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Bupe St. John's Wort, Suboxone, and CYP3A4

rules

Bluelighter
Joined
May 4, 2012
Messages
503
Okay, so supposedly, St. John's Wort is a CYP3A4 inducer, right? If that's the case, then anything that is metabolized by that enzyme should be metabolized a lot faster when taken in conjunction with St. John's Wort. If this is true, doesn't it make sense that St. John's Wort would cause Suboxone to have a much shorter half-life and thus duration of action? If not, then where did my logic fail me?
 
um i'm not sure but i'm pretty sure that st. john's wort has some kind of MAOI in it which makes it very dangerous to take with other drugs or even foods
 
St Johns warts isn't dangerous with other foods / drugs. There may be a couple (I've never heard of any) I'm not saying there isn't any food/drug you shouldn't mix with it. But in general, you will be fine.

To the OP - I take suboxone and st johns warts every morning and things like valerian root at night. I've never really noticed st johns adding any of the effects you mentioned.
 
yea i take st. johns wart daily with suboxone and did not notice any effects. maybe if you take a lot of SJW?
 
The active ingredient In St.John's Wort, is Hypericum Perforatum and Hyperforin Though some formulas sold as St.John's Wort do not contain Hyperforin.

St.Johns Wort's mechanism of action, from what I've read, is not entirely understood. It's thought to have weak Monoamine Oxidase Inhibitor properties, but it also effects seretonin, dopamine, and neuroepinephrine. Hypericin is thought to also activate GABA-A, GABA-B, and Glutimate Receptors.

Monoamine Oxidase Inhibitor's can be dangerous because they have potentially lethal interactions with many foods, prescription medications, OTC's, and supplement's (such as St.Johns Wort). Combining MAOI's with certain anti-depressants or serotonergic drugs, stimulants, and certain opioids(Tramadol, Meperidine) can cause Seretonin Syndrome, which is a drug reaction that can be potentially lethal.

As for St.Johns' Wort, it can cause multiple drug interactions through the induction of cytochrome P450 enzyme CYP3A4 and CYP2C9, resulting in increased metabolism And decreased concentration and effect. Buprenorphine, Methadone, Midazolam, and Alprazolam are just a few of the drugs known to have interactions with St.John's Wort. According to this study, buprenorphine is a rather potent inhibitor of CYP2D6, while Nor-Buprenorphine, Bupe's potent full-agonist metabolite, showed weak inhibition. Some people take St.John's Wort to try and inhibit the absorption of buprenorphine in hopes that the norbuprenorphine will fill up the receptor sites instead. I've personally tried it three times. The first time I noticed no noticeable interaction, the second two times (when I was at a slightly lower dosage) I experienced a shortened duration of buprenorphine's effects, and the urge to redose out of discomfort. No high was ever experienced.

There are also studys that show that St.John's Wort Causes drug interaction through the induction of the P-Glycoprotein Efflux Transporter. This can also cause a decrease in absorption and duration in certain drugs such as methadone, though it appears to not effect absorption or metabolism of buprenorphine.
 
OMG Thats so weird I was just thinking about this, I was hoping that it would speed up metabolism of bupe so one would be able to take a full opiate/opiod agonist quicker instead of waiting the full 48-96 hours before dosing this could be very valuable information!!
Why is St. John's Wort dangerous? The active ingredient in St. John's Wort is a monoamine oxidase inhibitor (MAOI)
http://atheism.about.com/library/glossary/paranormal/bldef_stjohnswort.htm

St johns wort is a very weak MAOI
 
so question anyone knw if you should take sjw or bupe first to try and experience an effect
 
Sorry for the Necro bump. I was gonna ask this very question. I'm 3 days on subs and not sleeping well. I know it's par for the course but that's not going to stop me from trying something to help me sleep. I bought this soda, the same company used to make a brownie that kicked my ass but the soda is called sippin syrup. Corny I know. It has chamomile extract, lavender extract melatonin, valerian root extracts, rose hips extract, hops extract, St John's Wort extract, skull cap extract, kava kava extract and then some b vitamins and sugar and the other stuff. I just am wondering if it's safe to drink this stuff while on subs. I'm thinking I should just get valerian root by itself because that and or kava kava is like a benzo and I think exclusively lives in the gaba neighborhood of the brain.

Anyway mods if necro bumps are frowned upon, let me know I'm more than happy to make a new one. I tried to add something substantive and I thought there was good discussion worthy of a revisit.
 
oh man i need that sippin syrup, sounds perfect .....oh no its spendy and im el broko.........someday!!
 
St. Johns wort is in special very, very weak and it needs loads of it to become dangerous. I tried the local brand with if I remember correctly 360mg and they said to take 3 in day so I went for 6, and then still got brain zaps so took my SSRI while on the St. Johns and guess what - nothing happened. Don't recommend this but just to say.

