svacheme3
Bluelighter
- Joined
- Sep 19, 2007
- Messages
- 701
I'm sure that everyone has done a good job at disseminating this information, but it can't be said enough the high-dose Loperamide (Immodium) is dangerous and is to be avoided. There is no practical reason to use Loperamide to get off of another Opioid. Using another Opiod simply prolongs the withdrawal process. This is why Loperamide should only be used at the dosage that leaves the individual without constant diarrhea.
Believe me, if Loperamide wasn't dangerous, I would be sanctioning its use, because, why not? However, this is not the case. Using Loperamide in high doses has produced numerous instances of severe Cardiotoxicity (Toxic effects related to the Heart and circulatory system). These events have lead to death in many instances. So, those who use Loperamide in high doses do so at their own risk. It can't be treated as just another Opioid or withdrawal tool. It's seriously dangerous when used in an excessive manner.
I apologize for hijacking the thread. I just really want people to be safe with this stuff. I'm not saying never use it, but use it for its intended purpose and nothing more.
Define "high dose" that should be avoided. I don't know why recommendations based on the most recent medical data on adverse cardiac events are suppressed here. Isn't 'if you're going to do this, here's the safest way besides abstinence to go about it' a basic HR principle?
The bottom line is cases severe enough to warrant medical attention average close to 400mg a day, going up to 1200mg a day. That's way beyond what's needed to even virtually eliminate withdrawal in all but the most extreme tolerance levels. We should differentiate between high-dose in the withdrawal aid context and high dose in the recreational context. 100mg or less q24-36h is 'high dose' but there is nothing in the literature to support proarrythymic properties on a short timescale (less than a month). Danger comes from doses far exceeding that or persisting for months. Take Immodiumsux above. Maybe if my recommendations hadn't been censored here previously, he might have been warned that when using high-dose for with withdrawal, the reported elimination half-life is 11 hours (and literature suggests longer in high dosages due to decreased absorption) so you need to account for that and not contintually dose in a way that excessively increases plasma levels, so his loperamide level just kept rising and he wound up in the hospital, instead of maybe seeing my post about this.
I want people to be safe too. People WILL use loperamide at levels sufficient to kill withdrawal, they need to know what that actually is, and how to avoid cardiotoxicity, without saying "well just don't do it". That's supposed to be how HR works.