Bluelight

Thread: Suboxone/cimetidine money saving tip

Page 1 of 3 123 LastLast
Results 1 to 25 of 56
  1. Collapse Details
    Suboxone/cimetidine money saving tip 
    #1
    I never put much faith in opiate/opioid potentiation with cimetidine, the few times I tried it with hydrocodone and morphine with negligible effect if any.

    But after trying it with suboxone I am a believer, it is an amazing potentiator of buprenorphine! It not only almost doubles the subjective feeling of a dose but also extends the effects. I took 1mg of suboxone sublingually yesterday at 6pm and its now 10:30am and I am still feeling it strongly, and last night I slept like a baby when usually I suffer from insomnia. Without using cimetidine 2mg of suboxone will barely hold me and keep me well, I certainly would not be feeling it the next day.

    My dosing schedule is:

    1 hour before taking the sub I dose 600mg of cimetidine, then dose the sub, and then every 6 hours afterward I dose 400mg of cimetidine until I can no longer feel the sub which is usually sometime after the 24 hour mark. I still am well at this point I just no longer conciously feel the sub.

    This is a big money saver with the cost of suboxone, as you can get 50 tablets of generic 200mg cimetidine OTC for under 5 dollars. Even if you have tried cimetidine before with other opiates/opioids give it a try with sub, you might be like me and able to get double the mileage out of your sub.

    It appears cimetidine does have some potential side effects:

    http://www.drugs.com/mtm/cimetidine.html

    FWIW I have personally never experienced any side effects from cimetidine, but do be careful.
    Reply With Quote
     

  2. Collapse Details
     
    #2
    Bluelighter pinpoint's Avatar
    Join Date
    Jul 2007
    Location
    At the scene of the crash
    Posts
    1,289
    this doesn't make a whole lot of sense since the action of cimetidine is its effect on certain enzymes in your stomach. since buprenorphine is not absorbed through your stomach, i don't believe cimetidine would have any effect on it. maybe somebody could care to explain. garuda, is it possible this is just placebo or what? your experience is good news, but you have no explanation of how it could work. what is your MOA?
    Reply With Quote
     

  3. Collapse Details
     
    #3
    Sorry I should have covered that, it has to do with inhibiting liver enzymes that metabolize the buprenorphine, in addition to reducing stomach acid cimetidine is a cytochrome CYP3 A4 enzyme inhibitor. It has nothing to do with the stomach, you're inhibiting the enzyme that breaks down bupe in your liver.

    White grapefruit juice contains a chemical that has a similar effect, I just find it cheaper and more convenient to use cimetidine instead of constantly drinking vast amounts of WGFJ.

    Here is the wikipedia page you can see the table where they list inhibitors and inducers, you want to avoid the inducers.

    http://en.wikipedia.org/wiki/CYP3A4

    Cimetidine, white grapefruit juice, and quercetin(OTC supplement) are the easiest to find of the inhibitors and also the safest.

    EDIT: From wikipedia again:
    http://en.wikipedia.org/wiki/Buprenorphine
    Buprenorphine is metabolised by the liver, via the CYP3A4 isozyme of the cytochrome P450 enzyme system, into norbuprenorphine (by N-dealkylation) and other metabolites. The metabolites are further conjugated with glucuronic acid and eliminated mainly through excretion into the bile. The elimination half-life of buprenorphine is 20–73 hours (mean 37). Due to the mainly hepatic elimination there is no risk of accumulation in patients with renal impairment and in the elderly.
    So inhibit the enzyme and you slow down the metabolization of buprenorphine, leaving more in your bloodstream and for longer.
    Reply With Quote
     

  4. Collapse Details
     
    #4
    Bluelighter pinpoint's Avatar
    Join Date
    Jul 2007
    Location
    At the scene of the crash
    Posts
    1,289
    that's what i got mixed up. i was thinking it had to do with your stomach, when in fact it's your liver that the enzymes are inhibited in.
    Reply With Quote
     

  5. Collapse Details
     
    #5
    But isn't norbupe a stronger mu agonist? I've thought about this before, but never done it, I always thought I would want my body to convert the bupe to norbupe.

