Opioids The Ultimate Opiate Potentiation Thread

[rolls]

But does it have to be white grapefruit juice?

All grapefruit will work but white has almost double of the compound that you are after, the more bitter it tastes the better. I'd recommend getting fresh white ones and putting the entire thing skin and all in a fruit juicer.

 

[DJ25]

Pharmacokinetics

Modafinil induces the cytochrome P450 enzymes CYP1A2, CYP2B6 and CYP3A4, as well as inhibiting CYP2C9 and CYP2C19 in vitro. It may also induce P-glycoprotein, which may affect drugs transported by Pgp, such as digoxin.


I got this off Wiki. I don't know if it would be of any help here as I'm not sure of these enzymes in relation to Opiate metabolism but if anyone does know, I thought I'd post it.

Even though Modafinil is a stimulant or whatever maybe a tiny dose (crunb from the pill) would help IDK.

I have no effects off of modafinil dose 200 mg so anyone who is tolerant may be interested. If of course these enzymes matter

 

[sonic]

^ Inducing CYP3A4 is going to make you metabolize most opioids faster unfortunately. The other enzyme that plays a major role in metabolizing some opioids is CYP2D6. Check the CYP450 interactions chart in the OD directory. Remember that some drugs (like codeine) are pro-drugs, so enzyme inhibitors don't always work the way you want them to.

 

[tadfish]

Just got some Tagamet wondering what its best for like i got lots of benzos and different opiates to try with. Just UTFSE i am but whats everyone think Tagamet works best with to potentate what opiates best? and how? just longer acting? or stronger?

some other info i got might help about Tagemet in australia from MIMS

Originally FROM MIMS:
Tagamet
PrintAdd to FavouritesCMITablets

Cimetidine
GlaxoSmithKline Australia Pty Ltd

MIMS Abbreviated Prescribing Information
Section: 1(a) Hyperacidity, reflux and ulcers
Consumer Medicine Information: Available

Pregnancy Category: B1

Sport Category: Permitted in sport

Uses/Indications: H2-antagonist. Short-term treatment of proven duodenal, gastric ulcer; maintenance in recurring duodenal ulcer after short-term therapy; maintenance less than or equal to 1 yr to reduce relapse risk in chronic benign gastric ulcer; short-term treatment (less than or equal to 12 wks) of persistent gastroesophageal reflux disease (GORD); symptomatic treatment (less than or equal to 2 wks) of GORD; treatment of gastrinoma (Zollinger-Ellison syndrome), scleroderma oesophagus


Contraindications: Concurrent dofetilide


Precautions: Excl malignancy; renal, hepatic impairment; haemodialysis; intubated ICU patients receiving mechanical ventilation; organic brain syndrome; high dose; chronic lung disease, diabetes, immunocompromised, elderly (incr risk community acquired pneumonia); pregnancy, lactation, children


Adverse Reactions: Headache; GI upset; tiredness, drowsiness; dizziness; hypersensitivity incl rash, anaphylaxis (rare); musculoskeletal pain; gynaecomastia, impotence (high dose); CV effects incl tachycardia (rare); others, see full PI


Drug Interactions: See Contra; CYP450 substrates (esp with narrow therapeutic index) incl coumarins, TCAs, class I antiarrhythmics, Ca channel blockers, oral sulfonylureas, phenytoin, theophylline, metoprolol; drugs affected by competition for renal tubular secretion eg procainamide, metformin, cyclosporin, tacrolimus; drugs affected by altered gastric pH eg atazanavir, some azole antifungals (eg ketoconazole, itraconazole, posaconazole); chemotherapeutic agents/ therapies eg carmustine, fluorouracil, epirubicin, radiation; narcotic analgesics eg morphine; myelosuppressants


TAGAMET (Tablets) Prescription required. S4
Cimetidine; pale green f-c;
Dose: May be taken with or without food. Acute duodenal, gastric ulcer: 800 mg at bedtime, or 400 mg morning and bedtime, or 200 mg 3 times daily and 400 mg at bedtime (4-8 wks); may incr to max 1.6 g/day. Maintenance recurrent duodenal ulcer: 400 mg at bedtime. Maintenance chronic benign gastric ulcer: 400 mg at bedtime for less than or equal to 1 yr. Zollinger-Ellison syndrome: 200 mg 3 times daily and 400 mg at bedtime; may incr to max 2 g/day. GORD: 800 mg at night or in divided doses for less than or equal to 12 wks; symptomatic therapy of GORD: 200 mg up to 4 times daily for less than or equal to 2 wks, max 800 mg/day. Scleroderma oesophagus: usually 1200 mg/day in divided doses. Renal impairment: reduce dose

 

[tadfish]

Sorry everyone I had trouble with the editing and deleting posts and quoting. Hope thats ok but though the info could be helpful. Especially for australians.
thanks tadfish still learning to do thing smashed online

 

[DJ25]

^ Inducing CYP3A4 is going to make you metabolize most opioids faster unfortunately. The other enzyme that plays a major role in metabolizing some opioids is CYP2D6. Check the CYP450 interactions chart in the OD directory. Remember that some drugs (like codeine) are pro-drugs, so enzyme inhibitors don't always work the way you want them to.

