Opioids Is it possible for one type of methadone to affect you differently than another?

[Swimmingdancer]

UPDATE: So I did some research and apparently the smaller mg pills have more of the so-called "inactive" ingredients, for example magnesium stearate, in them which can decrease absorption/bioavailability (thereby decreasing the effects). I've made a post at the bottom of this thread with more details and links to studies on this topic.

Original post:
So my question is basically does anyone know of any scientific reason for a person to have different effects from one type of methadone hydrochloride than from another? People mention noticing different types of methadone to feel stronger/weaker than others but most doctors and other Bluelighters say that is physically impossible and that it must just be a placebo effect. However there does seem to be a lot of anecdotal reports.

My recent personal experience has led me to ask this question. I was thinking of posting it in Advanced Drug Discussion but wasn't sure, so mods, feel free to move this if you think it will get more expert answers in a different forum.

I was taking 25mg Metadol tablets (from Palladin Labs) and then switched to 10mg Metadol tablets, but was still taking the same dose. I got very bad withdrawal symptoms after the switch, which at the time I assumed were caused by a previous dose decrease that maybe just hadn't started to be noticeable yet due to methadone's long half-life. But the withdrawal symptoms just kept getting worse and worse. After a few months of this, I switched back to the 25mg tablets - in the exact same dose as I had been taking of the 10mg tablets - and almost immediately felt much better. I think it is very unlikely that this is a placebo effect because I was not expecting any differences between them. Unfortunately I only have a small number of the 25mg tablets left and if I am going to ask my doctor to switch me back to the 25mg tablets I would like to have some info behind my reasoning so that I don't just get laughed out of the office for the withdrawal symptoms being "all in my head". I have also discounted the possibility that something in my diet has affected this as I am consuming the exact same foods/drinks and am not taking any other medications or supplements on any kind of regular basis.

Each METADOL 25 mg tablet contains: 25 mg Methadone Hydrochloride USP, Lactose, Magnesium Stearate and
Microcrystalline Cellulose.

Each METADOL 10 mg tablet contains: 25 mg Methadone Hydrochloride USP, D&C Yellow No. 10 Aluminium Lake, FD&C Blue No.1 Lake, Lactose, Magnesium Stearate and Microcrystalline Cellulose.

Since the only apparent difference in the ingredients is that the 10mg tablets contain dye, (unless there are different quantities of the other inactive ingredients, since quantities are not listed), it seems very strange that there would be such a pronounced difference in the effects.

My potential hypotheses are as follows:

1) Perhaps something about the inactive ingredients in the 10mg pills impairs my metabolism in some way. (I have read that artificial dyes can affect the kidneys and liver).
2) Perhaps there is actually more than 25mg of methadone in the 25mg pills. This seems highly unlikely, but there was a recall of them recently so who knows.
3) Perhaps I am allergic to the dye in the 10mg pills and the symptoms just happen to exactly mimic methadone withdrawal. Again, highly unlikely.
4) Perhaps there is some difference in the methadone at an atomic level or something which the manufacturer does't consider a real difference. I have no idea whether this one is even possible?

Anyone have any educated input? Please avoid responding if you don't know or are just going to say "The FDA would never allow that" or "that's impossible" without anything to back up such a claim.

Thanks very much

 

[Cane2theLeft]

These threads used to come up ALL the time when I modded here and we agreed that the vast majority of the time there is no difference ergo it's generally not worth discussing and beyond that, all we can do is speculate. The FDA so strictly regulates dosages in medication that there is virtually no difference from brand to brand to generic and as you know, the only differences are inactives which can SLIGHTLY change absorption and so forth but will have a negligible effect therapeutically outside potential rare exceptions.

There is really no way to answer your question except through speculation and usually these threads just draw a lot of people to make very unscientific claims which is discouraged here and why these threads haven't been permitted for a few years.

 

[tricomb]

^This If it says a certain dose on it if it's made in the USA then you can be certain 10mg methadone hcl = 10mg methadone hcl, methadone is a highly controlled substance and is treated as such. These threads are against the forum guidelines, sorry bro. You can search and find a lot of information on this subject anyways, despite the OD guidelines they appear often as cane said.

