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Inducing Cyp3A4, Inhibiting P-gp on Buprenorphine/Naloxone therapy (and OTC options)

alwayswrming

Greenlighter
Joined
Jun 18, 2016
Messages
8
Hello all,

Referring to an archived thread, I saw a few users mention that inducing Cyp3A4 (Cytochrome P450 3A4) and inhibiting P-gp (P-glycoprotein) can result in a more pronounced effect for patients on some form of bup/naloxone combination therapy (I currently take Zubsolv, but took Suboxone for many years before switching). I am curious if there are any members here who have confirmed this more recently than the 2010 thread I am referencing. If so, I am also curious what solutions are easily available over the counter, if any. My doc also prescribed Gabapentin/neurontin, which I have, at times, noticed a positive interaction, but not consistently.

Thanks for the feedback
 
Buprenorphine is a partial agonist. Norbuprenorphine is a full agonist and an important part of the clinical effects of the regime. If anything, you want to metabolize as much of the bup as you can so the full-agonist metabolite accumulates. On the other hand, if you are mixing your meds and still trying to get high, maybe methadone would be a more promising approach? If you get take-homes of juice, the methadone can be freebased, extracted and smoked.... or salted and injected. Either way, you get a huge hit. A friend in NZ perfected the trick by placing the green (or blue or yellow depending on location) linctus, thinned and based by adding a dilute NaOH solution into a large barrel and forcing it through a filter (vacuum filtration is best when working on multi-l batches) and dried. With 100% bioavailability and immediate onset, it's euphoric. Of course, once you start abusing methadone, your habit gets huge and only so many people will sell you their scripts. I've seen 2 guys go through this and Lifeline were lost for an answer. Huge doses with supervised consumption the only option and 6 years later, they are STILL on >200mg/day.

I offer this in the spirit of harm reduction. You can get very high, very cheaply... but good luck in 2019!
 
Buprenorphine is a partial agonist. Norbuprenorphine is a full agonist and an important part of the clinical effects of the regime. If anything, you want to metabolize as much of the bup as you can so the full-agonist metabolite accumulates.

That's why he said inducing CYP3A4 and inhibiting P-GP. While nor-bupe is a full agonist, it is apparently rapidly removed from the brain via P-GP.

Whether that is a good idea is an entirely different matter, of course, because it's going to fuck around with the plasma levels of a shitload of substances.
 
Idk.. it?s just very finicky. Some days I get a really nice buzz. Certainly it?s nothing like you?d get from taking full-on narcotics like hydro/oxycodone or diamorphine, but it?s a mildly euphoric, warm sensation. Other days, I don?t get shit, aside from a naloxone headache lol. I feel like daily diet, what I happened to eat for lunch, if I haven?t eaten all day, what I?ve had to drink, ... something has to be causing the variation. My best guess is that different foods will induce or inhibit various receptors/pathways.. but I have no experimental evidence to support this. Of course I had read the thread I linked in OP which got me thinking about all of this. Also, I currently take Zubsolv. I switched to this about 2 years ago when my insurance wouldn?t cover suboxone. The mild high I?ve described was never even achievable with Sub, and I only first experienced it when I started taking Zubsolv.
As for methadone.. no thanks. I?m just trying to get the most out of my current medication, nothing more. I started on methadone in 2007 and was on it until about 2010 when I left the god-forsaken methadone clinic and changed to Suboxone with a private doc. In 2016 I switched to Zubsolv, and I currently take 1 of the 8.6/2.1 tableta daily.
I?m not interested in trying to use illicit substances, either alone or in conjunction with my bup. Rather, I?d like to find some ways to maximize what I?ve already got.
 
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