Opioids Loperamide (Imodium) Megathread v. 2

[lolwhatzdrugs]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805428/

This may interest you guys.

Appreciate it, but I've already researched the literature on Methadone and Torsades de Pointes and QT elongation.

 

[Lorne???]

^^^ Yeah, that looks interesting, although I don't have time to read it right now. I have heard of the QT interval being delayed in newborns, which is why they often still use low dose morphine to wean them off, but I haven't heard of any adult cases that didn't involve massive doses.

It's say 45 pills at first (titrated up to them) and then tapered over like a week.
45-40-35-30-25-20-15-10-5-4-3-2-1

Thanks, I figured something like that. I'll tell her to start with half of that, and titrate up.

 

[Lorne???]

Taken from drugs.com:"
"

Studies in morphine-dependent monkeys demonstrated that Loperamide hydrochloride at doses above those recommended for humans prevented signs of morphine withdrawal. However, in humans, the naloxone challenge pupil test, which when positive indicates opiate-like effects, performed after a single high dose, or after more than two years of therapeutic use of Loperamide hydrochloride, was negative. Orally administered Loperamide hydrochloride capsules (Loperamide formulated with magnesium stearate) are both highly insoluble and penetrate the CNS poorly."

 

[lolwhatzdrugs]

Taken from drugs.com:"
"

They seem to be talking about two things. There is a difference between preventing morphine withdrawal (I believe most withdrawal happens in the PNS anyway, hence loperamides efficacy). My guess is they were looking for the naloxone to dilate the pupils reducing the constriction which opioids cause. Loperamide does not cause the constriction because that is a central effect. They're conflating withdrawal with analgesic/cns effects (though I bet some of the analgesia is non-CNS).

 

[Lorne???]

Yes, some analgesia is mediated via non-Cns mechanisms.

It's notable though, because "complete reversal of wd symptoms" is impossible without some central effect. But then, I can do low doses of opioids, and my eyes don't at all constrict, like 10mg of oxycodone would help RLS, but have no effect on pupillary construction.

Still, interesting on both counts. Actually, you should read the drugs page on it, they do mention Cns effects several times. They even warn against giving the drug to patients with hepatic impairment because of the risk for CNs effects.

Also, activated charcoal reduces plasma levels after oD by 90%, meaning some does get into the bloodstream with high doses...

 

[lolwhatzdrugs]

Yes, some analgesia is mediated via non-Cns mechanisms.

It's notable though, because "complete reversal of wd symptoms" is impossible without some central effect. But then, I can do low doses of opioids, and my eyes don't at all constrict, like 10mg of oxycodone would help RLS, but have no effect on pupillary construction.

Still, interesting on both counts. Actually, you should read the drugs page on it, they do mention Cns effects several times. They even warn against giving the drug to patients with hepatic impairment because of the risk for CNs effects.

Also, activated charcoal reduces plasma levels after oD by 90%, meaning some does get into the bloodstream with high doses...

I agree there must be some, but I bet most of WDs are mediated by the PNS, I'll have to check out the drugs.com entry. A good test would be a methylnaltrexone challenge - how much WDs are restored with a dose needed for complete PNS antagonism, but no CNS antagonism. It's really curious to me, because if most are moderated by the PNS this implies you could be high as shit on an opioid while still in PNS withdrawal. This idea has always intrigued me with it's paradoxical implications.

 

[Lorne???]

Ha! That would suck. No, it is a proven fact most WD symptoms are mediated centrally, this is why oral nalaxone can work without inducing wd as well, in contrast to loperamide. Worth a look though, I like the idea of M-naltrexone challenge!!!

 

[lolwhatzdrugs]

this is why oral nalaxone can work without inducing wd as well

I'm very confused by this statement. If naloxone is working then it is inducing withdrawals in opioid dependant people. I was under the impression that naloxone had extremely poor oral bioavailability, but if so it should avoid the first pass metabolism when IVed/Sublingually taken. Tough I understand that the naloxone in buprenorphine pretty does nothing I thought this was due to it's lower binding affinities even though it is absorbed into the bloodstream. TBH it's all quite confusing, mostly because doctors and medical literature seem to think that you can't IV suboxone. I've never done it but much anecdotal evidence says otherwise.