Yes I am aware of this, well the CYP 2D6 and the basics, well even that's questionable. However I am still a little baffled by Quinine's abilty to potentiate codeine as in all places that I have looked it is listed as a strong CYP2D6 inhibitor. I am researching at the moment and have probably missed something as I have read this thread but it was some weeks ago and have forgotten some of the content (fucking dyslexia-really pisses me off sometimes add drugs {in pops benzo thought} and- I'm fucked. However I wasn't looking into Quinine's effects at the time anyway so I'll let myself off with that, maybe other posters won't:D).

BTW do you guys realize how serious the fucking sides are/or can be from Quinine? My Nan told me it was just a cramp med (which it is), but I literally cannot believe it- 127 deaths according to wiki. Used to treat Mallaria I think amongst other things.

Don't worry if you just drink tonic water to obtain quinine, I read that to get a clinically significant dose; equivelent to 200mg, 12-16 litres would be required lol- not that this affects the potentiation as I don't know.

I asked my pharmacist today; (as I've been switched to Seroxat) to treat various issues- (the insert seems to cover pretty convincingly lol)- that I heard that the CYP2D6 Inhibition was bad and if my codeine will still be effective etc. He told me that the whole SSRI- CYP2D6/Codeine is mainly a myth and is minimal. He said that it all came from the trycylic AD's generation, however I have began reading a Journal that states that the opposite maybe true, or he just said it not to worry me, 'Quasi-Placebo-ish'. I must say I'll be happy if he's proved wrong as I could ask my GP for a stronger drug as a necessity Or ask him for an enzyme inducer, Gluthethimide springs to mind , that is if it's still available and again I'll look into it.

He also said Cimetadine, well Tagamet are now replaced by zantac and they're no longer available, unless he just meant the brand (I'm UK based), so I found Pepcid two believing that Famotidine would be a close enough relative to Cimet and................

Oh and just found out that Cimetidine is an inhibitor- doubly pickled now . Anyway a few things I need to do.

Are most opiate pills prodrugs?

 

[Mr Blonde]

^ How does quinine potentiate your codeine? I know about it potentiating the rush with IV heroin.

If your drinking tonic water I'd say the carbonation is doing more then the quinine.

And no, most opioids are not pro-drugs. Codeine and heroin are the notable ones, though there are a few that get metabolized into other opioids but the main effects come from the drug you ingested, not the metabolite (e.g. hydrocodone, dihydrocodeine).

 

[oh-pana321]

if im gonna use zanaflex for potentiating oxycodone, how much and when should i take it?

 

[TheMatador]

zanaflex sucks and isn't a good potentiator at all imo

 

[El Commandante]

Hi everyone,
This is my first post other than in the new members forum, and is a bit specific.
Basically I have been on 30mg of Methadone for about a month now. Personally I think I should have been put on a far higher dose than 30mg, which is why I've been looking into ways of potentiating it. Sometimes, honesty doesn't pay when your looking for an adequate dose which will help with the mental side of opiate addiction, as well as the physical.
Anyway, I've been taking grapefruit juice about 30-60 minutes before dosing everyday. Whether it has actually helped, i'm not too sure about.
I've also acquired some Tagamet and Hydroxyzine, which I read about on a thread on this forum entitled (surprisingly enough) "Methadone Potentiation".
Basically, what I need to know is how many of each should be taken, whether they should be taken before, with or after the meth and roughly when in terms of minutes, and whether I should just stick to using 1 or the other, or both together? Also, could I still keep using the GFJ and are there any side effects to be worried about, particularly mental ones from the Hydroxyzine.
Any help or advice would be gratefully accepted.
I also have some diazepam, which was mentioned in the thread, but have not attempted to combine it with meth as yet. Any advice on that one as well?
I should assure everyone that I have never felt even at the slightest risk of OD'ing on 30mg, so I am very doubtful as to whether combining any of these drugs with meth will be of any danger, when used at a safe level.
Cheers,
El Commandante

This is from a thread I started the other day. It was recommended by the mods for me to seek answers in this thread. TBH I have not yet read all the posts in this thread, so maybe the answers are already there, but i'm feeling too low mentally ATM, to read through all 25+ pages. I took 400mg tagamet an hour before my 30mg meth today, instead of my usual GFJ, but unfortunately nothing has really happened, in fact i've noticed the meth even less than I usually do. I also took 400mg about 2 hours and a half after taking the meth, but this too has had little or no effect. I should add that i raised my dose of olanzapine (anti-psychotic) from 2.5mg to 5mg a few days ago, which may be decreasing the effects of the meth yet further. It's so frustrating to hear of people experiencing intense nods from methadone, whereas for me it's a bit like taking an aspirin.

