dnaenterprises1@ya said:
Mr Blonde, what are the effects of repeated use of a drug on the CYP2D6 enzymes. What I mean is do the enzymes play any part in tolerance and addiction?? Can you deplete your enzymes from over-use? Would liver damage or hepatitis change your absorption of drugs?
Interesting question! Well for a start, as you may know codeine itself inhibits CYP2D6 so long term use of codeine may have some sort of effect on the levels of it. I'm thinking along the lines of your body may try to compensate by increasing levels, though from experiences of codeine addicts on here I've heard from who found they 'topped out' their dose, this may not be the case or there may be a physical limit to it depending on your own biochemistry.
When talking about codeine specifically, CYP2D6 definitely can have an effect on addiction and tolerance; if you are a poor metabolizer or normal metabolizer of codeine, you are less susceptible to addiction then someone who gets more morphine out of the drug and can take their dose higher. That isn't to say there aren't codeine addicts around who use only 400mg, but for those who can dose higher they can obviously take their tolerance up a lot more and get more effects, and also suffer from increased WD symptoms.
With regards to liver damage or Hep C, interesting question as I myself had a Hep C scare not that long ago and so did some research into it and from what I remember it does have some effect on enzymes, and a quick google search now seems to confirm that CYP2D6 is targeted by HCV anti-bodies, I think this means it may reduce effectiveness of the enzyme?
I did some searching around as well for information about liver fibrosis and cirrhosis and it's effects on liver enzymes, I managed to find a study which showed that people who are rapid CYP2D6 metabolizers (i.e. get more out of codeine) are more likely to have fast fibrosis (faster progression of liver scarring), which is interesting. This was in the context of Hep C patients, but I wonder if it could also affect scarring as a result of APAP damage?
Crankinit said:
On that note, has anyone had any experience with stores asking for name/address when you buy large boxes? I know one guy who says the store asked for his details when he bought a 48 box of nurofen plus. Could just lie I guess, but thats kind of sketchy.
In Brisbane they always ask from my experience; and not just for shady looking people either, my mother always has to give her name and address when she buys a large pack of Nurofen +, and I can assure you she doesn't look very suspect at all! :D