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Opioids Loperamide (Imodium) Megathread v. 2

Can anyone explain to me why tonic water should not help with loperamide?

I've seen this in several threads.

Well you can't believe everything you read ;) the problem with tonic water is the FDA limits the amount of quinidine.", to a subtherapyetic amount. Thus you would need INSANE amounts, and even then, quinine is far less potent than quinidine.

Finally, quinidine only inhibits CYP2D6, and most drugs(including loperamide) are primarily metabolized through CYP3A4.



So if cimetidine is the CYP3A4 inhibitor... what is classified as a PPG inhibitor????

EDIT: cimetidine is both, right?

Yes it is. But a mild PPG inhibitor. Cimetidine itself isn't quite enough, though it helps. But I also need large amounts of (insert ppg inhibtor/CYP3A4) for full effects.

I will say that if you are trying to taper, I wouldn't fuck with CNS effects. Large doses of loperamide with cimetidine will relieve WD symptoms. Remember that the long term effects of loperamide, used in such a matter are not at all known, or proven to be safe. Loperamide may be slightly neurotoxic; and it for sure causes torsades de pointes if extremely large doses reach circulation. And it's not something most people would appreciate. I will say, that it is more effective for WD than hydrocodone!
 
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Due to loperamide's high innefficiency for crossing the blood-brain barrier, could mannitol be used in order to facilitate the crossing better? I was reading on Wikipedia that mannitol shrinks the endothelial cells in the arteries, and is used to facilitate the crossing of pharmaceuticals. After intravenous administration of mannitol, the cells shrunk to the minimum after five minutes and stayed this way for thirty minutes. As mannitol is very cheaply available, maybe it could be used to help loperamide cross the blood brain barrier better? Also, possibly it could be administered via insufflation instead of intravenously, in order to create this effect? I was thinking, possibly on an empty stomach, in conjunction with all of the other CYP3A4 and PPG inhibitors, the standard dose of loperamide could be taken after insufflation or injection of mannitol, and possibly this could greatly increase the analgesic effects.

You don't need to snort mannitol man! But loperamide shouldn't be taken lightly; it's not at all suitable as a recreational drug, but it can help desperate addicts. Again, WE DO NOT KNOW THE LONG TERM(or really even the short term) effects if forcing such a drug into the CNS, working against the bodies defense.
 
Yes it is. But a mild PPG inhibitor. Cimetidine itself isn't quite enough, though it helps. But I also need large amounts of (insert ppg inhibtor/CYP3A4) for full effects.

I will say that if you are trying to taper, I wouldn't fuck with CNS effects. Large doses of loperamide with cimetidine will relieve WD symptoms. Remember that the long term effects of loperamide, used in such a matter are not at all known, or proven to be safe. Loperamide may be slightly neurotoxic; and it for sure causes torsades de pointes if extremely large doses reach circulation. And it's not something most people would appreciate. I will say, that it is more effective for WD than hydrocodone!

Well then is it possible to battle withdrawal symptoms (other than diarrhea) with just loperamide?? I'm just trying to get off the heroin while still working, so tonight after work I'm going to grab the loperamide and hopefully some cimetidine (but I've had a hard time finding some) some people say there are OTC Restless Leg Syndrome pills that contain quinidine or w.e

Another question: I read on another message board that SSRIs could possibly help Lope pass the BBB.... anyone hear this before?
 
Absolutely man, loperamide is a miracle, at least short term.

No you don't need SSRI's, nor would they help. Of course there are POM medications that would, but you can get central effects using OTC products.

But remember, a LOT of people say loperamide itself helps them, in large doses. For me personally it took CNS effects for full WD relief, but everyone is different.
 
Well I took the leap!! I finished off the last of my heroin at about... 1030 this morning. I took 400mg cimetidine at 2pm and took 400mg more 20 minutes later then 10 minutes later I took 200mg for a grand total of 1 Gram of Cimetidine... so then an hour and a half later from when I took the last cimetidine I took 20mg of Loperamide (10 x 2mg generic pills) I am planning on hopefully being able to start the lope glide before I get sick and then quickly taper down.

I'll come back to let everyone know how it goes... I am a bit skeptical but IWANTTOBELIEVEEEEEEEEEEEEEEEEEEEEEEE
 
Just for you Parrappa:

http://www.ncbi.nlm.nih.gov/m/pubmed/14663457/?i=5&from=/11014404/related

Says that 600mg quinidine increases BA of morphine, SIGNIFICANTLY. The mechanism behind this is inhibition of PGP in the gut.

So, quinidine is indeed effective for enhancing morphine. And it would MASSIVELY increase the BA of loperamide.

The problem? Tonic water contains(wait for it) around 15mg per bottle. It took 600mg in this study.
So you would need 40 fucking liters to get the same effect. Understand? You could drink a gallon of that shit, and it won't be nearly enough.

Now, find some pure quinidine, and enjoy the greatly increased effects. Otherwise, drop the tonic water.
 
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Anybody notice a difference between brand and generic loperamide when combating w/d? When I used the brand name, it worked well. When I used the equate brand it didn't prevent w/d at all?


Anybody know why this could be??
 
UPDATE

So I woke up this morning around 9 am expecting to be in a pretty bad way BUT I woke up and besides minor stomach cramps (I had a bowel movement too when I first woke up), claminess (mostly behind my knees??) and the occasional cold chill/goose bump attack, not too bad!! I had the lethargy and a general sense of malaise but I chalked that up to just not being high after going on a pretty good binge ...