 

[tadfish]

tagamet is great i good to get it off doc though waiting for opiate tolerance to go down again before i try again amybe i'll wait to th eonce a year get some H and mix it with dihydrocodeine and codeine maybe i shouldd try poppies tea but got sick of that shit drank quality stuff for a week plus a few times only leading to massive tolerance cause of long acting and waking up still high and having more.

 

[tadfish]

Will tagamet make codeine stronger i think it might make it weaker but make the morphine stronger so what best take them at same time if i was taking codeine i would take tagamet same time?

quinine helps things cross BBB i think.
I used it last night with dihyrocodeine, tagamet, kratom, quinine, some codeine and some spice diamond and it got me smashed.... or and i had some roofies (fluitnitrazepam).

When is best time to take tagamet and with what drugs is it best to take them with.
like i wondering cause i got scripts for all these different benzos and lots of them and i love my opiates.

So where is the tagamet thread UTFSE not help
Also whats everyones thoughts on taking kratom with opiates i can't find much info. I using kratom now to starve off breaking my ribs. I fuckin break my ribs and only get panadeine forte thats like 500 APAP with 30mg of codeine. I told the doc look i got fuckin tolerance oh codeine doesn't work on my it something to do with my stomach and no i don't wnat tramadol it makes me sick. fucking still gave it to me the fuck head. that will teach me to go ER in a dodgey neighbourhood best off gonig to expensive ER. for fucks sake. oh sorry for the rant

 

[DJ25]

Will tagamet make codeine stronger i think it might make it weaker but make the morphine stronger so what best take them at same time if i was taking codeine i would take tagamet same time?

quinine helps things cross BBB i think.
I used it last night with dihyrocodeine, tagamet, kratom, quinine, some codeine and some spice diamond and it got me smashed.... or and i had some roofies (fluitnitrazepam).

When is best time to take tagamet and with what drugs is it best to take them with.
like i wondering cause i got scripts for all these different benzos and lots of them and i love my opiates.

So where is the tagamet thread UTFSE not help
Also whats everyones thoughts on taking kratom with opiates i can't find much info. I using kratom now to starve off breaking my ribs. I fuckin break my ribs and only get panadeine forte thats like 500 APAP with 30mg of codeine. I told the doc look i got fuckin tolerance oh codeine doesn't work on my it something to do with my stomach and no i don't wnat tramadol it makes me sick. fucking still gave it to me the fuck head. that will teach me to go ER in a dodgey neighbourhood best off gonig to expensive ER. for fucks sake. oh sorry for the rant

If Tagamet is Cimetadine- DON'T take with codeine as it stops the enzyme conversion into morphine I believe but others here know much more about that.
This is from opioids.com- 1. A dose of Tagamet an hour before a hydrocodone/oxycodone session will make the drug last longer and have a better effect. Antacids should be taken at least 45 minutes after the Tagamet otherwise absorption of the Tagamet will be impaired. Grapefruit juice also has the same type of impact on liver enzymes; use a Maalox chaser to neutralise any systemic acidification effect from the grapefruit juice. Tagamet should not be taken with codeine because it impairs the metabolism into morphine necessary for it to have any real effect.

If Quinine helps Codeine cross the BBB I would think that it should be taken after the codeine is taken as many sources I've seen have disputed these two as quinine is metabolized by CYP 2D6 like codeine, this is from drugs.com- codeine and quinine (Moderate Drug-Drug)
MONITOR: Drugs that are inhibitors of CYP450 2D6 may interfere with the analgesic effect of codeine. The mechanism is decreased in vivo conversion of codeine to morphine, a metabolic reaction mediated by CYP450 2D6.

MANAGEMENT: The possibility of reduced or inadequate pain relief should be considered in patients receiving codeine with drugs that inhibit CYP450 2D6. An increase in the codeine dosage or a different analgesic agent may be necessary in patients requiring therapy with CYP450 2D6 inhibitors.

