Opioids Question about maximum codeine use.

[Backfromthebrink]

Yeah they know me by face and name at my local one too but they still ask me stupid things when I go in even though they know what my prescription is since I pick it up every week, can't stand them.

The usual dose time is 4 hours I know, but that's when taking it 30-60mg at a time, not 200mg a time right?

The only reason i'm taking damn codeine is to try stave off wd's from DHC which it isn't doing a great job at but I don't want to take too much and have a histamine release.

Lol...yeah Lloyds are pain in the fucking arse...they used to deliberately give me the wrong kind if fentanyl patch and when I'd complain they'd say "well you've opened the bag now"...like how the fuck would I know what was in it if I hadn't opened the bag?

With regard to your codeine..it kind of depends as people have different amounts of the enzyme that converts it to morphine but generally speaking (and it is only generaly) 600mg over a 24 hour period seems to be what most pain specialists recommend as the absolute maximum.. So as a guide if you're doing 200mg then I'd say 3 times a day

Someone is bound to disagree here based in something they've read in a text book but I'm just going off an article I've just read which was a study based in a real pain patient by a real pain management doctor.

Also there seems to be a degree of tollerence with regard to the histamine release....if you haven't experienced it on your first and second doses of the day, you're probably not going to at all.


edit ...here is the case study where I got the 600mg figure from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231548/


Quote "Codeine has a maximum recommended dose of 600 mg daily,?as it is dependent on the enzyme cytochrome P450 2D6 to metabolize it to norcodeine and to morphine, which is the actual analgesic."? .....

which is taken from..Repchinsky C, editor. Codeine Contin product monograph.?Compendium of pharmaceuticals and specialties 2007.?Ottawa, ON: Canadian Pharmacists Association; 2007. p. 562.

 

[thatrandomdude]

Lol...yeah Lloyds are pain in the fucking arse...they used to deliberately give me the wrong kind if fentanyl patch and when I'd complain they'd say "well you've opened the bag now"...like how the fuck would I know what was in it if I hadn't opened the bag?

With regard to your codeine..it kind of depends as people have different amounts of the enzyme that converts it to morphine but generally speaking (and it is only generaly) 600mg over a 24 hour period seems to be what most pain specialists recommend as the absolute maximum.. So as a guide if you're doing 200mg then I'd say 3 times a day

Someone is bound to disagree here based in something they've read in a text book but I'm just going off an article I've just read which was a study based in a real pain patient by a real pain management doctor.

Also there seems to be a degree of tollerence with regard to the histamine release....if you haven't experienced it on your first and second doses of the day, you're probably not going to at all.


edit ...here is the case study where I got the 600mg figure from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231548/


Quote "Codeine has a maximum recommended dose of 600 mg daily,?as it is dependent on the enzyme cytochrome P450 2D6 to metabolize it to norcodeine and to morphine, which is the actual analgesic."? .....

which is taken from..Repchinsky C, editor. Codeine Contin product monograph.?Compendium of pharmaceuticals and specialties 2007.?Ottawa, ON: Canadian Pharmacists Association; 2007. p. 562.

Yeah it seems like there's a lot of different opinions on what the "maximum daily dose" should be, it's funny since I usually take DHC I don't think it has a ceiling dose and I've never really been into codeine before but I've learnt a hell of a lot about it today haha.
I've drank about half the bottle (would equate to 300mg) in 5 hours or so and I've not really noticed any histamine reaction at all, but at the same time havn't really noticed it having any noticeable effect.

Still got the pain in my legs but the rest of the usual WD symptoms seem to be at bay.. Although I still think the leg pain is the worst of them all.

Since it only costs a tiny bit for a bottle I can't really complain anyway, but would much rather just be able to take my normal standard tablets instead of having to drink piss flavoured cough medicine.​

 

[Backfromthebrink]

Yeah it seems like there's a lot of different opinions on what the "maximum daily dose" should be, it's funny since I usually take DHC I don't think it has a ceiling dose and I've never really been into codeine before but I've learnt a hell of a lot about it today haha.
I've drank about half the bottle (would equate to 300mg) in 5 hours or so and I've not really noticed any histamine reaction at all, but at the same time havn't really noticed it having any noticeable effect.

