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  • BDD Moderators: Keif’ Richards | negrogesic

Benzos Temazepam & Clonazepam interchangeable?

FutureReference

FutureReference

Bluelighter
Joined
Jul 15, 2019
Messages
307
Hey all,

So recently I was upped from 4MG to 6MG Clonazepam daily. Not sure what it is but it has been harder to make my 40MG Oxy last all day for pain. Anyway, before I go on a tangent, I am wondering what a good combination would be?

I get 30MG Temazepam daily but no longer need it for sleep with increased Clonazepam. Tried 4MG and 20Mg Oxy but no help. A military buddy of mine said he is prescribed Temazepam for anxiety. I see many people here saying it potentiates opioids. Can I use it interchangeably with my Clonazepam? What is a good dose? I want to make my Oxy last as long as possible and if Temazepam can help that's great. Have an essential oil diffuser arriving tomorrow that I heard helps pain too. Thanks
 
Tamezapam and Clonazepam are both benzodiazepines. Like all benzodiazepines, they are interchangeable if you take the equivalent dose.

Being benzos, they both potentiate opiates. So you are already potentiating with Clonazepam.

About the dosage, sorry I can't comment because I don't know the amounts of opiates and benzos that you use daily, I don't know your tolerance or weight, ... And I don't think that anybody can or should comment on the amount of medications that you use in combination which isn't a safe practice anyway.
 
They are roughly interchangeable but can have quite different effects. The benzodiazepine binding site had various subunits for which different benzos have different affinities which in turn makes some benzodiazepines mostly hypnotic (like temazepam) while others, mostly anxiolytic (like alprazolam, at low doses). This is generally dose dependent, as high doses of any benzodiazepine will eventually become sedating. However low doses of drugs like temazepam are only rarely prescribed for daytime anxiety given their inefficacy as anxiolytics and the high incidence of sedation/amnesia. Z-drugs like zolpidem (ambien) bind preferentially to the alpha-1 subunit, making it strongly hypnotic but not effective at a muscle relaxant or anxiolytic.

Thus, they aren't exactly equal. 4mg of clonazepam is equivalent to somewhere approaching 100mg of temazepam, which would knock you out in a way 4mg of clonazepam wouldnt.

Have you tried dextromethorphan to potentiate your oxycodone? I never thought it worked too well, but I didn't suffer from chronic pain and was only trying to get higher. Dextromethorphan might help in your case, particularly since dextromethorphan has analgesic properties of its own. I would recommend the dextromethorphan-only containing capsules, which were available on amazon last time i checked (i think the ones i got were called robafen). Could be worth a try if you haven't already.

The real answer in your particular situation is a higher dose of oxycodone.
 
Also you could look into Levomepromazine (aka methotrimeprazine), it has its own analgesic effect (non-opioid) comparable to morphine (this study describes 15mg being equal to 10mg morphine in analgesic effect: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1922768/).

It also potentiates opioids strongly, so much so that at some point in the last decade research was being done to develop a morphine/levomepromazine combination product in order to provide equal pain relief with less opioids (tried to find the study about this but no luck).

It's an antipsychotic but has very low potency as an antipsychotic (so antipsychotic effects come about only at much higher doses). It's also great for nausea and sedation (it has antagonist effects at histamine receptors) so is used for chemo related nausea, palliative care etc. and for insomnia (which is what I'm prescribed it for, and it works really well).

As negrogesic said, the optimal answer for this issue would be more opioids although it might be easier to get the docs to write for an adjunct medication like levomepromazine than more opioids.
 
^^^^What dose do you take? (Those old antipsychotics can have pretty heavy duty side-effects.) I wonder what the differences in doses are like for palliative care versus the treatment of schizophrenia.
 
negrogesic said:
They are roughly interchangeable but can have quite different effects. The benzodiazepine binding site had various subunits for which different benzos have different affinities which in turn makes some benzodiazepines mostly hypnotic (like temazepam) while others, mostly anxiolytic (like alprazolam, at low doses). This is generally dose dependent, as high doses of any benzodiazepine will eventually become sedating. However low doses of drugs like temazepam are only rarely prescribed for daytime anxiety given their inefficacy as anxiolytics and the high incidence of sedation/amnesia. Z-drugs like zolpidem (ambien) bind preferentially to the alpha-1 subunit, making it strongly hypnotic but not effective at a muscle relaxant or anxiolytic.

Thus, they aren't exactly equal. 4mg of clonazepam is equivalent to somewhere approaching 100mg of temazepam, which would knock you out in a way 4mg of clonazepam wouldnt.

