Opioids loperamide tappering for 6 yrs tramadol addiction

[Jabberwocky]

Hello so I am struggling for 5-6 years with this shit I can't explain but not even morphine or oxy could replace my tramadol habbit (1000 mg per day) .
I tried tappering multiple times, 2 months in rehab etc but nothing.
I was researching about loperamide and I thought that about 12 mg would suffice, is this right?
and if yes how fast should I tapper off the loperamide?
would it really help with the snri ssri part like brain zaps of the withdrawal or just the opioid-like part of the w/d?

 

[ConcertaCaptain]

Just the opioid like part as brain zaps are sadly a bitter symptom of tapper or withdrawal off some antidepressants and SSRI's such as Lexapro, Paxil, Remeron, and others.

 

[Jabberwocky]

I know I got brain zaps when I was prescribed Effexor and I got rid of the medication. So what dose of loperamide should be ok at least for the opiate part?

 

[Painful One]

I would consider something other than Loperamide. Please.

The problem with Loperamide is that it is way strong (think fentanyl strong= approximately 100 times stronger than morphine according to Jansen Pharmaceuticals) and it has a horrible, horrible and long withdrawal of its own. Plus it can kill you or damage your heart permanently.

Even if just taken for a short period of time and rapidly tapered, which is what I tried to do over ten days time, still can end up with horrible Loperamide withdrawal. That happened to me. I feel lucky to be alive. The Loperamide withdrawal was the harshest, longest, worst opiate withdrawal ever.

The Loperamide would "hold off" the Tramadol withdrawal but you would still have the Tramadol withdrawal when you stop the Loperamide plus you would now have something worse on top of the tramadol withdrawal. You would have Loperamide withdrawal also. The Loperamide is so strong too that your tolerance would be so high that your normal dose of Tramadol would not even help at all.

The best way to go, is to taper down on the drug you are already using. Or go to a Doctor and get on suboxone or see what kind of comfort medication a doctor would give you. I would look up what the withdrawal symptoms are for any drug before you take it.
Read lots of people's experience with the negative effects of a drug before you ingest it. That is my advise. I learned the hard way. I don't want to see you have to endure such a horrible thing. I know withdrawal from tramadol is bad but the withdrawal from Loperamide is way worse. Many saying it is worse than heroin or methadone withdrawal.

 

[Prescottdave]

I would consider something other than Loperamide. Please.

The problem with Loperamide is that it is way strong (think fentanyl strong= approximately 100 times stronger than morphine according to Jansen Pharmaceuticals) and it has a horrible, horrible and long withdrawal of its own. Plus it can kill you or damage your heart permanently.

Even if just taken for a short period of time and rapidly tapered, which is what I tried to do over ten days time, still can end up with horrible Loperamide withdrawal. That happened to me. I feel lucky to be alive. The Loperamide withdrawal was the harshest, longest, worst opiate withdrawal ever.

The Loperamide would "hold off" the Tramadol withdrawal but you would still have the Tramadol withdrawal when you stop the Loperamide plus you would now have something worse on top of the tramadol withdrawal. You would have Loperamide withdrawal also. The Loperamide is so strong too that your tolerance would be so high that your normal dose of Tramadol would not even help at all.

The best way to go, is to taper down on the drug you are already using. Or go to a Doctor and get on suboxone or see what kind of comfort medication a doctor would give you. I would look up what the withdrawal symptoms are for any drug before you take it.
Read lots of people's experience with the negative effects of a drug before you ingest it. That is my advise. I learned the hard way. I don't want to see you have to endure such a horrible thing. I know withdrawal from tramadol is bad but the withdrawal from Loperamide is way worse. Many saying it is worse than heroin or methadone withdrawal.

Lope is not a strong opioid. It takes a large dose to even begin to feel an opioid like effect and most of the med does not cross the BBB. I think you could do more good by leaving out the fent comparison as that will only encourage people to abuse this drug. Focusing on the effects it has on ones heart is a much better route. Do you have any type of research to back up the idea that Lope is comparable to fentanyl in terms of potency?