Still got the pain in my legs but the rest of the usual WD symptoms seem to be at bay.. Although I still think the leg pain is the worst of them all.

Since it only costs a tiny bit for a bottle I can't really complain anyway, but would much rather just be able to take my normal standard tablets instead of having to drink piss flavoured cough medicine.​

You're quite fortunate to have got codeine linctus at all nowadays as most chemists will try and fob you off with pholcodeine instead....which is next to useless for your purposes.

How long do you have to wait until your next DHC script again?

 

[thatrandomdude]

Monday next week will be earliest I can get it I think, yeah I've tried in pharmacies previously and they all either said they didn't have it or recommended solpadeine cough syrup. There's plenty of online chemists that still sell the linctus though, at not too bad prices aswell but the shipping costs about the same as the product.

 

[Backfromthebrink]

Monday next week will be earliest I can get it I think, yeah I've tried in pharmacies previously and they all either said they didn't have it or recommended solpadeine cough syrup. There's plenty of online chemists that still sell the linctus though, at not too bad prices aswell but the shipping costs about the same as the product.

Yeah solpadine couch syrup is the pholcodeine which is useless for combating withdrawls.

 

[Lorne???]

750mg per day may be feasible

Antishistamines we’re just a precaution because of large doses

Really wouldn’t recommend QID’ing large doses, however spreading it out may help metabolism-try experiment in, without going too much over the max dose

A lot if people will disagree, though if you don’t constantly reside and handled it the first time, it should be ok

 

[thatrandomdude]

750mg per day may be feasible

Antishistamines we’re just a precaution because of large doses

Really wouldn’t recommend QID’ing large doses, however spreading it out may help metabolism-try experiment in, without going too much over the max dose

A lot if people will disagree, though if you don’t constantly reside and handled it the first time, it should be ok

The bottle I got was only 200ml anyway = 600mg. Honestly I think I took about 150mg at first to see how i'd feel, then have just been sipping away at it for the rest of the day. Probably got 200mg left in it, not feeling bad at all and it's holding the wds at bay.

 

[Michael_25]

These are one time doses, you're suppose to titrate codeine. I believe 360mg is the suggested max daily dose.

It may hold true then. If they are first time doses for first time users, then it appears more accurate. Codeine was the first opiate I tried. On my first go I used 300 mg and felt fine. Two days later I upped it to 360 -- still feeling fine. Now, I can barely feel 450 mg so I use oxy and hydro. However, new users should err on the side of caution and use the chart provided as a guide.

 

[thatrandomdude]

just an update, if anyone else is worried about going through DHC withdrawals and thinking about drinking codeine linctus to help with it, don't. I got next to no sleep from the RLS and the sorbitol acting as a laxative. Seemed like it was helping the tiniest bit yesterday, placebo maybe?? Was still in a lot of pain. Managed to speak to my GP today and got sorted out anyway, but I can not recommend that stuff. Not sure if it made me feel any better or worse, but I slept (or attempted to) as if I hadn't had anything.

Thanks for all your advice people, stay safe.

TL;DR, codeine sucks for trying to stave off withdrawals from its cousin dihydrocodeine.

 

[wheaters]

I would just take the L and go through withdrawels (if any) for a few days the leave it a couple weeks.

Get your dose down to as oreviously stated the 200-240mg a range per day and stay out if the danger zone all together !

Stay safe

 

[Lorne???]