    Perhaps I'll give this a try soon. Actually, there's no point, because I'm not going to feel anything either way; I take sub for maintenance, and feel nothing from it. The only way this would do anything good for me (personally) would be if it enabled me to dose lower, because my insurance doesn't cover the pills, so if I could dose lower I could save a little money.

    I'll try to find some stats on the differences between bupe and norbupe, but I'm pretty sure norbupe is a stronger mu agonist, so it seems like you would want it metabolized. Hell, you might even want to induce CYP3A4...
    Reply With Quote
     

  6. Collapse Details
     
    #6
    Quote Originally Posted by johanneschimpo
    But isn't norbupe a stronger mu agonist? I've thought about this before, but never done it, I always thought I would want my body to convert the bupe to norbupe.

    Perhaps I'll give this a try soon. Actually, there's no point, because I'm not going to feel anything either way; I take sub for maintenance, and feel nothing from it. The only way this would do anything good for me (personally) would be if it enabled me to dose lower, because my insurance doesn't cover the pills, so if I could dose lower I could save a little money.

    I'll try to find some stats on the differences between bupe and norbupe, but I'm pretty sure norbupe is a stronger mu agonist, so it seems like you would want it metabolized. Hell, you might even want to induce CYP3A4...
    According to wikipedia:

    http://en.wikipedia.org/wiki/Buprenorphine

    The main active metabolite, norbuprenorphine, is a δ-opioid receptor and ORL1 receptor agonist, μ- and κ-opioid receptor partial agonist, but buprenorphine antagonizes its effects.[6]
    Personally I might have some reservations about taking that much cimetidine day in and day out for maintenance, you could also look into quercetin and bergamottin but they might be more expensive then cimetidine.

    I know its subjective experience, but it really works for me. The first time I took 2mg with cimetidine I nodded for the first time off of suboxone. After that I reduced the dose to 1mg.

    And like I said with hydrocodone and morphine I really noticed no significant potentiation so I was surprised.
    Reply With Quote
     

  7. Collapse Details
     
    #7
    Ah I see. So even if norbupe is a stronger, or full, mu agonist (which I'm 99% sure it is), it doesn't matter because bupe is going to compete for the receptors (and win).
    Interesting... makes me want to dealkylate it in some way and see what its like on its own. Anyone got a liver I can borrow?
    Reply With Quote
     

  8. Collapse Details
     
    #8
    norbuprenorphine is also far more toxic.
    Reply With Quote
     

  9. Collapse Details
     
    #9
    make that two livers?

    Benadryl and Benzos are good too. (I know, groundbreaking information, thank me later)
    Reply With Quote
     

  10. Collapse Details
     
    #10
    Bluelighter InHerOwnWrite's Avatar
    Join Date
    Nov 2006
    Location
    Philadelphia, PA
    Posts
    1,060
    wow, this is good news. i stopped shooting subutex a long time ago, but i do snort it occasionally for pain.
    IME, cimetadine HAS helped with my oxy use- always made the high more intense and last longer.
    but thanks garuda, i'll give this a try next time i decide to use sub.
    Reply With Quote
     

  11. Collapse Details
     
    #11
    nevermind...search button used
    Last edited by iEatKusH4BFasT; 04-06-2008 at 02:50.
    Reply With Quote
     

  12. Collapse Details
     
    #12
    Bluelighter
    Join Date
    Oct 2002
    Location
    Philly
    Posts
    1,544
    This is something i will definately try SOON. In the past month I went from 6-2 mg a day depening, but if this works I will report back because i know the penny pinching of suboxone maitinence therapy. I wish there is a generic, when is the patent up? If this works I will report back.

    Good to see you sent me a message Inherownwrite, I hope everything is doing well (for you) and I will see you sometime in the near future hopefully. Muah
    Reply With Quote
     

  13. Collapse Details
     
    #13
    Bluelighter Mr Blonde's Avatar
    Join Date
    Oct 2006
    Location
    Brisbane, Australia
    Posts
    13,718
    How do you dose your sub, garuda? Sublingually?

