blahblahblah said:
Also does anybody have any information concerning bupe's potential to damage the liver?
I really cant find to much info on it other than its debatable and not to prescribe to patients that have liver or kidney problems.
My understanding is that bupe is relatively easy on the liver for the average person with normal liver function. People who have existing liver issues, particularly hep C, should monitor their liver function when using bupe, because there is some evidence of problems.
Acute hepatitis due to buprenorphine administration
European Journal of Gastroenterology & Hepatology 16(10):1033-1037, October 2004.
Herve, Sophie a; Riachi, Ghassan a; Noblet, Catherine b; Guillement, Nathalie b; Tanasescu, Stephana b; Goria, Odile a; Thuillez, Christian b; Tranvouez, Jean-Luc a; Ducrotte, Philippe a; Lerebours, Eric a
Abstract:
Background: Buprenorphine, a synthetic molecule derived from thebaine, has been commercialized in France since 1987 as a substitute treatment for pharmacodependence on opiates. Hepatotoxicity is poorly documented, since only few cases of hepatic injury have been reported.
Methods: We report seven cases of acute cytolytic hepatitis due to buprenorphine. All patients were former drug addicts by the parenteral route and had been receiving withdrawal therapy with buprenorphine for an average of 91 days at a daily dosage ranging from 2 to 12 mg. Liver tests, complete viral screening and an abdominal computerized tomography scan were performed in each patient.
Results: Five out of seven subjects presented with acute icteric hepatitis without abdominal pain or fever. Average alanine aminotransferase levels were 39 times the normal rate. There was no sign of liver failure. All patients had anti-hepatitis C virus-positive serology and two had positive hepatitis C virus-RNA. Although no specific treatment was administered, buprenorphine doses were reduced whenever possible. Cytolysis and jaundice resolved rapidly in all cases, although treatment was continued at the same doses in four cases and the dosage was reduced by 50% in three other cases.
Conclusions: Although buprenorphine hepatitis is uncommon and has spontaneously good evolution, we suggest better monitoring of hepatic profiles in patients whose mitochondrial function is already impaired by viral infections or other toxic factors.
The Safety of Methadone, LAAM, Buprenorphine in the Treatment of Opioid Dependency
Unexpectedly, buprenorphine AEs (adverse events) included 5 mentions of non-viral hepatitis, 3 listings of hepatotoxicity, and 1 case of abnormal liver function test results. There were no specific mentions of hepatitis or hepatotoxicity associated with LAAM or methadone.
The significance of this is unknown at present; however, concerns regarding buprenorphine hepatotoxicity have been expressed by practitioners using the agent in Australia (A. Byrne, MD, Redfern, NSW, Australia, e-mail communications December 19, 2000 and January 4, 2001). Furthermore, a prospective investigation by Petry et al. (2000) in 120 buprenorphine-treated opioid addicts found that those with a history of hepatitis C exhibited significantly increased AST and ALT levels (p < 0.05) in a dose-dependent fashion. They recommended that liver enzyme levels be closely monitored in such patients.
Elevated liver enzyme levels in opioid-dependent patients with hepatitis treated with buprenorphine
Petry NM, Bickel WK, Piasecki D, Marsch LA, Badger GJ. Am J Addict. 2000;9(3):265-269.
Abstract: The purpose of this study was to assess changes in liver enzyme levels among opioid-dependent patients treated with buprenorphine. Liver enzyme levels were evaluated among 120 individuals before treatment and following a minimum of 40 days of buprenorphine treatment (2, 4, or 8 mg/70 kg/day).
Among patients with a history of hepatitis, AST and ALT levels significantly increased (p < .05) with buprenorphine treatment. The odds of observing an increase in AST were determined to be dependent upon buprenorphine dose (p < .05; odds ratio = 1.23 per 1 mg increase in dose). These results suggest that liver enzyme levels should be monitored carefully when patients with hepatitis are treated with buprenorphine.
. Even that much cash is still cheaper than what I'm paying for the oxys, dilaudids, and smack, plus it's legal so I don't always have to be looking over my shoulder when it comes to opiates.