Some people have favorite brands that they respond to better, based on their individual body chemistry. Not because the pills are faulty, unless they've been ordered from some shady online pharmacy against the Ryan Haight Act (RIP) or out of the country w/e, you can be confident that the pills are the same strength. If a certain brand works better for you, I don't see any reason why you shouldn't be able to choose your brand too, as long as it's affordable.

 

[Swimmingdancer]

I think my thread is different from the usual "Hey is Roxane stronger than Mallinkrodt? My dealer says it's the shizzle" type threads. However, I haven't seen those getting closed either.

I am not asking for a definitive answer in what is causing the difference for me personally, just what is possible. I know there are some very educated Bluelighters out there who perhaps have some knowledge about pharmacology, biology, how artificial dyes affect the body, etc. Personal experience is welcomed as well, but random speculation based on nothing is not what I am looking for.

I also don't live in the US so the FDA's public stance on the issue is not very relevant to me, and if you had read my thread I was asking about possibilities aside from a difference in the actual amount of methadone in the pills.

 

[tricomb]

Im not even familiar with those pharmaceutical companies you originally listed. What country are you in? does it have an agency equivalent to the US Food and Drug Administration who's duty it is to make sure everything is consistent.

 

[Swimmingdancer]

^This If it says a certain dose on it if it's made in the USA then you can be certain 10mg methadone hcl = 10mg methadone hcl, methadone is a highly controlled substance and is treated as such. These threads are against the forum guidelines, sorry bro. You can search and find a lot of information on this subject anyways, despite the OD guidelines they appear often as cane said.

Some people have favorite brands that they respond to better, based on their individual body chemistry. Not because the pills are faulty, unless they've been ordered from some shady online pharmacy against the Ryan Haight Act (RIP) or out of the country w/e, you can be confident that the pills are the same strength. If a certain brand works better for you, I don't see any reason why you shouldn't be able to choose your brand too, as long as it's affordable.

I don't see how this thread is against the forum guidelines, could you explain what guideline I am violating?

My problem with requesting a specific tablet is that they are actually from the same brand, just different strengths. My doctor wants me to take the smaller ones as he thinks it will be easier to measure for tapering. I am thinking that it is probably something to do with my body and not "faulty pills". I suppose I could just tell my doctor I seem to be sensitive to the dye.

 

[Swimmingdancer]

Im not even familiar with those pharmaceutical companies you originally listed. What country are you in? does it have an agency equivalent to the US Food and Drug Administration who's duty it is to make sure everything is consistent.

I am in Canada, so we do have Health Canada, which should be pretty good. Ocassionally there are screw-ups, I know some of the 25mg tablets were recalled recently but the pharmacy didn't tell me why. I was basically just trying to politely say I'd had enough of Cane2theLeft going on about the FDA when I'd already heard that argument from him and it didn't answer my question ;-) What I was wondering is whether there is a possibility of the cause being something other than that the tablets are not the strengths advertised. I do agree that it's pretty unlikely that a substantial difference from the labelled dosage could go unnoticed for any period of time, I was not debating that.

 

[tricomb]

7) NO QUESTIONS RESULTING IN ENDLESS SPECULATIVE DISCUSSION

^ I would suggest you do bring it up with your doctor. C2TL was making a valid argument, you should call the pharmacy and ask why, if they don't tell you, call the pharmaceutical company or Canada's equivalent of the FDA.

 

[Swimmingdancer]

7) NO QUESTIONS RESULTING IN ENDLESS SPECULATIVE DISCUSSION

^ I would suggest you do bring it up with your doctor.

Ok I didn't think that applied because I was not asking for people's opinions or expecting "endless speculative discussion", I was asking what the known scientific possibilities were. In my OP I asked that people not respond if they didn't know or didn't have any facts to back up their claims. If you think that no one on here is likely to know anything about how the body's metabolism of methadone or drugs in general could be affected by inactive ingredients, or symptoms of an allergy to artificial dye, or the quality control process for drugs in Canada, or the chemical structure of methadone, etc, then feel free to close the thread. But please understand the intention behind my post.

These are not things my doctor knows anything about, but of course I am going to ask if I can switch anyway.

If you think people in ADD might know more on these topics then feel free to move it there.

 

[tricomb]

I understand your intention, and I have heard of people reacting to dyes in strange ways as you described, but have not personally experienced it, so I can't tell you if it feels like methadone WD also.

