to harm reduction materials.

If you would like to discuss this with Mods regarding other forums that's fine but this stands for OD

 

[Jekyl Anhydride]

Can I reference point number 7 on the forum rules thread in the PED forum linked below....

http://www.bluelight.org/vb/threads/211091-Forum-Rules

That's also 13 years old. You could always ask about updated rules and Trends of that forum.

 

[Backfromthebrink]

That's also 13 years old. You could always ask about updated rules and Trends of that forum.

The conversation I had with CFC wasn't 13 years old...it was 2 dsys ago. If you're suggesting that they have changed then the senior mod is obviously unaware...I doubt ir

This is my point...you're saying "rules and trends of that forum" that's irrelevant...you can't apply site rules like that..

Either price discussion within set limits is allowed On Bluelight or it isn't..

With respect, you're the one editing posts and you're the moderator...it's really yourself who should be seeking clarification

 

[Jekyl Anhydride]

If you clarified it with CFC then posts of that nature are fine in PED. I'm discussing the rules for OD. This is what they are and if you can't abide by them then please don't post in OD. PERIOD

 

[Backfromthebrink]

If you clarified it with CFC then posts of that nature are fine in PED. I'm discussing the rules for OD. This is what they are and if you can't abide by them then please don't post in OD. PERIOD

What mind blowing arrogance. All you needed to say was that it's not a site rule at all and varies from forum to forum (which makes absolutely zero sense BTW).

You agreed with the earlier poster statement that they weren't allowed across the board..

Now your saying their are "special rules" for OD?

Unless banned and prevented from doing so I'll post wherever I please.PERIOD.

 

[Slow_Mobius]

Jekyl is right. In OD, we don't allow price discussions for substances including OTC meds. The user agreement applies to any forum on the site, but in addition to the user agreement, sub-forums have their own set of guidelines. One of our guidelines pretty clearly states that we don't allow pricing for any drugs. That includes OTC medications.

Anyways, this isn't an appropriate debate for this thread, so if you have any concerns about the rules or need more clarification, I would create a thread in the Site technical help forum or take it up via PM

 

[Backfromthebrink]

Jekyl is right. In OD, we don't allow price discussions for substances including OTC meds. The user agreement applies to any forum on the site, but in addition to the user agreement, sub-forums have their own set of guidelines. One of our guidelines pretty clearly states that we don't allow pricing for any drugs. That includes OTC medications.

Anyways, this isn't an appropriate debate for this thread, so if you have any concerns about the rules or need more clarification, I would creat a thread in the site support forum or take it up via PM

Thats fair enough...Thank you I appreciate your politeness

I don't appreciate the breath taking arrogance and rudeness of your colleague. I phrased all my ponits to him with the words "with respect"...it appears respect is not a 2 way street in his case.

Anyway, never mind I'm done here.

 

[Lorne???]

^ Agreed Jekly, though people do not realize the pharmacokinetics, and that even enzyme inhibitors (and especially Pgp) can have a DRAMATIC effect on absorption and effect

My point was that posting those warnings up front would be prudent, imo.

Not a mod, so would you consider this? The "therapeutic" window is narrow at best, and just think that stronger/more specific warnings are warranted, outside of simply posts.

And loperamide has some place in allieviting some or many WD symptoms temporarily; it is massive or long term use, or chugging grapefruit juice and Tagamet or even stronger inhibitors

Can post references to it's abymissal BA% at "normal" doses, although high doses should increase it, so 100mg may be over 10x as potent than say, 25mg w/ even modest inhibitors(maybe more(

Replying to Jekly's post, not about price discussion, although pointing that pharmacies are now charging , A LOT a pop for Suboxone strips, and generic is only ($withheld) 30-40% less, and many Dr's won't prescribe them, so may be worth mentioning may be worth mentioning to people considering Bupe-vs Methadone

Will not mention prices again, just saying "w/out insurance' buprenorphine treatment is still often outrageous

 

[Lorne???]

Thats fair enough...Thank you I appreciate your politeness

I don't appreciate the breath taking arrogance and rudeness of your colleague. I phrased all my ponits to him with the words "with respect"...it appears respect is not a 2 way street in his case.

Anyway, never mind I'm done here.