However opioids.com seem to dispute this by saying that it HELPS the conversion so I'm very confused here-2. Quinine and quinidine accentuate the buzz of opiates but only directly help with codeine metabolism by boosting the amount changed into morphine. The prescription antihistamine promethazine (Phenergan) helps out codeine even more, and is found with codeine in the Schedule V cough syrup Phenergan VC With Codeine. Quinine will tend to have its effect without impairing hydrocodone but does seem to burn off the buzz more quickly and may flatten the dose-to-response curve.

I'm very happy today though as I've got some Promethazine which is over the counter in the UK, but still closely watched. So under the counter really. I took one earlier and have to say that it's the first antihistamine I don't mind the effects of- it reduced my anxiety quite well. I wonder which other goodies they keep under the counter in the droors- definitely Codeine linctus I bet! The med also says that it's script only or recommended by a pharmacist but she just gave it to me (bonus). It has no marketing labeling i.e the box doesn't look like Nytol wood.

This Quinine subject really needs clearing up as I'm sure it's not as simple as the CYP2D6 interaction otherwise it wouldn't be spouted around various websites, maybe it helps conversion of Codeine to morphine outside the liver like the brain or with whatever is left maybe but I'm skeptical. I was reading the Sides Quinine can produce and unless it's helping me big time I aint taking it.

BTW Mr Blonde- This is why I was saying quinine will potentiate codeine, well not saying more asking

 

[El Commandante]

Any ideas as to why my 400mg tagamet, consumed an hour before taking methadone, followed by another 400 2 and a half hours later, had less effect for me than GFJ? Should I try taking 800mg instead?
Also what's a reasonable dose of hydroxyzine to combine with 30mg and should I still take GFJ/tagamet when following this route?

 

[chinky]

whats the best way to potentiate after oral administration?

 

[ChillMike420]

I'm not responding to anyone specific, just posting in this thread, with what I use for potentiation and enhancement of my opiates (OxyContin), and with them, I believe they actually work at varying degrees:

Grapefruit Juice

Tonic Water (Quinine) - barely, but *defintely NOT suggested* when used with Gin & Tonic's, you can imagine, it works much better...

Benadryl

Xanax

other opiates (obviously)

sometimes Tylenol (APAP) helps the Oxycodone

and of course, good ol' medical grade Marijuana!


So, there you go... if you take a combo mixer of all of those, with a few 80mg OxyContin's, you're set for a pain-free, euphoric weekend! Be careful though, know your limits, maintain control & willpower, and never forget to use in moderation, and knowing what's right for you, and what your mind and body can handle and use. Don't overmedicate for the sake of wanting to be plastered, as that always leads to disaster. Just thought I should add those warnings and tips. Hope this helps all in this thread and those who come to this thread for straight answers, for I know what I posted from experience. Take care...


- Mike.

 

[tadfish]

Well last night i took first 75mg phenergan then, quinine tablets, with CWE codeine, gabapentin and 3 tagamet then waited an hour+ and had 100mg oxycodone with temazepam and clonazepam.
I was nodding hard all night long in and out of a dreamy almost tripping state talking jibberish passing out into my food face first etc.
My girl found some uppers amphets put them under my nose as i was hardly breathing at all and wasn't able to be woken up. i snorted an amount and went off to sleep nicely allnight from 7.30pm i usually go to bed well after 1am.

Now i have put on a bupe patch to see me through the week and had some codeine to start the day.

I realise that tagamet stops codeine but when u have it with dihydrocodeine it doesn't and if u have tagamet at same time as codeine it works well as it makes the morphine stay around longer and i always use phenergan with it.

I starting to thing that the biggest danger is the potentiation with anti histmiane brain damage.

Going to smoke some Kratom and spice see how thats starrts the day off also.

Dam how do i abuse these patches!

 

[rolls]

Take it easy tad, sounds like your taking a shit load of stuff. I'd be worried about my liver more than anything.

 

[Obyron]

I didn't think smoking kratom did much, which is why most people take it as a tea?

Be careful dude. Sounds like you're headed at full speed toward an OD.

 

[El Commandante]

I have now tried 50mg of hydroxyzine with my methadone on the last 2 days. It really doesn't seem to have made a great deal of difference either way TBH.
I presume that taking it as close to the dose of meth is the best method? Maybe 100mg might be more effective.
Taking Tagamet (400mg) seemed much less effective to me than Grapefruit Juice normally does. Is there anything else that needs to be taken with the tagamet to make it work? Someone mentions taking antacids elsewhere on this page. Is that what I needed to do?
AFA GFJ goes, is 1 beaker of the stuff a reasonable amount to be taking before 30mg methadone, or would it be better to take more?