Tchort
Bluelight Crew
- Joined
- Mar 25, 2008
- Messages
- 2,392
I have noticed anecdotal evidence over the years of Methadone and Buprenorphine maintenance patients in the US who use/abuse Cimetidine (Tagamet) on a daily basis to increase the potency, duration, sedation, etc of either MMT or BMT. It is a commonly known fact, even among patients/users who do not know the specific activity of CYP450-CYP3A4-inhibition as well as typical anti-histaminic activity, that Tagamet will 'boost' their legal maintanence opioids. Sometimes this information is passed down through clinic patients to other clinic patients, or even from employees of clinics to patients (also anecdotal), as well as a plethora of internet resources on the subject including police reports of stolen OTC medications for these purposes to websites like this one giving out the information.
It has been demonstrated that daily administration of Cimetidine (or any active CYP3A4 inhibitor) before taking an opioid such as Methadone or Buprenorphine will alter the blood serum levels of said opioid, in a way creating a pseudo-dose increase. The body is 'tricked' into believing more Methadone or Buprenorphine is taken, and reacts accordingly through the effects received through combining Tagamet and an opioid (specifically legal maintanence opioid). Discontinuation of the Cimetidine/Tagamet by an MMT or BMT patient who has been taking specifically larger than recommended amounts of the OTC drug (400mg-2,000mg+) daily for a lengthy period of time ought to result in opioid withdrawal syndrome symptoms similar to having a dose reduction (severity dependant upon individual reaction and sensitivity to Cimetidine and the opioid in question, individual dose of opioid and Cimetidine, length of use and dose of Cimetidine and opioid, etc).
I have yet to find someone willing to admit to having a Tagamet habit- someone who has started a daily routine of taking Cimetidine/Tagamet before taking their daily dose of Methadone or Buprenorphine noticed this negative reaction when they stop taking the Cimetidine normally on a daily basis, for whom it has become a problem, or who has taken steps to taper their dose of Cimetidine/Tagamet to alleviate the problem.
Are there any BL members who have experienced this problem? While I am specifically interested in MMT or BMT patients and Cimetidine/Tagamet, which I think would be the most common CYP450 inhibition habit problem due to the widespread knowledge, are there any posters who are dependant opioid users who use potentiators (specifically CYP450 inhibitors such as GFJ, Ranitidine, etc) who have noticed and experienced this problem?
It has been demonstrated that daily administration of Cimetidine (or any active CYP3A4 inhibitor) before taking an opioid such as Methadone or Buprenorphine will alter the blood serum levels of said opioid, in a way creating a pseudo-dose increase. The body is 'tricked' into believing more Methadone or Buprenorphine is taken, and reacts accordingly through the effects received through combining Tagamet and an opioid (specifically legal maintanence opioid). Discontinuation of the Cimetidine/Tagamet by an MMT or BMT patient who has been taking specifically larger than recommended amounts of the OTC drug (400mg-2,000mg+) daily for a lengthy period of time ought to result in opioid withdrawal syndrome symptoms similar to having a dose reduction (severity dependant upon individual reaction and sensitivity to Cimetidine and the opioid in question, individual dose of opioid and Cimetidine, length of use and dose of Cimetidine and opioid, etc).
I have yet to find someone willing to admit to having a Tagamet habit- someone who has started a daily routine of taking Cimetidine/Tagamet before taking their daily dose of Methadone or Buprenorphine noticed this negative reaction when they stop taking the Cimetidine normally on a daily basis, for whom it has become a problem, or who has taken steps to taper their dose of Cimetidine/Tagamet to alleviate the problem.
Are there any BL members who have experienced this problem? While I am specifically interested in MMT or BMT patients and Cimetidine/Tagamet, which I think would be the most common CYP450 inhibition habit problem due to the widespread knowledge, are there any posters who are dependant opioid users who use potentiators (specifically CYP450 inhibitors such as GFJ, Ranitidine, etc) who have noticed and experienced this problem?