Opioids Potentiating SR and IR Oxycodone for legitimate pain

Hello

I broke my leg quite badly in a car crash last year, took me a few months to get back to walking again.

I am regularly prescribed Oxycontin [Slow-Release Oxycodone] and sometimes Endone [Instant Release Oxycodone] for legitimate pain issues i have with my leg.

As my tolerance has increased over time and my doctor wants to start reducing the amount that i am prescribed, i'm looking into ways to potentiate the effects of Oxycodone.

Unfortunately i have little to no knowledge in this area, and doing google searches seems to come up with repeatedly contradictory information, so i thought here would be a good place to start.

The list of medications i have access to, which google has suggested some might be good potentiators, includes:


Prescription
Lyrica
Endep
Clonidine
Valproate

Pharmacy
Phenergen
Doxylamine Succinate

I also have limited access to Diazepam, Tramadol and possibly Gabapentin, as well as some illicit drugs, however i haven't found much evidence that they potentiate, and my preference would be to only take these occasionally due to health issues.


Any information will be appreciated, google provides soo much contradictory information i can't make heads or tails of it.

If you have a prescription for Lyrica there is no need to get Gabapentin. Benzo's and Clonodine have a 'synergistic' effect that makes the sedation side effect of opiates stronger, and also increases the chances of CNS depression. Phenergen which is promethazine will actually potentiate oxycodone, as will other first generation antihistamines such as Hydroxyzine and Diphenhydramine. Actually I imagine Doxylamine would too. Other potentiators would be NMDA antagonists, like Dextromethorphan. Then there is also white grapefruit juice, or you can get the chemical in WGFJ in OTC medications Tagamet/Cimitedine.

Eating a whole white grapefruit before the oxy always helped me a little. Or get the good natural grapefruit juice, the pink grapefruit is no good though, only white

I chime in to support what Z-neg and Jet have added. These drugs should help during a reduction in your dose, I can't say they'll actually potentiate oxycodone apart from the White Grapefruit juice which, loosely understood, may supress particular enzymes that aid in the metabolism of oxycodone although I couldn't tell a difference (I was too tolerant to higher doses of oxy though, so I'm possibly an unfair representative for that combo).

Benzos, antihistamines and Clonidine can increase the sedation of an opioid and/or opiate, so can Lyrica but if you haven't used Lyrica you may benefit from it's potential to help reduce some aches and pains.....it may also send you around the twist the first week or so too depending on dosage so I advise titrating that one from say 75mgs max then beyond to no more than 300mgs morning and then again at night for a total of 600mgs daily.

Try each of these on their own with your oxy before adding in others otherwise you cannot safely assume what is working and safely consume the drugs listed without some experience - you may react badly to antihistamines and/or Lyrica. You could try the Gabapentin if you don't agree with Lyrica but it appears to be preferred by those who have used both.

Even when using a high dose of the partial agonist Buprenorphine I find 75mcg (micrograms) of clonidine to just drop me straight into nod land.....i never used it with oxycodone but I think I would have to keep moving cos as soon as I sit at a computer and start typing my head hits the desk....and that's with bupe so be careful. Stay hydrated and take care.

http://www.bluelight.org/vb/threads/534200 utse..

- HS

Do you smoke pot? I have read a lot about people switching from painkillers to pot, or having to use less when smoking.

My doctors seem to think that I have Hyperalgesia. Hyperalgesia is an increased sensitivity to pain, which may be done due to damage to nociceptors or peripheral nerves.

Opioid induced Hyperalgesia may develop as a result of long term use in the treatment of chronic pain. Various studies of humans and animals have demonstrated that primary or secondary Hyperalgesia can develop in response to both chronic and acute exposure to opioids. This side effect can be severe enough to warrant discontinuation of opioid treatment. Source : Wikipedia

My dose is low. That proves my doctors partially full of shit.


Also from Wikipedia. A nociceptor is a sensory nerve cell that responds to damaging or potentially damaging stimuli by sending signals to the spinal cord and brain. This process, called nociception, usually causes the perception of pain in sentient beings.

