opiate tolerance with different opiates

[Raihiar]

Hi Guys

Just wanted to ask a quick question
I have quite the tolerance to Tilidin (analgetic potency of about 0.2, anywhere between 500 and 700mgs a day. [started with 100mg/day])

now i have come into a small supply of hydromorphone (analgetic potency of about 7.5)

my question is: should i take the much more potent hydromorphone as if i had no tolerance to tilidin?
or does the tolerance to the relatively weak tilidin make it impossible to get effects from a low dose of the hydro?

 

[nAON]

There is indeed cross-tolerance between opiates, however if you've never used the drug before, it's still advised to start low and work your way up.

 

[Swimmingdancer]

^Exactly. There is no way to know exactly how much cross-tolerance you will have so it's always best to initially start with a low dose whenever taking a new opioid, especially a strong one.

 

[pillboxskid]

Im in england so we dont have the array of wonderfull painkillers America have.!! :-( But could sombody tell me roughly what the equiverlant 300 mgs of dihydrocodeine to oxies be.? Also wich painkiller in america would you say is in the closest in resemberlence to Dihydrocodeine here in england in relervencey, potenceywize, duration, and action, thankyou! :D

 

[Swimmingdancer]

Im in england so we dont have the array of wonderfull painkillers America have.!! :-( But could sombody tell me roughly what the equiverlant 300 mgs of dihydrocodeine to oxies be.? Also wich painkiller in america would you say is in the closest in resemberlence to Dihydrocodeine here in england in relervencey, potenceywize, duration, and action, thankyou! :D

This is kind of a different question from the original post - you are always welcome to start your own thread if there are no recent threads on a topic and you couldn't find the answer in a search

Anyway: here is our opioid equivalency chart: Opioid Conversion Chart
You should always take posted conversions as a rough estimate/average that in practice can vary greatly from person to person, so always initially start with a lower dose than it says when trying a new opioid, but the posted conversion for dihydrocodeine to oxycodone is 5mg dihydrocodeine = 1mg oxycodone. So 300mg DHC should generally equal around 60mg oxy. Start lower than that to be on the safe side though - some people say DHC may have a nonlinear or ceiling effect so conversions may get more inaccurate when you are taking high doses of DHC.

Closest opioid to DHC that is used widely in the US would be hydrocodone (hydrocodone is more potent though).

 

[pillboxskid]

Thankyou my friend!

 

[Raihiar]

thanks for the help guys
i'll take the advice and start low

 

[Serotonin101]

I found out the hardway how different cross tolerances can be. I was using ~240mg oxycodone daily when I switched to heroin. ~70mg heroin almost killed me.