 

[Lorne???]

Yeah sorry, I've been drinking all night and was probably confusing. I meant methyl-naltrexone. No, you can research yourself. Pretty much mu agonists are the only thing that COMPLETELY alleviate withdrawals, but that doesn't mean a (primarily) Pns stimulator can't help. Honestly, morphine's receptor fixation half-life is (supposedly) less than 1 second, and in general, all opioids have a "hit and run" receptor binding profile so it wouldn't take much. I actually wish you we're online, ilI think your the only person who had intelligently studied loperamide!

 

[xtcgrrrl]

I've been using Imodium to stave off WD until I got my shipment of pods/seeds (which I got today) but I DID notice a little analgesia from it. Not enough by a long shot, but enough for me to get out of bed (which is all I needed, really.) I was taking about 10 g a day. Fortunately I still have plenty around for my tapering-off plan for when I'm able to survive without opiates (hopefully I'll find a better medicine for my aches and pains, since opiates DO help the back pain but not the general aches and pains that MAY be related to fibromalyia but we don't know yet. Or it could be Lyme disease, another delightful possibility suggested to me by my mother!) Is that a common side effect of loperamide? I was just taking it to ward off WD, not for pain. However if it could help, even slightly, I could work it into the regimen of things I've self-prescribed for my condition. Or maybe it could act as a "blocking" agent so more of the poppy stuff gets to my brain? This thread isn't very active so I don't expect a response anytime soon...

 

[lolwhatzdrugs]

I've been using Imodium to stave off WD until I got my shipment of pods/seeds (which I got today) but I DID notice a little analgesia from it. Not enough by a long shot, but enough for me to get out of bed (which is all I needed, really.) I was taking about 10 g a day. Fortunately I still have plenty around for my tapering-off plan for when I'm able to survive without opiates (hopefully I'll find a better medicine for my aches and pains, since opiates DO help the back pain but not the general aches and pains that MAY be related to fibromalyia but we don't know yet. Or it could be Lyme disease, another delightful possibility suggested to me by my mother!) Is that a common side effect of loperamide? I was just taking it to ward off WD, not for pain. However if it could help, even slightly, I could work it into the regimen of things I've self-prescribed for my condition. Or maybe it could act as a "blocking" agent so more of the poppy stuff gets to my brain? This thread isn't very active so I don't expect a response anytime soon...

Lol wut?

You should be a little more specific. First assumption was too absurd (it is a loperamide thread) so you're probably talking about poppy pods.

2nd bolded sentence. Nah, bad idea.

It raises your tolerance pretty drastically, and I haven't the slightest clue what you mean by blocking agent.... Naloxone binds to opioid receptors and doesn't illicit a response - effectively a blocking agent. For your pain this would be a bad thing.

If you mean "maybe it will bind to peripheral opioid receptors and therefore free up more receptors where the morphine can than swim through my blood and bind in the CNS" then - bad idea. It raises your tolerance very very rapidly. Taking it when you don't need it is probably a bad idea, especially if you need this type of (morphine) for analgesia.

 

[xtcgrrrl]

Oops, I meant mg, not g, sorry. And thanks for clearing that up! I've just read about it elsewhere (forget where) and wondered.

 

[crunkazcanbe]

Hey guys i have one quick question i have been taking 20 mg of lope now daily for 2 days now at about 2pm last 2 days . Is that a extreme dose ? I am someone who abuses every opiate i can get my hands on . I just moved from ga to nc about 2 months ago and lost my connect for the 30 mg Roxie's i love . When I moved i didn't have but 100 of them left and taking 10 aday for a total of 300 mg of oxy a day habit i quit cold turky. i went threw hell for two weeks straight and still am now but mainly its mentally i just crave them so thats how I found out about lope and after i read all the post about it being bad on heart and people dying from it i worry about me dying from it now.

It has been 6 hours now since i last took 24mg if i quit now will i be fine? How long will i be constipated like hell to ? I feel so bloated . Btw i took the 24 mg with a 40 mg extended release Prilosec and 4 500mg regular strangth tums.


