Opioids Will Carbamazepine potentiate Codeine?

[pally pete]

From what I have read over the years, most Opiates require CYP inhibition for potentiation. From what I have learnt, Codeine is the exception to the rule - whereas it needs CYP Induction for potentiation.


How true is this.. as I have a draw full of 100mg Carbamazepine tablets (Which I know is a potent CYP2D6 Inducer) and some CWE Codeine which I've been doing 600mg worth of CWE but not been feeling too much. I know 600mg can be considered wasteful, as there is a disputed ceiling dose of around 300-500mg for Codeine, but I always presume that I lose about 20% through CWE.


Also the solution is never clear, it is a bit cloudy, but when left to stand at room temperature for 10 minutes or so there is no white powder/Paracetamol residue at the bottom of the glass. What I have read is that this is fine to drink, as if there were to be any considerable amount of Paracetamol in the final solution it would sink to the bottom of the glass which I would be able to see.


I have a high tolerance but my Oxy man has let me down, so this is next best thing/only thing.


I've posted on this board before about Codeine and been roasted. Please don't bother replying if your just going to tell me how shit/weak Codeine is.


Thanks in advance

 

[kleinerkiffer]

I was under the impression that carbamazepine induces CYP3A4 more than other isozymes (I'm not sure if it even induces other isozymes) so this would lead to more norcodeine which isn't that active

 

[pally pete]

I was under the impression that carbamazepine induces CYP3A4 more than other isozymes (I'm not sure if it even induces other isozymes) so this would lead to more norcodeine which isn't that active

You were bang on. It's an inducer of CYP3A4 - So would taking it help clear Diazepam out my system?

Thanks for your help.

 

[kleinerkiffer]

So, I checked a few sources and while it not only induces CYP3A4 it doesn't induce CYP2D6 so it looks like the only viable way to boost codeine is glutethimide (I did a quick search but I'd have to look into it more: another metabolite of codeine is codeine-6-glucuronide and it seems that this metabolite could be responsible for most of the effects, the enzyme is UGT2B7 and I skimmed over a paper stating that TBHQ may increase mRNA of said enzyme, but it looks like it's cancerogenic in higher doses)

Regarding diazepam, CYP3A4 is one of the enzymes metabolizing diazepam so yes, it seems likely that carbamazepine will increase metabolism thus decreasing the duration of action

 

[musing]

It will get codeine out of your system quicker without getting you higher (or high at all)