    This is very interesting, I would have thought the cimetidine would just extend the half life rather then potentiate.

    Any ideas on the reason for this? Something to do with the metabolites of the drug itself maybe?
    Reply With Quote
     

  14. Collapse Details
     
    #14
    someone who takes suboxone every day for maintenance please try this and see if you catch a buzz off your regular dose...i gotta know if it works
    Reply With Quote
     

  15. Collapse Details
     
    #15
    I take 4mg a day for maintenance. If I decide to go crazy and take a big dose, like 24mg, it doesn't do a damn thing to me. So I can say that for me, this wouldn't do anything. It might make it better therapeutically though - either by letting me take a lower dose (say 3mg), or by extending how long it lasts having to dose less often. I don't expect it to make any noticeable difference for me (I'm only talking about for me, I don't know about others).

    I'm on sub maintenance, and it won't get me high no matter how much I take.
    Reply With Quote
     

  16. Collapse Details
     
    #16
    Temporary Ban DexterMeth's Avatar
    Join Date
    Oct 2003
    Location
    ♤♡Night poopie♢♧
    Posts
    51,809
    ^i started on 12mg and have been on 8mg for almost a year. I take cimetidine every now and then (it's VERY COSTLY where I live...at least the stores I've seen it in...only tagamet)...but it definately boosts the high and the duration of sublingual bupe.. I def dont get high either as i'm on BMT...but every now and then i get a random decent nod from bupe...and the cimetidine has USUALLLY seemed to be the factor. Definately not worth paying almost $15 for 30 200mg pills of cimetidine though. (yeah it sucks in my area...maybe i'm just not looking hard enough...then again I could care less as I'm getting off bupe on my own soon enough...already started to titrate)
    Reply With Quote
     

  17. Collapse Details
     
    #17
    Bluelighter
    Join Date
    Nov 2008
    Location
    paaa
    Posts
    443
    bupe is weird i have been on suboxone for 16months and even when u do get high from it its speedy like no opiate ever i cant sit still i look like a crack head lol but in my area its xpensive to man i dont know why there no generic form of it
    Reply With Quote
     

  18. Collapse Details
     
    #18
    Bluelighter pallidamors's Avatar
    Join Date
    Sep 2008
    Location
    Bankailorado
    Posts
    7,237
    Quote Originally Posted by euphoricc View Post
    bupe is weird i have been on suboxone for 16months and even when u do get high from it its speedy like no opiate ever i cant sit still i look like a crack head lol but in my area its xpensive to man i dont know why there no generic form of it
    There's no generic form of it because the patent hasn't expired yet (I think). Or maybe the patent recently expired or will this year; either way, once that happens, unless the patent is renewed, there will be a generic form. May I suggest the journal for posts like this in the future though? Welcome to BL man! (or woman!)
    Reply With Quote
     

  19. Collapse Details
    back from the dead 
    #19
    Sorry to bring the post back from the dead, but I am interested in minimizing the amount of costly subutex I use so:

    Whats general consensus about bupe + cimetidine?

    Does it work as a potentiator or not?


    stay safe
    Reply With Quote
     

  20. Collapse Details
     
    #20
    BL Ambassador Captain.Heroin's Avatar
    Join Date
    Nov 2008
    Location
    I wished with all my heart that we could just...leave this world behind. Rise like two angels in the night and magically...disappear.
    Posts
    44,946
    Quote Originally Posted by garuda View Post
    White grapefruit juice contains a chemical that has a similar effect, I just find it cheaper and more convenient to use cimetidine instead of constantly drinking vast amounts of WGFJ.
    I find it does help with lengthening buprenorphine, but I get a better potentiation out of benzos such as valium or xanax when it comes to WGFJ. I love a glass of WGFJ, I need to buy some more.

    I can completely understand how you see it more convenient and feasible than drinking a lot of grapefruit juice.

