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Bupe Suboxone/cimetidine money saving tip

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.

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.
 
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!!!!
 
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.

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.

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?

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.
 
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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.)
 

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Cimetidine, if it does antagonize metabolism of buprenorphine, should not make the high any higher but would make it longer. Although you could theoretically be increasing the amount absorbed in the gut by increasing the pH. Most patients are told not drink anything acidic at least 15 minutes before sublingually ingesting Suboxone.
 
^ I though this thread was about speeding up the metabolism from bupe to norbupe, since norbupe is a stronger mu agonist. I'm fucked up, so I don't know. :|
 
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.)

haha

well drawn
 
thats from 0-4 then 4-16 thats weird bupe is goofy i actually prefer 16 holds me better if i do 4mg il prob use dope that day lol
 
OP, where are you getting your cimetidine?

I went to three places today, safeway, walmart, and Fred Meyers (i live in oregon) and Fred Meyers was the cheapest at $4.99 for 30 tabs (Generic Brand)
 
OP, where are you getting your cimetidine?

I went to three places today, safeway, walmart, and Fred Meyers (i live in oregon) and Fred Meyers was the cheapest at $4.99 for 30 tabs (Generic Brand)

I was getting mine from Kroger, they had 50 pill bottle of 200mg cimetidine for 4.99. I also picked some up cheaply when it was put on clearance since it was getting close to going out of date.

Nearly every pharmacy and grocery chain will have generic store brand cimetidine, forget name brand Tagamet.
 
OP, where are you getting your cimetidine?

I went to three places today, safeway, walmart, and Fred Meyers (i live in oregon) and Fred Meyers was the cheapest at $4.99 for 30 tabs (Generic Brand)

Every Rite Aid has tagamet, both brand name and generic. if you have one in your area, check it out.
 
I can't seem to even find any White Grape Fruit Juice... what the hell? I didn't even see it at the grocery store, hell maybe I overlooked it but Captain.Herion, does it really make a difference with Alprazolam???
 
This works!

I have recently been trying to lower my suboxone maintenance dose to conserve my stash. I am prescribed 3 mg per day and I choose to insufflate my pills, not in an attempt to get high, but because I find that to be the most effective roa for me.

Anywho, I have been taking 4 mg recently and ran a little low on my stash, so I have begun to taper. I went down to 3 mg three days ago and have been feeling crappy. I get achey and depressed anywhere below 4 mg and this has always been the case. (I have been on sub maintenance for 4-5 years, and have attempted to stop multiple times, FYI.)

Today I took 800 mg of cimetidine an hour before insufflating 2 mg sub. This was at 9 am, and now at 4:30 pm while I am writing this, I still feel better than I have the past few days at 3 mg. I also took a 5 hour energy shot a few hours ago. I read somewhere that they help potentiate the sub because of the caffeine and vitamin b.

Update: again I am totally blown away by how well this works! It has allowed me to take half my normal dose and literally be well enough to make it 48 hours without redosing. Granted I didn't feel fantastic day two, but it certainly made conserving my stash so much more pain free than what I've experienced the numerous other times I have ran low at the end of the month.

Anyways, I am amazed at how well this worked. Tomorrow I will try this without the 5 hour energy shot and see if it works as well. Cheers to the OP for tipping me off about this! I have tried literally everything to lower my dose without suffering from horrible depression. (plugging, alcohol solution, white grapefruit juice, etc.)
 
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I just thought I'd add something to this.

While reading up on bupe/cimitidine I came across:
http://bja.oxfordjournals.org/cgi/content/abstract/67/6/748

Cimitidine is thought to not only affect opiates, but benzo's as well. The xanax pamphlet lists stats, the Merck index only mentions there may be metabolism contradictions with clonazepam.

Some cimitidine is taken, and a while is waited, to allow it to pass through the stomach, into the liver, where it blocks the CPY34A4.

Then some Suboxone is taken, not orally, and it will go about as normal.

Then a small amount of Suboxone is swallowed, along with some more cimitidine, and some benzo's. I know that Xanax is affected by cimitidine, and the merck index mentions it as possibly affecting that of clonazepam. Additionally correct me if I'm wrong but benzo's are absorbed so quickly,like alcohol, because they can pass right through the stomach lining.

Since the Suboxone causes the contents of the stomach to be held more, a higher % of the benzo's will be absorbed through the stomach, causing a more rapid onset of peak blood concentration levels, along with a longer duration, because all of it was absorbed in a shorter time.