As as far as the OP's situation goes. I would taper the tramadol down so that when you quit the SSRI like WD's will be minimal or much less. Kratom, tianeptine sulfate, codiene and low dose lope below 18 mg are all viable options to complete a taper.

Quitting opioids sucks. No surprise. Taking high dose Tramadol unfortanetly is much more dangerous then low doses of all the opioids I previously listed. 1000 mg of tramadol is way above the maximum recommended dose. People have had sezuires from far less. You need to taper your dose down to 500 mg or less ASAP otherwise you are risking a grand mal seizure. Given your dose of tramadol is in the danger zone low dose Buprenorphine would also be a option. Take action now or risk dying.

 

[Painful One]

^^^ I agree with you. However...

The Loperamide is an opiate that the manufacturer made while trying to make something as strong as fentanyl and it is a fentanyl analog.
This was the drug they had come up with right before creating fentanyl. You can find that information from the actual research papers.

Loperamide is very much stronger than most people know.
I would definitely stick with the dosage on the box for only a few days.
Other people have had serious problems due to using loperamide.

It does not matter that it does not cross the BBB. It is still having strong peripheral effects. The lack of a high is deceiving to people because they do not realize just how strong it is.

I don't want to see OP have to endure Loperamide withdrawal for two months after going through hell with tramadol.

I agree about the tapering the dosage ASAP!
If that cannot be done, I would switch to suboxone or methadone.
Those options would be a lot less dangerous.

 

[Prescottdave]

^^^ I agree with you. However...

The Loperamide is an opiate that the manufacturer made while trying to make something as strong as fentanyl and it is a fentanyl analog.
This was the drug they had come up with right before creating fentanyl. You can find that information from the actual research papers.

Loperamide is very much stronger than most people know.
I would definitely stick with the dosage on the box for only a few days.
Other people have had serious problems due to using loperamide.

It does not matter that it does not cross the BBB. It is still having strong peripheral effects. The lack of a high is deceiving to people because they do not realize just how strong it is.

I don't want to see OP have to endure Loperamide withdrawal for two months after going through hell with tramadol.

I agree about the tapering the dosage ASAP!
If that cannot be done, I would switch to suboxone or methadone.
Those options would be a lot less dangerous.

Lope is not an opiate it is an opioid. I can't find any information about it being a fent analogue though I could maybe see that as a possibility.

I did find it was made shortly after the synthesis of fentanyl citrate by Janssen. Can you link me to the research paper or clinical trials which shows it is an analogue of fentanyl?

 

[Jabberwocky]

I've been on this dose for years, never had a seizure, actually once but combined with Effexor and speed sulphate since then never and then I was on 1500 mg. the taper is not an option as soon as I get to 250 in 5 days I'm back on 500 then 750 then again 1000, so I would love to try it CT max with lope or something weaker, codeine just makes me have an alergic reaction (mad histamine release), tho from morphine I never had such a reaction.

 

[Prescottdave]

I've been on this dose for years, never had a seizure, actually once but combined with Effexor and speed sulphate since then never and then I was on 1500 mg. the taper is not an option as soon as I get to 250 in 5 days I'm back on 500 then 750 then again 1000, so I would love to try it CT max with lope or something weaker, codeine just makes me have an alergic reaction (mad histamine release), tho from morphine I never had such a reaction.

Tapering to 250mg from 1000 mg in 5 days is not really a taper. If you have a hard time tapering on Tramadol you are going to have a really hard time switching to a safe dose of Lope.

I will say it again. Given your dose of tram is twice the maximum dose you are at a high risk of having a sezuire. I would highly encourage you to get on a low dose of Buprenorphine.

Stay safe. It just takes one sezuire while driving or it the wrong place to end your life. Not worth even the slightest risk.

 

[Hodor]

the taper is not an option as soon as I get to 250 in 5 days I'm back on 500 then 750 then again 1000

I agree with Prescottdave, going from 1000 to 250 in 5 days is too rapid to be considered a real "taper".
Decreasing the dose by 50 (or even 25) mg per day should pretty much nullify the brain zap issue.