Your OP had a hypothesis about different brands having different amounts of methadone, which is the part that provoked the closure of the thread and triggered the relevant information with the government agency like the FDA. I'll leave this open for now to see if you get more insight on the dyes issue but I doubt anyone will have anything that you can apply to your individual situation.

For example, I have asked about different generic versions of certain drugs where there seems to be a difference in the way my body processes it, notably alprazolam. I prefer a few generic versions over others, there are quite a few available, and I feel like the differences is not the amount of alprazolam that's different, I also suspect that the inactives are playing a part, but I don't think anyone could answer this for me, it's just speculation because everybody reacts differently.

 

[Swimmingdancer]

I understand your intention, and I have heard of people reacting to dyes in strange ways as you described, but have not personally experienced it, so I can't tell you if it feels like methadone WD also.

Your OP had a hypothesis about different brands having different amounts of methadone, which is the part that provoked the closure of the thread and triggered the relevant information with the government agency like the FDA. I'll leave this open for now to see if you get more insight on the dyes issue but I doubt anyone will have anything that you can apply to your individual situation.

Thanks tricomb. I wasn't suggesting that different brands regularly had different amounts of methadone, I just meant I couldn't 100% discount the possibility of this particular batch of these particular pills having something abnormal about them since there had been a recall of them recently. I was just including that in my list in case people said that taking a different quantity of methadone was the only way it was possible for a person to experience differing effects.

I am thinking that is likely that is something to do with the dye. I was just hoping for some kind of facts to back up that hunch. That you have heard of something like that before helps me at least And at least I did the research on the ingredients so that I can have something to go on when I talk to my doctor about switching.

 

[tricomb]

Yes, about that recall I would call the pharmaceutical company and find out what was wrong, I would think that is public information, although I am not familiar with Canada's legal system or healthcare.

 

[jippytheclown]

It really sucks here asking questions sometimes doesn't it. Either you get overwhelmed in scientific jargon you do not understand or you get discounted for your legitimate questions. I am moving across the american continent in 3 weeks. I am changing to Metadol tablets. My Dr. is giving me 2 months worth , so I am covered till I get a new DR. He was also kind enough to change my status from methadone maintenance back to chronic pain patient. He still would like me to find a DR. out there before I leave. That is difficult. I have looked on the college of physicians website to find chronic pain patient doctors, but you need a special Dr. code at some point. I see him next week so we will see what transpires. He is great. I told him how this was my last obstacle to moving so far, how I dreaded withdrawl, and knew I was going to a Heroin rich environment. He said "shut up and let me talk. Take it easy. You have nothing to worry about. Enjoy yourself. I will take care of everything". I had rehearsed my speech for so long it was hard to shut up. I had a letter from my addictions counsellor, photocopy or my train ticket, contact info for my destination, etc. I did not want this to fuck up.

 

[jippytheclown]

I am going from 30mg juice to 25mg pills. SHould I expect any difference. A legitimate pain patient friend told me the methadone tablets hit fast and are strong. He was concurrently on methadone, fentanyl, dilaudid, morphine, and oxycontin for a work injury. That is nuts. The dr. warned him that people watched his office and would follow people home to find out where they lived and rob them for their prescriptions. He was broke into once, but had police friends, so no problem with reports. I did fentanyl patches a few times or more 18 yrs ago. I took them off when I started nodding or I knew I would never wake up again. Reused them with tape and heating pads over my heart. They lasted weeks, then I gave them to friends that used them longer. Wild stuff. Good thing I never had the lollipops.

 

[jippytheclown]

A person I met in detox said the pills wear off way quicker and you notice when they run out. He worked in Emergency at the local hospital so the dr. eventually gave him tablets so no-one would notice and put his job in jeopardy. He quit dry turkey at 40mg. I cannot imagine it. I have taken the monster methadone for 12 yrs. My brother 17 yrs. It is truly a burden.

 

[pbuilder]

Dude what are you even going on about... First off you can edit your post so you don't triple post, second off this thread is old, and third off you added about a grand total of nothing worthwhile to this thread... Maybe make a blog?

 

[Znegative]

now, now...

While the debate over the most effective formula of methadone is one of interest to me and many other opiate enthusiasts and pain patients, the last few posts clearly demonstrate why a post like this is agains the forums guidelines. If this does not end here, it will likely devolve into every member and their mother posting which methadone formula they prefer.