    EDIT: From wikipedia again:
    http://en.wikipedia.org/wiki/Buprenorphine
    ^ Not everything on the above webpage is incorrect, but some of it most certainly is. I wouldn't trust wiki as a source TBH ^

    But, I do admit that wiki is right about the cytochrome P450 enzyme CYP3A4. That part isn't wrong, just other parts of wiki's page on buprenorphine.
    Reply With Quote
     

  21. Collapse Details
     
    #21
    I typed something up but lost it, so I'll just toss you a few links instead:
    http://www.bluelight.ru/vb/showthread.php?t=368133
    http://www.bluelight.ru/vb/showthread.php?t=342726
    Reply With Quote
     

  22. Collapse Details
     
    #22
    BL Ambassador Captain.Heroin's Avatar
    Join Date
    Nov 2008
    Location
    I wished with all my heart that we could just...leave this world behind. Rise like two angels in the night and magically...disappear.
    Posts
    44,946
    Quote Originally Posted by johanneschimpo View Post
    Perhaps I'll give this a try soon. Actually, there's no point, because I'm not going to feel anything either way; I take sub for maintenance, and feel nothing from it. The only way this would do anything good for me (personally) would be if it enabled me to dose lower, because my insurance doesn't cover the pills, so if I could dose lower I could save a little money.

    I'll try to find some stats on the differences between bupe and norbupe, but I'm pretty sure norbupe is a stronger mu agonist, so it seems like you would want it metabolized. Hell, you might even want to induce CYP3A4...
    norbuprenorphine is a better mu-agonist, this is true.

    You get better levels of norbuprenorphine when you take smaller doses of buprenorphine itself. I find 0.5mg at a time (two to three times a day) is best, I dropped down about a month ago from 1mg three times a day and find it works even better.

    Even if you take buprenorphine as maintenance and intend not to feel anything from it (ie 'high') there's nothing wrong in taking WGFJ; it really does lengthen the buprenorphine's effect, and pharmacologically, this is a positive medicinial effect. There's nothing wrong in wanting it to last longer.

    BTW JC it will also potentiate diazepam well. (as I'm sure you know) WGFJ is the only way I enjoy diazepam by itself to be honest.

    I can understand why you wouldn't want to try it though, if you're using buprenorphine strictly for maintenance you might want the most steady, regular, consistent dose.

    Quote Originally Posted by garuda View Post
    According to wikipedia:

    http://en.wikipedia.org/wiki/Buprenorphine



    Personally I might have some reservations about taking that much cimetidine day in and day out for maintenance, you could also look into quercetin and bergamottin but they might be more expensive then cimetidine.

    I know its subjective experience, but it really works for me. The first time I took 2mg with cimetidine I nodded for the first time off of suboxone. After that I reduced the dose to 1mg.

    And like I said with hydrocodone and morphine I really noticed no significant potentiation so I was surprised.
    from http://en.wikipedia.org/wiki/Norbuprenorphine:

    However, it has a slightly different binding profile to opioid receptors, acting as a stronger partial agonist at the mu opioid receptor than buprenorphine itself, as well as being a potent full agonist for the nociceptin receptor.
    Still, wiki isn't always correct, but I am sure nor-buprenorphine is a better mu-agonist than buprenorphine is.
    Reply With Quote
     

  23. Collapse Details
     
    #23
    Bluelighter
    Join Date
    Nov 2008
    Location
    paaa
    Posts
    443
    pallidamors ty i see the stupid patent geeze...lol 400 dollars for 60?roughly 6.50 a pill still seems high to me but o well kasad-i cant tell a dif i am on maintenance so i wont ,but what i will do is try it and report back ill prob get flamed for this but (my) fav potentiator is klonopin i know u cant over do it like 4mg of sub and 1mg or 2 of klon and its relaxing..... anything more =death and thats no funn!!!!
    Reply With Quote
     