Any how i finely got a doc up here in North Carolina that is going to start me on the 15mg Roxie's with the 10/325 percs for my three bulging disks i have in my lower back and i have no real need to keep taking the lope i was just trying to catch a buzz until Friday when i go to pick up my meds but now i am worrying after reading post of people dying and such with heart probs . Will I be ok just did like 10 2mg lops one day and 12 the next day? Btw i am a 25 yo guy

Oh and also i am a daily smoker about a pack a day also a daily drinker who drinks a 750ml of 90 proof rum aday along with the causal xanax and Valium i use . Did 24 1mg xanax in one night Sunday . never been threw benzo withdrawal and its prob because i am a daily drinker . I have heard opiate withdrawal is a walk in the park compared to benzo . I can not see how that is considering cold turkey from 300mg aday of oxycodone had me feeling like i took some acid or something i felt like i was in a dream world for like 2 weeks straight and had me thinking about jumping off a bridge and i had absolutely no sleep for 2 weeks. Not lying . I always snorted my 30 mg Roxie's and smoked and Iv a few times. Just a FYI

Dont kno why i am jumping back on the opiate train after just getting off and seeing the withdrawals. :-(

But just a little re assurance that i will be fine from the 2 days of lope use will be nice.

 

[Tommyboy]

It makes 0 sense.

1. Loperamide tastes terrible
2. Chewing it would not do shit for constipation, and would probably only increase time to peak plasma (I believe it's 4 hours) which would lessen the duration of 17-20hrs
3. Sublingually?! ICKKKKKKKK Also unnecessary.
4. Everything else you mentioned is or people who think they can squeeze more into their brain for a high. You can do that, but not with what you listed, with research drugs like ceroport which are not available to the general public (ie researchers).

Take pills incrementally (1-4 at a time) waiting four hours between adding more to stop withdrawals. Unless you have a strong tolerance like me (150mg of hydrocodone to get high, you need to start with 40-50 pills) But this should always be titrated up to reach the lowest effective dose. If you just pop handfuls, you may be taking too much, and may become more dependant on opioids than you were before.

A lot of people end up taking too much since they are trying to prevent having to feel any withdrawals. The problem with that is if you are taking a high dose of opiates and then start feeling a little shitty the next day it will take way more lope to keep you from feeling withdrawals than if you were to wait until you are really sick where smaller amounts would be needed to get you well. It's basic logic that the longer you go without an opiate the less you will need to get well again.

I agree, but I would never suggest starting with 50 loperamide. My tolerance was higher than yours(150mg hydro would (maybe) have had me ok for a few hours) and I started with 50, and got INTENSE stomach pain, and cramping.

So in some cases, regardless of tolerance it can cause problem.
If someone has a very high tolerance, lope is pretty much useless(aside from stomach relief) but in any case, I'd only start with 20 or so, and go up from they're.

I also think that some people take more than needed. Lope is just supposed to be used to make the withdrawals more bearable as you taper off. Even with a heroin habit I've never taken more than 20mg of lope, but usually only 16mg which is just so I can get a little bit of sleep.

The key that I stand by for any taper is to wait as long as possible before taking the tapering medication. That allows for a smaller dose to be more effective for you, which allows for a quicker taper since it would be starting at a lower dose and then going down from there.

Hey guys i have one quick question i have been taking 20 mg of lope now daily for 2 days now at about 2pm last 2 days . Is that a extreme dose ? I am someone who abuses every opiate i can get my hands on . I just moved from ga to nc about 2 months ago and lost my connect for the 30 mg Roxie's i love . When I moved i didn't have but 100 of them left and taking 10 aday for a total of 300 mg of oxy a day habit i quit cold turky. i went threw hell for two weeks straight and still am now but mainly its mentally i just crave them so thats how I found out about lope and after i read all the post about it being bad on heart and people dying from it i worry about me dying from it now.

It has been 6 hours now since i last took 24mg if i quit now will i be fine? How long will i be constipated like hell to ? I feel so bloated . Btw i took the 24 mg with a 40 mg extended release Prilosec and 4 500mg regular strangth tums.