Tapering with ultra-high-dose loperamide is just about the worst solution you could go for, especially since a number of people have just ended up addicted to lope instead.

 

[ObieWan]

I never knew you could experience WD from loperamide, though it makes perfect sense. I have been addicted to alcohol, hydro, benzos, and bup and they are all a bitch, but never tramadol. I wish I could give more insight specifically for this problem.

 

[DrewDogBaby209]

I am not trying to start shit or get in the middle of your guys conversation or take sides but I have read that loperamide is very strong and related or compared to Fentanyl not sure which one though....Also I can't remember where I read that and I'm not doing any research or links bcuz I don't want to ever think about taking loperamide for withdrawal again. I hope you understand but I'm on methadone and I fucking hate loperamide so much now. Bad memories that I don't want to ever relive. Have a good day guys take care and God bless you all... Please stay safe... I don't want to lose anyone else to opiates or opioids again.

 

[Painful One]

Yep. Anyone who is smart is telling you that Loperamide is the worst option!

 

[Prescottdave]

I am not trying to start shit or get in the middle of your guys conversation or take sides but I have read that loperamide is very strong and related or compared to Fentanyl not sure which one though....Also I can't remember where I read that and I'm not doing any research or links bcuz I don't want to ever think about taking loperamide for withdrawal again. I hope you understand but I'm on methadone and I fucking hate loperamide so much now. Bad memories that I don't want to ever relive. Have a good day guys take care and God bless you all... Please stay safe... I don't want to lose anyone else to opiates or opioids again.

Loperamide works by a number of different mechanisms of action that decrease peristalsis and fluid secretion, resulting in longer gastrointestinal transit time and increased absorption of fluids and electrolytes from the gastrointestinal tract.

It is a phenylpiperidine derivative with a chemical structure similar to opiate receptor agonists such as diphenoxylate and haloperidol. The chemical structure and potency of loperamide does not share any similarities to fentanyl.

Fent is active in the sub mg range. Lope is active starting at about 1 mg though this dose does not cause any type of CNS depression nor opioid like activity in the brain. Those doses only act on receptors in the gut.

https://www.ncbi.nlm.nih.gov/pubmed/18192961

 

[DrewDogBaby209]

What we are trying to say is that if loperamide DID cross the BBB it would be a very strong opioid.

According to pharmacy times:

"When compared to morphine, loperamide has been shown to be 40-50 times more potent in producing antidiarrheal and central nervous system (CNS) depressive effects. The difference with loperamide, in contrast to morphine, is it really only produces its depressive effects in the gut due to poor gastrointestinal absorption.1 Additionally, any loperamide that does happen to make it across the blood brain barrier (BBB) is rapidly pumped back out via P-gp efflux pumps."

This doesn't say anything about it being related to fent but it does say that it is a strong opioid if it were to cross the bbb

I'm done talking about loperamide so whatever you decide to come back with good for you PD. Have a great night BL.

 

[Prescottdave]

What we are trying to say is that if loperamide DID cross the BBB it would be a very strong opioid.

According to pharmacy times:

"When compared to morphine, loperamide has been shown to be 40-50 times more potent in producing antidiarrheal and central nervous system (CNS) depressive effects. The difference with loperamide, in contrast to morphine, is it really only produces its depressive effects in the gut due to poor gastrointestinal absorption.1 Additionally, any loperamide that does happen to make it across the blood brain barrier (BBB) is rapidly pumped back out via P-gp efflux pumps."

This is why it is used as an antidiarrheal as apposed to a pain med. Being 40-50 times more potent then morphine on the gut receptors has no barring on the potency of the drug on say your breathing or receptors that are located in your brain. Again this has nothing to do with Fentanyl.

Additionally the small amount of the drug that does reach the brain is kicked back out. Unfortanetly we have found that some does reach the brain but only enough to cause a slight high.

So it is not a Fent analogue nor is it close to fent in terms of potency on opiate receptors in the brain. It does how ever make people really constipated. Sounds like a shit drug literally.