The only thing real about it is that it causes photosensitivity, so avoid too much solar exposure.
 
Sorry for the Necro bump. I was gonna ask this very question. I'm 3 days on subs and not sleeping well. I know it's par for the course but that's not going to stop me from trying something to help me sleep. I bought this soda, the same company used to make a brownie that kicked my ass but the soda is called sippin syrup. Corny I know. It has chamomile extract, lavender extract melatonin, valerian root extracts, rose hips extract, hops extract, St John's Wort extract, skull cap extract, kava kava extract and then some b vitamins and sugar and the other stuff. I just am wondering if it's safe to drink this stuff while on subs. I'm thinking I should just get valerian root by itself because that and or kava kava is like a benzo and I think exclusively lives in the gaba neighborhood of the brain.

Anyway mods if necro bumps are frowned upon, let me know I'm more than happy to make a new one. I tried to add something substantive and I thought there was good discussion worthy of a revisit.
Have you tried L-trypthophan? It works wonders for me. Im on 8mgs of bupe per day and I like to take 3x 500mg caps of tryptophan and valerian extract at night.
 
Have you tried L-trypthophan? It works wonders for me. Im on 8mgs of bupe per day and I like to take 3x 500mg caps of tryptophan and valerian extract at night.
5-htp is the stronger cousin of L-tryptophan, it is basically circumventing the rate limiting step in serotonin biosynthesis and enough of it is as active as SSRIs. Just that you can't keep enough of it in your stomach. But one should give it a try before being hooked on SSRIs like I am.
 
5-htp is the stronger cousin of L-tryptophan, it is basically circumventing the rate limiting step in serotonin biosynthesis and enough of it is as active as SSRIs. Just that you can't keep enough of it in your stomach. But one should give it a try before being hooked on SSRIs like I am.
IKR? But 5-htp made my tummy hurt badly so I prefer l-trptophan 🙂

I've heard one should not take it everyday tho cuz it might cause a dependance in which case im fucked cuz I've taken it for months, well execpt for when I ocasionally take dxm cuz I wanna avoid serotonin syndrome.
 
IKR? But 5-htp made my tummy hurt badly so I prefer l-trptophan 🙂

I've heard one should not take it everyday tho cuz it might cause a dependance in which case im fucked cuz I've taken it for months, well execpt for when I ocasionally take dxm cuz I wanna avoid serotonin syndrome.
I took 5-htp for months and had no withdrawal. Also I took it with venlafaxine AND DXM (together; don't do it) and had a fun time.
L-tryp will replenish more transmitters though, not just serotonin, but more slowly so and it's the same reaction chain, 5-htp is just a few steps downwards but yeah problem is that most of it gets metabolized into serotonin in the stomach which leads to nausea and one not able to take enough. Solution would be a peripheral decarboxylase inhibitor like carbidopa if you can get one. Some L-dopa shouldn't hurt but I read that one shouldn't mess with..
 
Have you tried L-trypthophan? It works wonders for me. Im on 8mgs of bupe per day and I like to take 3x 500mg caps of tryptophan and valerian extract at night.
I think I tried 5 htp a long time ago. But I'll go grab some l tryptophan on your recommendation. I hate melatonin because it gives me crazy dreams. Although so does gabapentin which I like. Anyway, yeah I'll give it a shot. I'm sleeping alright on 16mg per day of bupe. But when I try to lower my dosage, I'm gonna need some help. Of course if I have the willpower, I can just do my last dose of bupe before bed, so we'll see. I don't want to be on bupe long term.
 
I think I tried 5 htp a long time ago. But I'll go grab some l tryptophan on your recommendation. I hate melatonin because it gives me crazy dreams. Although so does gabapentin which I like. Anyway, yeah I'll give it a shot. I'm sleeping alright on 16mg per day of bupe. But when I try to lower my dosage, I'm gonna need some help. Of course if I have the willpower, I can just do my last dose of bupe before bed, so we'll see. I don't want to be on bupe long term.
For me melatonin does nothing at all. Nothing, at up to 16mg.

Can you get memantine? It does a good job avoiding opioid withdrawal, so you could use bupe when wanted without rushing into a dependency. I withdrew painlessly from 120mg morphine. But gabapentin helps too.
 
I've heard of that but, every time I sign up for a dark website, it gets shut down and it's such a pain in the ass to write the 500 character password and secret phrase and all that stuff ( yes I'm a lazy bastard). But I will definitely look into it
 
Jesus... when I was first ever put on methadone my keyworker suggested taking St John's wart as I was depressed.

She was proper shady. Man I miss her.
 
I've heard of that but, every time I sign up for a dark website, it gets shut down and it's such a pain in the ass to write the 500 character password and secret phrase and all that stuff ( yes I'm a lazy bastard). But I will definitely look into it
You don't need the darknet for memantine, look for online pharmacies, and compare prices.
 
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