If this post is confusing: Night before this ^^^ i took 1 gram of Cimetidine and after an hour took 20 mgs of loperamide (I wasn't sick yet but I wanted to get a jump on it) Took 10 more mgs right before I went to sleep along with .5 mg alprazolam.
 
Actually, I just realized that both brand Imodium and equate worked fine. It was a DG generic brand that I used a 3rd time that did not work for me. Still strange, but I was more concerned on price so nevermind. Although, I still have to ask why would any generic brands be different? I simply think it's interesting.
 
Actually, I just realized that both brand Imodium and equate worked fine. It was a DG generic brand that I used a 3rd time that did not work for me. Still strange, but I was more concerned on price so nevermind. Although, I still have to ask why would any generic brands be different? I simply think it's interesting.

It could be psychosomatic just cause the brand name is "the name you can trust!"*

But also it could be true...you get what you pay for... for me legit Benadryl gives me more of a nod effect with heroin then the Walgreens name brand. It could be the processing plant or the way it's made where it is, if they use inferior chemicals/products to make the actual Loperamide or Diphenhydramine (respectively)... just a thought.
 
OK so I have another question to contribute:

Does loperamide BLOCK other opiates or do they POTENTATE other opiates???

Please respond soon, this morning I took 1gram of Cimetidine then 30mg of Loperamide then a couple hours later I came up on a free gram of black tar.... I've already used a good portion of it and idk I also took 1mg of alprazolam and IDK!!! I feel like I should be more inebriated
 
If you take crazy high doses, OR if you take high doses with multiple 3A4/PPG inhibtors(thus yielding CNS effects) then it will up you're tolerance. Also, there is PNS tolerance that could come into play though.

But remember heroin isn't exactly consistent. Could just be that the tar is a little less potent, and/or has a higher morphine ratio(morphing being less potent than diamorphine, and slower acting, and generally less euphoric, and I doubt it's as effective smoked).
 
I just thought I would share this as another use of lope beyond those bad withdrawals-- twice since bring 24 days clean I've messed up and the first time other than sweating in my sleep I was fine. Unfortunately, the second time I woke up the next day feeling like shit-- not as awful as withdrawl gets but decently agonizing and it seemed up just be getting worse def not PAWS stuff or just that. Took lope and I'm fine. Plus, I haven't been sleeping much since I got clean and can actually sleep now. I'm not sure what this is all about... There's no way that was full blown withdrawal but it wasn't a comedown-- took to long to show up-- and wasn't just paws. So, if ya fuck up you don't have to feel like complete and utter shit for it to work. Good luck, guys. So squeaky clean it hurts.
 
Cimetidine Question

How many times do you have to dose the Cimetidine in order to titrate up? Since you take the Loperamide an hour after you take the Cimetidine, and the loperamide takes up to 5 hours to kick in and cimetidine has a half life of 2 hours... I'm confused... can you see where I'm confused? if not wouldn't you have to dose the cimetidine every 2 hours and continue to titrate until you feel somewhat better??
 
How many times do you have to dose the Cimetidine in order to titrate up? Since you take the Loperamide an hour after you take the Cimetidine, and the loperamide takes up to 5 hours to kick in and cimetidine has a half life of 2 hours... I'm confused... can you see where I'm confused? if not wouldn't you have to dose the cimetidine every 2 hours and continue to titrate until you feel somewhat better??

Half-life is irrelevant to duration.(well, with many drugs, including cimetidine.)

But inhibition isn't conditional on a drug remaining in circulation. Inhibition happens because of direct action on enzymes. Once significantly inhibited, it can take DAYS to fully recover. That is why I suggested you start with large doses, and then simply maintain with moderate, to maintain the inhibition. Hope that helps :)

(PS: I can now say, it works EXPONNTIALLY BETTER with WGJ. 48-64oz before the lope = unbelievable results.
 
Ok so last night I started feeling dope sick (runny nose, yawning, cold sweats) so I dosed the 1 gram of cimetidine waiting an hour and a half and took 40 mgs, crushed up, of Loperamide, I woke up this morning expecting to be in complete agony after taking my Mirtazapine for sleep, but I woke up feeling fine. I'm kind of worried right now cause part of me is waiting for a wave of sickness to hit but I feel FINE!! Off 40 mgs with the cimetidine all that's happening is I'm yawning a lot and runny eyes.

My questions tho is now that I know 40mg keeps me well how should I go about this taper? Do I take the cime/lope every day for the taper??

Day two: Took 1gram CMI then an hour and 15 minutes later took 19 (38mgs) of Loperamide... is this correct? If I just drop the lope by 1 pill a day? do I need to dose the Cime everytime as well???

I'm just trying to do this correctly and I'll relay my experience on here... coming up on 27 hours since last heroin smoked, still feel fine, just can't shake this underlying feeling the withdrawals are going to just bust through. Took a .5 mg of alprazolam to calm those nervs.
 
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Yeah, you can drop 1 pill a day, sure. Just ind the dose that is comfortable.

For me a large dose lasts 36 hours or so.
 
I'd take a gram a day at first, then maybe 600-800mg a day for a while.

You should really invest in some WGJ though, cimetidine seems to lose effectiveness on it's own(YMMV)

Just be careful or you'll end up with CNS effects from it, though!
 
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