  24. Collapse Details
     
    #24
    BL Ambassador Captain.Heroin's Avatar
    Join Date
    Nov 2008
    Location
    I wished with all my heart that we could just...leave this world behind. Rise like two angels in the night and magically...disappear.
    Posts
    44,946
    Quote Originally Posted by johanneschimpo View Post
    Ah I see. So even if norbupe is a stronger, or full, mu agonist (which I'm 99% sure it is), it doesn't matter because bupe is going to compete for the receptors (and win).
    Actually, not always. If you take a small dose (ie less than 2mg) this should be optimal for nor-buprenorphine, if you take more, there tends to be more buprenorphine. At larger doses, buprenorphine tends to spill into other neurotransmitter receptors, and can limit the production of monoamine neurotransmitters, which typcially leads people to being very frustrated and/or agitated. Also, at higher doses, people are more likely to get side effects (though they are still possible at low doses).

    Interesting... makes me want to dealkylate it in some way and see what its like on its own. Anyone got a liver I can borrow?
    LOL

    nor-buprenorphine doesn't readily cross the BBB. I'm pretty sure the only way to efficiently experience it is through a small dose of buprenorphine.

    Quote Originally Posted by Ham-milton View Post
    norbuprenorphine is also far more toxic.
    Any evidence, or just heresay?

    _____

    For the record, individuals are different and there are different effective doses of buprenorphine for different people: some get more out of taking a low dose, others need more. There are natural reasons for this. However, The difference between taking 1mg and 4mg is a lot different than 4mg and 16mg due to buprenorphine's dose-response curve. If anyone can get an image of this, that would be great to be posted here.

    Quote Originally Posted by InHerOwnWrite View Post
    wow, this is good news. i stopped shooting subutex a long time ago, but i do snort it occasionally for pain.
    IME, cimetadine HAS helped with my oxy use- always made the high more intense and last longer.
    but thanks garuda, i'll give this a try next time i decide to use sub.
    I wouldn't snort subutex, I would advise consuming it sublingually with alcohol via 6/7's method. (Using the alcohol to help dissolve and transport the active ingredient through your mucous membranes, not to actually drink the alcohol). This way, you get 70% bioavailability instead of 50% (or 30% which is sublingual w/o alcohol).

    What doses do you usually take, if you don't mind me asking?

    Quote Originally Posted by euphoricc View Post
    pallidamors ty i see the stupid patent geeze...lol 400 dollars for 60?roughly 6.50 a pill still seems high to me but o well kasad-i cant tell a dif i am on maintenance so i wont ,but what i will do is try it and report back ill prob get flamed for this but (my) fav potentiator is klonopin i know u cant over do it like 4mg of sub and 1mg or 2 of klon and its relaxing..... anything more =death and thats no funn!!!!
    You can take large doses of benzos with buprenorphine, it's just not advised. Like combining alcohol and large amounts of benzos, you will make an ass out of yourself.

    I watched someone take 16mg to 20mg of lorazepam over the course of a day with 1mg IV buprenorphine (no opiate tolerance, large benzo tolerance) - they ended up forgetting what they had just done, and ended up consuming more and more lorazepam without thinking about it. They tried eating a PB&J sandwich, and it ended up in a mangled, gooey mess...and some of it was on their forehead/face,etc.

    It definitely represses your breathing a lot too, which is why it isn't all that safe.
    Last edited by Captain.Heroin; 12-06-2009 at 00:23.
    Reply With Quote
     

  25. Collapse Details
     
    #25
    Quote Originally Posted by Captain.Heroin View Post
    If anyone can get an image of this, that would be great to be posted here.
    Found it right on Reckitt Bensinger's website.


    OK, you caught me. I drew it. Poorly. (Don't mind that one line curves and that one is straight... its just because making a nice freehand curve with a mouse is a pain in the ass.)
    Attached Thumbnails Attached Thumbnails Click image for larger version. 

Name:	crudely drawn bupe thing.jpg 
Views:	600 
Size:	12.4 KB 
ID:	6848  
    Reply With Quote
     

Page 1 of 3 123 LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •