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Opioids oxy targin naloxone metabolism?

Axolotln

Bluelighter
Joined
Feb 22, 2022
Messages
64
I’ve been orally taking variations prescribed oxy for years, most recently Oxynorm IR at variable intervals throughout days-weeks ‘as necessary’. (Ie sometimes once a day is enough, other times several times throughout the day at variable crossover). I’ve been switched to Targin ER. Dosages adjusted for continuity. I know I’m fine with the first dose within a 16-24hr period, regardless of its amount, but if I take a second targin or oxy ie IR PRN, within that 16-24 hours, I then lose the relief I took it for, opposed to when previously not taking the combination where adding more would bring it up not down.. I understood targin’s ER formulation and combined Naloxone to have gastric / liver first pass majority elimination.. so this doesn’t make sense to me.

Q: why, when at the same dosages as 0.5/IR, does taking an additional Targin dose, after the 1-2 hour first pass wait time, but within the 12–16 hour ER ‘active period’, interact negatively? (ie Reduced relief opposed to greater). Thank you
 
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