Rybee
Bluelighter
- Joined
- May 29, 2013
- Messages
- 1,305
Hi Guys, I'm after some harm reduction advice with opiate potentiators really,
I currently take 375mg of Venlafaxine which is the highest licensed dose prescribed, technically it's a SNDRI (serotonin–norepinephrine–dopamine reuptake inhibitor), and as always it contraindicates with everything with the possibility of Serotonin Syndrome.
On one hand I understand that contraindications are often highlighted even where there's a small possibility of SS occurring. However, on the other hand I do appreciate that SS is a serious, potentially life-threatening, drug reaction.
I have read the 2 mega threads on opiate potentiators but read such conflicting advice and then got in a bit of a muddle when I realised that opiate potentiators aren't generic to all opiates per say. For example some will work fine with Codeine but not so great with Oramorph - or so I believe, please do correct me if I'm wrong. My only doubt/question to this would be that since Codeine is a Morphine pro-drug, surely they will both benefit from the same potentiator? As opposed to Dihydrocodeine which isn't metabolized into Morphine - so different potentiators may be more effect for it?
Whatever potentiator is used it needs to be available OTC in the UK. I've read up on a lot of potentiators but then realise that they are more exclusive to the US or px only.
I will potentiating either Codeine Phosphate or Morphine Sulphate (Oramorph). The most freely available/easiest are below:
- Dextromethorphan (with Venlafaxine = Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
- Promethazine (with Venlafaxine = Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
- Grapefruit Juice (with Venlafaxine = Can't find much solid information, though it does seem likely to affect the Venlafaxine
So to me, Dextromethorphan just doesn't seem worth the risk. Promethazine seems like a fairly safe bet. Grapefruit Juice... I can't see this sending me into seizures?
Apart from them three, are there any other OTC potentiators that I should consider as a form of harm reduction for using in conjunction with Codeine / Oramorph?
I'm fairly new here and though I have grasped the basics I'm not up to scratch with the enzyme actions in Grapefruit Juice etc... so please bear with me!
Really appreciate your help peeps! =)
Rybee
I currently take 375mg of Venlafaxine which is the highest licensed dose prescribed, technically it's a SNDRI (serotonin–norepinephrine–dopamine reuptake inhibitor), and as always it contraindicates with everything with the possibility of Serotonin Syndrome.
On one hand I understand that contraindications are often highlighted even where there's a small possibility of SS occurring. However, on the other hand I do appreciate that SS is a serious, potentially life-threatening, drug reaction.
I have read the 2 mega threads on opiate potentiators but read such conflicting advice and then got in a bit of a muddle when I realised that opiate potentiators aren't generic to all opiates per say. For example some will work fine with Codeine but not so great with Oramorph - or so I believe, please do correct me if I'm wrong. My only doubt/question to this would be that since Codeine is a Morphine pro-drug, surely they will both benefit from the same potentiator? As opposed to Dihydrocodeine which isn't metabolized into Morphine - so different potentiators may be more effect for it?
Whatever potentiator is used it needs to be available OTC in the UK. I've read up on a lot of potentiators but then realise that they are more exclusive to the US or px only.
I will potentiating either Codeine Phosphate or Morphine Sulphate (Oramorph). The most freely available/easiest are below:
- Dextromethorphan (with Venlafaxine = Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
- Promethazine (with Venlafaxine = Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
- Grapefruit Juice (with Venlafaxine = Can't find much solid information, though it does seem likely to affect the Venlafaxine
So to me, Dextromethorphan just doesn't seem worth the risk. Promethazine seems like a fairly safe bet. Grapefruit Juice... I can't see this sending me into seizures?
Apart from them three, are there any other OTC potentiators that I should consider as a form of harm reduction for using in conjunction with Codeine / Oramorph?
I'm fairly new here and though I have grasped the basics I'm not up to scratch with the enzyme actions in Grapefruit Juice etc... so please bear with me!
Really appreciate your help peeps! =)
Rybee
