Loperamide Suboxone...Precipitated Withdrawal?

[Stargazer]

Good morning everyone and to everyone struggling to stay on track, in withdrawal etc. Im with you.

Im posting this information because I found conflicting information when searching yesterday-so in hopes of possibly helping someone whose concentration is barely there due to w/d - may you find some relief, stay hopeful and continue fighting to get sane.

For those that aren't familiar w my story-Im an IV heroin user. Was clean for a year and a half and have slipped up in the past few months getting myself a dependence on opiates again. When I use- I do anywhere from 5-7 bags of H.

As of recently, I went 8 days w/o h then 5 days ago did 5 bags. It was cold-turkey-Im usually able to get a few subs but my connect has been flaking out not getting urine tested in order to get Rx renewed-unexpectedly yesterday I was able to get 2 strips. But I had already taken 12mgs (6 tabs) of loperamide Shit. Now what?

Im not a suboxone expert- so Im never sure what Im doing. I took the lope at around 6am and got the strips around 12noon. Will taking the sub cause precipitated w/d? I wasn't feeling well and lope did zero at relieving w/d. I didn't think that low of a dose would for me. (When Ive used loperamide in the past for w/d I take it in much higher doses).

At 2:30pm I took 2mg sub. Felt a little better 30mins later. Took 2 more mg 45mins later and was stable =feeling well ( anxiety reduced tremendously, able to focus, no chills, sweats etc. )


I felt no precipitated w/d. I found conflicting information. I just wanted to share my experience-as I really couldn't find much.
Hope everyone is in a good place today.

 

[simco]

Thanks for posting this, 10years. I'm so glad you didn't run into trouble with the subs getting along badly with the lope.

And hell yeah for getting back up and running at this again. You're a fucking champ. I can tell (from your recent posts) how hard you're working. It's gonna click for you; keep trying. Keep practicing.

Yesterday I went to an NA meeting and a guy I like a lot was back after a relapse. He's a tough guy--55 years old; been using for ages. He and I talked after the meeting and he cried like a baby...he was SO pissed about relapsing. I gave him a hug and told him how glad I was that he came back.

Wish I could give you a hug, 10years.

Sim

 

[fatstep]

I was dependent on lope last december using a minimum of 50mg daily to just feel shitty, but halfway sane nevertheless. I went into detox and dosed the suboxone about 18hrs after dosing last and about 30hrs after last soing any heroin, but my dependence was solely loperamide that I got afyer jumping from 65mg methadone daily plus .25g-.5g good quality heroin on top and used lope while in a 28day program and came out with a dependency to lope that lasted 2 more months foing from 50-150mg daily. Point being I DID NOT enter Precip WDs dosing 4mg sub after ~18hrs of my last lope dose. It did take me until the next morning to truly feel normal though bc thats when I got 4mg more sub and then from then on got 8mg daily for 4 days then one day at 6mg then one at 4mg then one day at 2mg then none. Felt like hell 13 days later in a 120day program and could not cope. All I could take was ibuprofen so I bailed and relapsed of course.

 

[simco]

Others will correct me if I'm wrong, but my understanding is that since loperamide doesn't cross the blood/brain barrier, the risks of precipitated WD for someone maintaining on it are minimal. But I'm curious to hear from anyone who does know more about the subject.

 

[Jabberwocky]

Yup, I wouldn't be too worried about it.

As long as you don't take buprenorphine while you're actually under the influence of loperamide (in other words, as long as you wait until you not longer feel any subjective buzz from a very high dose of loperamide) to take you buprenorphine, there shouldn't be an issue with precipitated withdrawal.

Take the buprenorphine when you start to feel the symptoms of withdrawal coming on after taking the loperamide. That will probably be at least the next day post high dose loperamide use. Of course, if you you have a crazy fast metabolism you could definitely get away with it same day, it's still good to wait as long as possible between taking the two drugs (for a variety of other reasons as well, such as the common opioid side effect of constipation).

I have taken the two medications one after the other and not experienced an issue with the buprenorphine precipitating withdrawal when I take it following loperamide use.

 

[Stargazer]

Sim-Thankyou for the supportive and encouraging words ?-and I would gladly accept that hug as well .

You're correct about the blood brain barrier-but I had this nagging doubt-what if?

Thanks for the input fatstep. I was wondering about that-what about long-term use of loperamide? If it would change anything. So thanks for aswering that.

Im still soldiering on. I took the last of the suboxone I had (2 mg). Im hoping I'll be ok and that this taper helped.

 

[simco]

Thinking of you, 10Years!

 

[xburtonchic]

In my experience you will not precipitate withdrawals with low doses of lope. It wouldnt be able to cross the BBB at 12mg. I cant speak for higher doses or of what would happen if you were also taking what you need to take to make it cross the blood brain barrier, but common sense is telling me it could be problematic in that sense, since it would be attaching to receptors in the brain.

I wouldnt test it thats for sure lol.

Hope youre doing well OP