And yeah, I like the pills more. However, if you want to avoid this issue, if it even exists (not calling you a liar SD, placebo can be very powerful, even as I write this part of me is convinced that the tablets are somehow more 'euphoric" than the cherry liquid I drink at my program), than I would recomend taking Methadone rectally. The BA is slightly lower (insignificantly so), but the much faster onset and peak makes the effects feel as strong, if not stronger than oral dosing. I can't imagine that when preparing the oral solution or methadone tablets for plugging that any inactive ingredients would be able to fuck with rectal absorption.

So anyway, I'm going to end this now. PM me if there are any further questkons.

 

[Swimmingdancer]

I asked Znegative to re-open this temporarily so I could update it with some new info. I did some research and apparently the smaller mg pills have more of the so-called "inactive" ingredients - binders/fillers/excipients/etc - in them which can decrease absorption/bioavailability (thereby decreasing the effects). One in particular that I've found some studies on is magnesium stearate. It astounds/frustrates me that this is actually something that should be well-known in the pharmaceutical industry but they don't seem to care or alert doctors, pharmacists or patients. We just get treated like we are insane or imagining it if we report any differences in different formulations. I know it can be a tricky topic to discuss here on Bluelight because we have a rule against "which brand is best" threads and and a rule against threads that appear like they will only generate speculation, but I did state that I was interested in any scientific reasons for this and not just people's guesses. Sorry if the thread started going into discouraged territory

Here is some stuff on magnesium stearate. I've read that some other non-therapeutic ingredients in pills have similar issues as well.

Magnesium stearate, a lubricant, commonly used in tablet and capsule formulations, is water-insoluble and water-repellent. Its hydrophobic nature tends to retard drug dissolution by preventing contact between the solid drug and the aqueous GI fluids. Thus, increasing the amount of magnesium stearate in the formulation results in a slower dissolution rate of the drug, and decreased bioavailability.
[Source]

The results showed that the efficiency of Magnesium Stearate begins to fall after 1% concentration and most assuredly after 2% concentration. The blend that contained 1% MgSt had the lowest hydrophobicity, the highest percentage of drug released in a set time frame, the most dissolution, and therefore the most uniformity, and the least relative standard deviation from the mean.
[Source]

Traditionally, excipients have been regarded as inert. However, there are many instances in which excipients have been shown to have a significant effect on the biological availability of the drug. Positive or negative effect on the drug bioavailability can be seen with a drug-excipient interaction.

Two tablet formulations were prepared including either Magnesium Stearate (MS) and Colloidal Silicon Dioxide (CSD), or Talc (TA)(which did not interact with the drug) as lubricant in order to evaluate the effects of excipients on some of the tablet characteristics. The results obtained from the drug dissolution studies showed that the interaction between the drug and MS or CSD and hydrophobicity of excipients had an effect of the dissolution of drug. Faster drug dissolution for formulation F2 (the talc formulation) was noted compared to that for formulation F1 (the MS/CSD formulation) due to drug-excipient interaction and the difference in hydrophobicity of the formulations. The permeability studies showed that the significant differences were observed between permeability of pure drug and the drug in formulations, which could be attributed the interaction between drug and MS or CSD and the hydrophobic nature of MS and CSD combination compared to that of talc.
[Source]

And btw thanks for the plugging tip znegative. With my near-constant withdrawals I have chronic diarrhea so I'm not too sure if rectal administration will work out well for me. I suppose I could make a solution and micron filter it to remove the unwanted ingredients but that sounds like a lot of work. So far I've just been trying to let me body get used to the smaller/less effective pills, but I had to slightly raise my dose at first to compensate.

 

[DooMMooD]

If its made in a factory outside of the USA, those factories are only required to be inspected by a member of the FDA once every 10 years.

Meaning they could, like a hotdog factory, be shoving rat carcasses in with their feet and not get caught for a minimum of a decade.

And considering the FDA is very understaffed and underfunded (ironically funded poorly by the same companies it claims to keep tabs over, hmmmm), it usually turns out to be MUCH longer than 10 years.

In short: who the FUCK knows whats going on in those factories in terms of quality controls. Literally 0 guarantees.

 

[Seraphina121]

Hi Swimming dancer. I agree with you. I have had to recently change brands of liquid methadone and over the last 4 days since the change my legs hurt and I can't sleep. Not terrible w/D but enough to notice. So I think it depends on your own body.