It wasn't quite that bad, they're have been worse; he was simply saying it is NOT allowed in OD, regardless of other subforums.

Most will not let you post price discussion, at all

Think they're should be a general outline for HR medications like MD treatment or especially, buprenorphine, though that is a different discussion, and my mains priority, aside from HR and trying to help people(and educate those who are willing, and hopefully be educated in the process and occasionally having an interesting discussion) is updating the mega threads.

Have already made a new, much more thorough benzodiazepine chart, need to post references, and would be willing to go be an updated and more thorough information about opioids next, just want to make sure it is the taken seriously, as it is time consuming

Any help would be appreciated... Mostly posting references, though any help or info appreciated

 

[Jekyl Anhydride]

^ Agreed Jekly, though people do not realize the pharmacokinetics, and that even enzyme inhibitors (and especially Pgp) can have a DRAMATIC effect on absorption and effect

My point was that posting those warnings up front would be prudent, imo.

Not a mod, so would you consider this? The "therapeutic" window is narrow at best, and just think that stronger/more specific warnings are warranted, outside of simply posts.

And loperamide has some place in allieviting some or many WD symptoms temporarily; it is massive or long term use, or chugging grapefruit juice and Tagamet or even stronger inhibitors

Can post references to it's abymissal BA% at "normal" doses, although high doses should increase it, so 100mg may be over 10x as potent than say, 25mg w/ even modest inhibitors(maybe more(

Replying to Jekly's post, not about price discussion, although pointing that pharmacies are now charging , A LOT a pop for Suboxone strips, and generic is only ($withheld) 30-40% less, and many Dr's won't prescribe them, so may be worth mentioning may be worth mentioning to people considering Bupe-vs Methadone

Will not mention prices again, just saying "w/out insurance' buprenorphine treatment is still often outrageous

No I hear you about pGp Inhibitors and think straight up info is key, it's just the shock of hearing somebody going to the hospital and needing cardioversion or some type of trans cutaneous pacemaking for some F'd up Q-T patterns that leaves an impression on people that don't care about the pharmokinetics and good stuff like you and I.

I'd like to get some more info put down about the Bi-Phasic response to dose curve mixed with some horror stories for everybody else.

Digging your Benzo chart too Lorne???

 

[Lorne???]

^ Thank You

Agreed, wasn't trying too fan flames, or "Buc the system"; It is a rule, and it is not arbitrary; and don't think you or anyone else have rude.

Enough of that, once completed w/ sources, would you consider updating or adding it?

And another question, have thought about making a "simplified" post w/ more basic information for people, while maintaining the current; one abridged, and one like some of us are interested in, w/ detailed information

If thought it would be taken seriously want to update opioid info next, some of it is simply wrong, or outdated

Makes me wish that was able to get into these discussions, I must admit, though am not a mod, of course

Maybe make a prototype or something

(Example: Oxy oral BA% basically averages ~50; so similar to intranasal

And plugging it has similar BA% thought it results in delayed absorption and lower Cmax; however it last significantly longer

( Oxycodone Tmax p.o 1.5-2hrs rectal ~ 3-4hrs)

Diamorphine oral can reach 50%, and w/ large doses can reach 70%

Just examples

 

[Jekyl Anhydride]

Enough of that, once completed w/ sources, would you consider updating or adding it?

And another question, have thought about making a "simplified" post w/ more basic information for people, while maintaining the current; one abridged, and one like some of us are interested in, w/ detailed information

If thought it would be taken seriously want to update opioid info next, some of it is simply wrong, or outdated

I think there have been a few throughout the years but so many different sources vary. I like the info on which meds have higher Lipophilicity and what not to help determine the best ROA's but yours seems comprehensive.


So back to the OT what do you think about the danger potential of Quinine or Quinidine.? Or the dangers of something like Nuedexta? Quinidine esp increases the Q-T interval by itself as well as inhibition of P-Gp or MDR1.

I think some disregard the danger for pure potentiation. At least the club stores are limiting sales to 2 boxes or 1.6g as of Jan 1st. I still think there should be a happy medium somewhere for the folks with IBS and GI maladies.

Going the way of pseudoephedrine restriction just seems like too much but 1.6g is too far in the wrong direction.