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  • BDD Moderators: Keif’ Richards

Oxycodone Interactions Risk Assessment

Nosada

Greenlighter
Joined
Nov 11, 2010
Messages
19
Location
New York
I recently came into possession of 30mg of oxycodone (specifically Roxicodone) and while checking into the possible side-effects, interactions, etc. I came across two interactions between this and other medications that I take regularly. Not being very experienced with opiates, especially of the pharmaceutical variety, I wanted to get an opinion on the risks associated with combining these substances.

First off is generic Alprazolam, in extended release tablets. I normally take one milligram each day, not enough that I feel any physical or psychological addiction to take note of, so I could certainly skip taking it for a day if it proves to be too much of a risk. I know opiates and benzodiazepines combined possess the danger of excessive central nervous system depressing effects, but since I take a relatively low dose and most likely have a significant tolerance to the Alprazolam, and will not be dosing more than 15mg of the oxycodone for a first time experience with the substance, I was wondering if this presented a significant risk. I know well about the dangers of mixing these two substances, but most poor or dangerous experiences seem to come from taking fairly high doses of at least one, if not both, so will the 1mg of extended release benzo present much of a risk?

My second question and interaction is the more pertinent one. I also take Ziprasidone 120mg each day, and found it to have similar CNS-depressing dangers as the other interaction. However, after a thorough search through google and bluelight, I couldn't find any information on the severity of this interaction, just the fact that there is one. I feel more worried about this possible interaction, because while 120mg is a typical activated dose for this drug, it is certainly more potent, or at least a much greater milligram content than the Alprazolam. Additionally, I'm a bit concerned about this possible interaction just because of the complete lack of information on how dangerous it might be, or on the interaction at all. Benzos and opiates are a well known risky combo, but is there significant risk between the opiate and atypical anti-psychotic?

Finally, I will most likely be adding in some amount of an amphetamine salt mixture, specifically dextroamphetamine and amphetamine. All the information I've found and heard on this final combination is that it poses none of the risks of the typical speedball of opiates and cocaine, and that in fact the two drugs do not interact at all, or have no significant risks associated with combining them. Is this combination truly as safe as I've heard it is?

-Finally, finally, a two part addendum to my post. First, please save me the typical "If you are prescribed an anti-psychotic you shouldn't be doing drugs at all" post. Although I'm a new poster, I am very experienced with every typical substance as well as a laundry list of RCs and their effects on my mental state, and I take the medication for its mood balancing effects, not its anti-psychotic effects. I'm neurotic, not psychotic, and I know what I can and can't handle right now.
Also I'm a bit new here, pretty much first time poster, and I wasn't sure if this would be considered basic or advanced, so I put it here in Basic to be safe rather than deleted/publicly humiliated or whatever the tradition is here, so feel free to move this wherever it may be best suited to. Overall I'm interested in the interactions between pharmaceutical opiates and this atypical anti-psychotic, since as I said, there doesn't seem to be much if any information on the interaction. I just want a proper risk assessment on the overall situation, since risks do seem to be present. Thanks, and I appreciate the help for a pretty green poster.
 
In regards to the alprazolam, if you have a tolerance to it, I wouldn't worry about it too much. I would be more worried about taking too much oxycodone with the alprazolam than the alprazolam being the source of any issues or overdose-like reactions. Danger does exist, however, if you take the oxycodone (or another opiate), the alprazolam (or another benzo) and alcohol.

I cannot comment on the anti-psychotic personally, but I'm guessing that you're right about the increased danger of sedation. However, if you have a tolerance to these effects, the risk is smaller.

I imagine another Bluelighter with experience with ziprasidone will be able to give you a more detailed answer. :)

What is your previous opiate experience/tolerance like?
 
My holy bible, the Medscape, tells me that ziprasidone and oxycodone interaction is significant and doctors should monitor it. It is plainly because both cause sedation.

Same goes out for alprazolam.

Should not be too worried though as it says only monitor instead of fatality for example.
 
I have been in the hospital many times and some of the times when they used pain meds and other meds that cause sleepyness. The rule has always been wait 4 hours between the two. So take the oxy at whatever dose you were planning on than wait at least 4 hours before using any of the other above med. That what I do. I have never had a problem although I don't take these same meds. Like I will take Tramadol which has a warning about taking with opiates and then I wait 4 hours before ingesting the oxy. I have always been fine. Waiting 4 hours between the meds should not be too much of a big deal.
 
Alprazolam boosts significantly oxycodone high so I used to do few mg of alprazolam at the same time I dosed 60mg of crushed oxycodone.

But dont do with that kind of amounts. Start something like 0.5-1mg of alprazolam and 15mg of oxycodone. And have someone sober who is not afraid to call ambulance for you if you stop breathing.
 
Thanks for all the replies guys. Typically the sedation effects of the anti-psychotic don't hit me until several hours after I take a dose, and it won't hurt to miss just one day's supply, so I'll probably just take that part out of the equation. I don't have much if any tolerance to opiates, haven't even touched the stuff in probably a year, so I was going to meter out the 15mg in several small doses over the course of several hours just to be safe. I wasn't too worried about the alprazolam, just mostly the anti-psychotic, since other than the FDA's interaction warning between the two substances, there's literally no reports of their interaction on the internet. But I guess if no one has reported it having dangerous effects yet, and I do have a pretty good feel for how the anti-psychotic will effect me, then it probably isn't much of a risk, I just like to do my research, especially before trying something new, and having those interactions concerned me a bit. I'm going to go ahead with trying it out tonight, and I guess if anyone is still interested I can report back on how things went. Thanks again for all the helpful responses everyone.
 
Ok so I've been going through this pill, insufflated, and between a quick conversation with a friend and my initial disappointment in the effects, turns out the people I got this pill with greatly talked up its potency, or they have the opiate tolerance of a small child. Gone through more than half the pill, heart-rate, breathing, general CNS effects all fine. Somewhat euphoric, warm, typical opiate effects, but overall much, much less potent than what I was led to believe. Guess I should have made it more apparent that this was just a little Roxi and not an Oxy, don't think I'm at any risk of ODing or having bad CNS depression, but thanks for all the info anyway, you guys are always a reliable community for this type of thing and I really appreciate it.
 
Sorry for all the self-bumping, but final update for now. Seem to be coming down, getting quite itchy but adding in some amphetamines is helping so far. Everything went fine but not quite as expected. The opiates were pretty weak, nowhere near as powerful as they were talked up to be. I handled the whole pill no problem. I ended up taking an extra 2mg of alprazolam for a little boost, but even between that and the anti-psychotic, there was no significant CNS depression. Adding in amphetamine salts didn't seem to have the synergism of a traditional speedball, especially in the beginning, the amphetamines definitely overpowered the opiates. Overall it was a pretty enjoyable experience, but not something worth repeating, past all the hype my friends gave me about the roxi, it still didn't compare at all to the euphoria and comfort of traditional heroin. It was still an interesting experience though, and I thank all you guys for your insight and support.
 
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