Opioids Loperamide w/ Losartan for QTc concerns?

[znb]

I take approximately 120 MMEs a day. Oxycodone Rx. I am a pain management patient that is genetically screwed over. Trying to hop to minute doses of Rx fentanyl did nothing. Giant doses, (try a 100mcg patch... at once over about 8 hrs and my pupils constricted for about 3 hours of that) did a tiny bit of something, like enough to keep me out of W/D but if I am going to be in pain and tapering I would prefer it to be at least semi legal. For next to wit I need to wee in a cup.

So... to the tummy aisle I go!

Looking to taper off with loperimide. Being the research fool that I am, I have perused the entire lope thread, (it's quite the roller coaster at 3am) and I notice that the concern is the increased QTc interval issue for stopping the ticker in mid tock. Now, I am somewhat of an amateur pharm geek myself, so I know that losartan has been shown to shorten the QTc interval.

I was thinking a 20mg loperamide dose to start as I am completely intolerant of W/D since most comfort meds bounce off me or cause true nightmare fuel levels of side effects. (i.e. gabapentin has caused me to bleed from the eyes - and now you know why I am a pharm nerd) so I am hoping I am onto something here. I am holding steady right now, so no giant rush, but if nothing else, this could help someone else, losartan is a first line HBP med.

Also, I didn't know whether to label this opioids or harm reduction. If I did this wrong I want to know for next time.

Hope to everyone,
Z.

 

[negrogesic]

I'm a little confused, are you trying to entirely get off of 120 MME worth of oxycodone (so like 80mg?)

If that's the case you'll need more than 20mg of loperamide/day. But perhaps I'm not understanding the situation.

(Also, this is a perfectly fine place to post this, welcome to bluelight!)

 

[znb]

I'm a little confused, are you trying to entirely get off of 120 MME worth of oxycodone (so like 80mg?)

If that's the case you'll need more than 20mg of loperamide/day. But perhaps I'm not understanding the situation.

(Also, this is a perfectly fine place to post this, welcome to bluelight!)

Basically I am under medicated. My genetic condition is rare but not killing me, but due to it certain meds just work weird, some barely work.

I wish to be able to take the amount I need to stay out of pain in situations without dropping off a cliff afterwards. Loperamide, used conservatively, seems to be a possible answer. From my understanding, this medication can be dangerous because it lengths the QTc intervals and can damage the heart. Well, the drug losartan has been proven to shorten QTc intervals. I know I am getting into the weeds with this, but I am hoping that this might help mitigate that particular risk.

Saw that the general consensus is the lower the starting dose you can tolerate, the better so I was thinking small, but with my normal dose of oxy I take and my weird reactions, maybe I should up it?

Either way, I use losartan for mildly elevated BP and realized that it could help with the heart issue that can come with loperamide use. That seems to be what harms people who take it in higher doses. Maybe it could help others? It's mildly sedating, but nothing heavy, I take it with 20mgs of oxy at night. Once again though, everyone's experience is different. Just curious if any pharm nerds have an opinion.

Thank you for the welcome. I love this place. You guys helped me, help my best friend find the best combo of meds while he dealt with terminal cancer. (I was a researching lurker. What a world we live in...) For that I will be eternally grateful.

Z.