Have you tried dextromethorphan to potentiate your oxycodone? I never thought it worked too well, but I didn't suffer from chronic pain and was only trying to get higher. Dextromethorphan might help in your case, particularly since dextromethorphan has analgesic properties of its own. I would recommend the dextromethorphan-only containing capsules, which were available on amazon last time i checked (i think the ones i got were called robafen). Could be worth a try if you haven't already.

The real answer in your particular situation is a higher dose of oxycodone.
Click to expand...

Thank you for the in-depth response! Yeah I'll be honest, I tried taking 60MG Temazepam instead of the 3MG Clonazepam and still managed to have a minor panic attack. I guess I don't know enough to make it work for PTSD but it does help with sleep really well.

I am sorry if this is ignorant, but is what you refer to DHC? I saw a lot of people talking about that but unfortunately couldn't find anything about it in the US. If it could help with pain I would give anything a shot! Black Seed Oil works slightly but I do hope they up my dose to 60MG of Oxycodone as 40 simply isn't enough.

Quere said:
Also you could look into Levomepromazine (aka methotrimeprazine), it has its own analgesic effect (non-opioid) comparable to morphine (this study describes 15mg being equal to 10mg morphine in analgesic effect: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1922768/).

It also potentiates opioids strongly, so much so that at some point in the last decade research was being done to develop a morphine/levomepromazine combination product in order to provide equal pain relief with less opioids (tried to find the study about this but no luck).

It's an antipsychotic but has very low potency as an antipsychotic (so antipsychotic effects come about only at much higher doses). It's also great for nausea and sedation (it has antagonist effects at histamine receptors) so is used for chemo related nausea, palliative care etc. and for insomnia (which is what I'm prescribed it for, and it works really well).

As negrogesic said, the optimal answer for this issue would be more opioids although it might be easier to get the docs to write for an adjunct medication like levomepromazine than more opioids.
Click to expand...

Currently, I am on Oxycodone, Clonazepam, Citalopram and Temazepam. I never have heard of Levomepromazine. My psychiatrist is very kind to me and has offered me medications for PTSD. Would Levomepromazine negatively interact at all with my current meds? If it can guarantee more relief for my Oxy I will ask for it my next visit!
 
Yikes i just reread what I wrote sorry for the typos.

Dextromethorphan isnt DHC (that is dihydrocodeine).

Dextromethorphan is also known as DXM and is available over the counter. The capsules can be bought on amazon. Search "robafen" or dextromethorphan capsules on amazon. It may help extend your pain relief, probably more so than the black seed oil and is cheap and readily available. Seeing how its cheap and readily available it might be worth trying.

The levomepromazine that someone suggested won't interact with your medications in any dangerous way, but it may have alot of side-effects (it is heavily sedating and impairs cognitive).
 
Last edited:
negrogesic said:
^^^^What dose do you take? (Those old antipsychotics can have pretty heavy duty side-effects.) I wonder what the differences in doses are like for palliative care versus the treatment of schizophrenia.
Click to expand...
FutureReference said:
Thank you for the in-depth response! Yeah I'll be honest, I tried taking 60MG Temazepam instead of the 3MG Clonazepam and still managed to have a minor panic attack. I guess I don't know enough to make it work for PTSD but it does help with sleep really well.

I am sorry if this is ignorant, but is what you refer to DHC? I saw a lot of people talking about that but unfortunately couldn't find anything about it in the US. If it could help with pain I would give anything a shot! Black Seed Oil works slightly but I do hope they up my dose to 60MG of Oxycodone as 40 simply isn't enough.



Currently, I am on Oxycodone, Clonazepam, Citalopram and Temazepam. I never have heard of Levomepromazine. My psychiatrist is very kind to me and has offered me medications for PTSD. Would Levomepromazine negatively interact at all with my current meds? If it can guarantee more relief for my Oxy I will ask for it my next visit!
Click to expand...

My understanding is that levomepromazine's antipsychotic effects are only an issue at high doses, for that reason it isn't usually used for psychotic illness because it would require huge doses that would be sedating as fuck.

Depending on how wound up/over overstimulated I feel I take between 12.5 - 50 mg when I go to bed and within 30 mins I feel fuzzy and sedated. As an adjunct for pain relief you would probably also be taking 50mg max.

I have never experienced any side effects at the listed dosage range aside from the desired sedation and pain relief and perhaps some dry mouth. Obviously you may still experience side effects from it as we are all different but my experience is that it's side effect profile at low doses is no worse than one of the first generation sedating antihistamines like promethazine.

I certainly can't guarantee it will give you relief but I would definitely recommend it and believe that it's quite likely to help.

It's also quite handy to have around for nausea if that is a problem for you as well.

Quere
 
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