Once the Suboxone allows the stomach contents to be emptied, they will enter the liver, where there is already Cimitidine inhibiting CPY34A4 (which is an enzyme that both eliminated Suboxone, and Benzo's). With this new emptying, comes a new batch of cimitidine, to continue to inhibit CPY34A4.

I believe this method will lead to a longer acting (some would say stronger) dose of suboxone, as well as a more rapidly absorbed, more fully absorbed, and longer elimination of Benzo's.

Seem's pretty good to me. Please correct my errors, as I only want to learn as much as possible.

----
Edit:
My girlfriend and I have both taken Suboxone along with various dosages of cimitidine (by no means scientific), but pre,during, and post dose of Suboxone.

I'm not 100% sure if it increases the effects, although I would assume so since it made me much more tired, however, it certainly makes it last way longer. CPY34A4 is blocked for a long time. The reason I know this is because over the past few days while taking the combination, I've been sleeping like 14 hours.
 
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Suboxone w/ Cimetidine

I've recently started my Suboxone treatment, I believe I've been on it for just over three weeks. I had some cimetidine at my house still from using the opiates of course, and decided why not try taking some of these with my suboxone. I've been taking 600mg of cimetidine like an hour before I take my 12mg of Sub., and I have been noticing quite a bit of difference. For one it seems like my overall mood is somewhat better, and as someone else listed in this thread, it seems to almost speed me out. I keep finding myself writing long elaborate things here on BL. Also I've been cleaning up around the house hardcore, organizing stuff, and it feels pretty good. As far as feeling like it potentiates the suboxone in a way that it makes me feel a buzz... I don't think it does that. However normally when I wake up in the morning I can't wait to take my next dose of sub. Over the last two days though that I've been using the cimetidine I really don't notice the feeling of needing to take it right away, today I waiting til the evening before I took it. So yes I do believe that the cimetidine does potentiate the suboxone in the fact that it really seems to make it last much longer, and make my mood better. Shit if I can keep doing this and skip some days of taking it that would be awesome I'm gonna try it soon; maybe tomarrow. I would save money and pills this way; I'll comment back in a week or so I'll say and let yall know whether when using the cimetidine in conjunction with the suboxone if I can take it every other day. I hope this works; I'll save so much. =D

Peace, and much love. <3

I so glad I found this thread, I thought I was noticing some differences, and it's nice to be able to find other ppl who share the same opinion!
 
^ Ranitidine provides something like 1/10th the CYP inhibition that Cimetidine does (so, a negligible amount for this purpose)- CYP inhibition is what potentiates opiates (by slowing their metabolism).


So buy Cimetidine. Though I guess it isn't OTC everywhere (it is in the US though).
 
I feel compelled to throw my hat into the ring with this one...
it's a bit OT but valuable info nonetheless.

I've been taking suboxone for maintenance for over a year and half now and for me it's a godsend. I won't go into my whole history here but suffice it to say I've been a heroin addict on and off for quite a long time.

anyway - when i started on sub I was taking about 8-12mg a day and felt absolutely *nothing* no matter how much I took (up to 24mg a couple of times) or in what manner (tried snorting it once - nothing)

then about 3 months into my sub treatment my doctor put me on Lamictal - a mood stabilizer - and I immediately noticed it's potentiator effects.

nowdays I take 8mg of sub in the morn and 8mg at night and about 75-100mg of the Lamictal with each dose.

it's a bit strange because it's not 100% of the time and it's not always the same strength but probably 75% of the time I *do* get high - not a lot, and the euphoria only lasts for maybe an hour, but nonetheless - it's definitely there.

I find that if I take too much of both I get drowsy and I nod - but without the raging euphoria we all know so well so it's kind of pointless.

the best I can compare it to is when I didn't have a habit and I would eat a bunch of codeine, a nice opiate buzz but nothing overwhelming.

I haven't tried the Cimetidine as of yet but I'm off to the pharmacy now so I'll let y'all know how that works out.

I suppose I could've started a whole new thread but I felt y'all would appreciate the info.

cheers,

b

ps - I was prescribed the Lamictal because my doctor diagnosed me as having bipolar II. this is distinct from bipolar I in that it's much less acute and there's rarely if ever an intense 'manic' phase (i've never had one).
it presents very similar to depression (which I was also diagnosed with - like 90% of all the opiate addicts I know) so it's a bit hard to say which is one and which is the other.
personally I have my doubts about the BP II diagnosis but for obvious reasons I've been reluctant to re-open the matter.

I guess the tiger never changes his stripes eh?

<sigh>

oh well - it could be worse, I could be on methadone.
 
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