Both of these things are something to consider. My one doctor wants to put me on a Ketamine iv drip for eight hours, to reset or lower my tolerance to opioids/opiates. I'm considering it.

Lastly, I had a pain doctor mention that cannabis and opiates synergize well.

Alright, imo you got enough good answers and there are enough threads like this, so I'm going to close this now.
If you want me to re-open the thread PM me

Re-opened

Kava kava is fantastic for potentiation and/or synergism IME. I tried cimetidine once, and while I couldn't tell if the effects were any stronger, it noticeably enhanced duration.

First off thank you to everybody who took the time to reply.

Znegative said:

If you have a prescription for Lyrica there is no need to get Gabapentin. Benzo's and Clonodine have a 'synergistic' effect that makes the sedation side effect of opiates stronger, and also increases the chances of CNS depression. Phenergen which is promethazine will actually potentiate oxycodone, as will other first generation antihistamines such as Hydroxyzine and Diphenhydramine. Actually I imagine Doxylamine would too. Other potentiators would be NMDA antagonists, like Dextromethorphan. Then there is also white grapefruit juice, or you can get the chemical in WGFJ in OTC medications Tagamet/Cimitedine.

Click to expand...

Is there any specific timing recommendations you or anybody else suggests with taking the phenergen with either the instant or slow release oxycodone? I have tried taking them at different times and i can't really tell if one is more optimal then others?

SKR said:

Benzos, antihistamines and Clonidine can increase the sedation of an opioid and/or opiate, so can Lyrica but if you haven't used Lyrica you may benefit from it's potential to help reduce some aches and pains.....it may also send you around the twist the first week or so too depending on dosage so I advise titrating that one from say 75mgs max then beyond to no more than 300mgs morning and then again at night for a total of 600mgs daily.

Click to expand...

Benzo's seem to do very little for me expect in high doses they make me feel extremely lethargic and dizzy, clonidine seems to help with the physical anxiety i get when i run out of oxycodone, and Lyrica did seem to have solid synergy, however i am now out and my doctor does not wish to prescribe it to me, the box that i had was from when i was discharged from the rehabilitation centre last year.

manboychef said:

Do you smoke pot? I have read a lot about people switching from painkillers to pot, or having to use less when smoking.

Click to expand...

It has never agreed with me in the past, however i will try experimenting with it WRT my pain. My big question here is, is there any medications that i've listed that i should AVOID taking whilst smoking MJ?


My biggest query is for TIMING, is there optimal dosage timing people have found when taking medications such as clonidine, benzo's and phenergen and the best times to take them with my slow-release oxy, as about 90% of the oxycodone i have is slow-release. I don't crush them up or anything like that, and i'm fine with that, maximizing the length of time that the oxycodone works is pretty much my only concern, compared to me maximizing any 'buzz' i can get from the tablets.


Lastly, what do people recommend is the best way to reduce my opiate tolerance in the medium to long term? Having tablets less days overall, or having tablets most days but minimizing the dosage as much as i can?


Once again, i appreciate any help you guys can provide.

promethazine (phenergen) and clonidine will potentiate, pregabalin (lyrica) will have a synergistic effect that can make the oxycodone seem stronger. and there is really no need for you to have gabapentin at all if you have lyrica because lyrica is almost exactly the same as gabapentin except stronger and better.

Not sure if I can add anything new to this topic, though perhaps another personal experience. Usually I use Lyrica, benzos and Diphenhydramine to potentiate Oxycodone/Hydromorphone, and Dextromethorphan to manage my opioid tolerance plus I alternate the potentiators. Of course you also have to keep an eye on your Lyrica and Diazepam dosages... tolerance builds up awfully quick. Try not to use Diazepam on a daily basis and try to withdraw from opioids every now and then. Good luck mate!

Edit:

G'Kar said:

...Lyrica did seem to have solid synergy, however i am now out and my doctor does not wish to prescribe it to me, the box that i had was from when i was discharged from the rehabilitation centre last year.

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Lyrica and Oxy synergize quite well. A good way to keep the Oxy-dosage low. Talk to your doctor about that. If he's a good one he'll understand... if not you'll have to find one that does.