Any how i finely got a doc up here in North Carolina that is going to start me on the 15mg Roxie's with the 10/325 percs for my three bulging disks i have in my lower back and i have no real need to keep taking the lope i was just trying to catch a buzz until Friday when i go to pick up my meds but now i am worrying after reading post of people dying and such with heart probs . Will I be ok just did like 10 2mg lops one day and 12 the next day? Btw i am a 25 yo guy

Oh and also i am a daily smoker about a pack a day also a daily drinker who drinks a 750ml of 90 proof rum aday along with the causal xanax and Valium i use . Did 24 1mg xanax in one night Sunday . never been threw benzo withdrawal and its prob because i am a daily drinker . I have heard opiate withdrawal is a walk in the park compared to benzo . I can not see how that is considering cold turkey from 300mg aday of oxycodone had me feeling like i took some acid or something i felt like i was in a dream world for like 2 weeks straight and had me thinking about jumping off a bridge and i had absolutely no sleep for 2 weeks. Not lying . I always snorted my 30 mg Roxie's and smoked and Iv a few times. Just a FYI

Dont kno why i am jumping back on the opiate train after just getting off and seeing the withdrawals. :-(

But just a little re assurance that i will be fine from the 2 days of lope use will be nice.

Yea you should be fine. The people that died took way more than that, and they died the same day as taking it.

 

[crunkazcanbe]

A lot of people end up taking too much since they are trying to prevent having to feel any withdrawals. The problem with that is if you are taking a high dose of opiates and then start feeling a little shitty the next day it will take way more lope to keep you from feeling withdrawals than if you were to wait until you are really sick where smaller amounts would be needed to get you well. It's basic logic that the longer you go without an opiate the less you will need to get well again.



I also think that some people take more than needed. Lope is just supposed to be used to make the withdrawals more bearable as you taper off. Even with a heroin habit I've never taken more than 20mg of lope, but usually only 16mg which is just so I can get a little bit of sleep.

The key that I stand by for any taper is to wait as long as possible before taking the tapering medication. That allows for a smaller dose to be more effective for you, which allows for a quicker taper since it would be starting at a lower dose and then going down from there.


Yea you should be fine. The people that died took way more than that, and they died the same day as taking it.

Thanx for letting me know . Also both times of taking the lope all i ever noticed was hot flashes and bad constipation still no bawel movements on the 2nd day of using . The hot flashes was not the typical opiate warmth . I thought the 1st day i used i had a bit of euphoria but i called it bs and just a placebo thats why i tested the 2nd day and this time only got hot flashes and cramps . But with oxy i still shit atleast 2 times a week no shit yet to come i mean i feel like i need to i am bloated and feel like my food when i eat just stays right there . How long from 24 mg lope will it be when I have a bowel movement.

 

[lolwhatzdrugs]

A lot of people end up taking too much since they are trying to prevent having to feel any withdrawals. The problem with that is if you are taking a high dose of opiates and then start feeling a little shitty the next day it will take way more lope to keep you from feeling withdrawals than if you were to wait until you are really sick where smaller amounts would be needed to get you well. It's basic logic that the longer you go without an opiate the less you will need to get well again.

Indeed. But the problem is people want it RIGHT THEN when it's the worst. Saying "I'll feel much better in a few days and need less" sounds good on paper, but when you're there, and you have something to fix it OTC, self control is quite hard. You may not get high, but you can get normal. I completely agree though. at one point I was taking 144mg a day when I had no tolerance, and now I haven't ever taken more than 100 mg (and usually only on the first day) and most of the time half of that or less.

 

[Mc83]

Hey guys I'm over 2 months clean of lope. I am a little scared. I have to have my gallbladder out and I worry that even though I feel 100% the drugs for surfer will throw me backwards. I'm terrified actually, lope ct was the worst experience of my life and I don't want to end up back there

 

[lolwhatzdrugs]

When withdrawling/cting lope, is it possible to remove the long term withdrawals by switching to a short half life drug for a while?

 

[Mc83]

Lolwhatzdrugs- I can't remember what forum/site I read it on but someone was saying that if available it would be better to jump to a short acting opiate( they recommended Percocet/oxy)for 2-3 months and ct from that instead of the lope. But who has a 3 month supply of Percocet available on a whim.

 

[southeast]

I'm coming off years of heavy heroin and I didn't taper that much. This was me crying and shaking in a room, stomach crazy, but its better than it lasting forever to me.
And, despite reading the shit out of stuff saying its all that helps I say no sub or methadone.
Get some benzos, klonodine, ketamine, and immodium.