Codiene isn’t great anyway

Yiu may be an intermediate or poor metabolizer; though like I said Codiene isn’t great with any kind of tolerance

And have pure dhc; that isn’t bad; would try IM, maybe ( fit me, if wasn’t so skinny)

half a gram dhc, reaching even a 50-75% equality threshold isn’t practical and possibly impractical-BTW, what country, if u don’t mind

 

[thatrandomdude]

Codiene isn’t great anyway

Yiu may be an intermediate or poor metabolizer; though like I said Codiene isn’t great with any kind of tolerance

And have pure dhc; that isn’t bad; would try IM, maybe ( fit me, if wasn’t so skinny)

half a gram dhc, reaching even a 50-75% equality threshold isn’t practical and possibly impractical-BTW, what country, if u don’t mind

Yeah codeine doesn't seem great, I wasn't sure how much DHC tolerance converts to codeine tolerance, turns out a fair bit. I drank the whole bottle and didn't feel any pleasant effects at all, yeah that's what I have pure DHC (thankfully managed to speak to my GP today about it and he said he'd rather me take the tablets than drink cough syrup) I'm from UK. Do you think half a gram DHC is too much over a day? (12 - 14 hours or so). I thought DHC didn't have a ceiling dose

 

[Lorne???]

No, not at all, just riiterating that because codiene does have a ceiling, and is less potent , that even getting what would equal half of your usual DHC dose(500mg, so you would need 250-375ng to stave off wd, generally?) may not be practical, or even possible, w/ a weird prodrug like codiene(and so mild)
(Some would probably prefer tramadol)
Dhc May be Codiene’s cousin, though it is almost like hydrocodone more so; it is an active Mu agonist, usually ~double the potency if codiene, and yet it does produce a “semi-active” metabolite(dihydromorphine, vs hydromorphone for hydrocodone) usually it is considered insignificant, yet in some rapid 2D metabolizers, larger amounts can be produced to actually contribute to the effects/analgesia

It is still somewhat atypical, though more like hydro, in many ways, IMO-odd they don’t really use it in the states when it is more potent than codiene, and reliable, yet still a more “mild” opioid” - of course that would make sense and we cannot have that

Seriously, they make 7.5mg tablets of codiene? Wtf? Ok, done picking on codiene, it is an opiate, it just doesn’t stand up to it’s big bro, Morphine

 

[Backfromthebrink]

No, not at all, just riiterating that because codiene does have a ceiling, and is less potent , that even getting what would equal half of your usual DHC dose(500mg, so you would need 250-375ng to stave off wd, generally?) may not be practical, or even possible, w/ a weird prodrug like codiene(and so mild)
(Some would probably prefer tramadol)
Dhc May be Codiene?s cousin, though it is almost like hydrocodone more so; it is an active Mu agonist, usually ~double the potency if codiene, and yet it does produce a ?semi-active? metabolite(dihydromorphine, vs hydromorphone for hydrocodone) usually it is considered insignificant, yet in some rapid 2D metabolizers, larger amounts can be produced to actually contribute to the effects/analgesia

It is still somewhat atypical, though more like hydro, in many ways, IMO-odd they don?t really use it in the states when it is more potent than codiene, and reliable, yet still a more ?mild? opioid? - of course that would make sense and we cannot have that

Seriously, they make 7.5mg tablets of codiene? Wtf? Ok, done picking on codiene, it is an opiate, it just doesn?t stand up to it?s big bro, Morphine

In the UK they only make the 15, 30 and I believe 60mg codeine phosphate tablets...

DHC I believe there is also a 120mg XR tablet...in fact for many years these were uses instead of methadone and subs for ORT in British prisons.

I think you and I were once discussing lope used as a bridge in between scripts and I mentioned that I had used it occasionally back in the day for that purpose...I think you said sonething along the lines if why not just use CWE codeine instead since I'm from the UK.. While that would obviously be safer than high dose lope (which I think was your point), it just doesn't cut it at all when your on any if the heavy hitter opioids like morph, oxy, fent etc...but lope can..Unfortunately it involves doses that are inherently very unsafe (around the 200mg range...with potentiators/inhibitors on top).

I would have thought that if one was "only" on DHC though, codeine would at least be able to stave off WDs...it's weaker for sure but not that much weaker...and to stave off withdrawls you're not trying to match the potency of the original compound in terms of its analgesic effect...just mitigate the withdrawl that comes from its absence...and for DHC I would have though that codeine would be able to do that

 

[SS373dOH]

Apparently in Canada anything over 8mg has to be rx'd..

 

[Backfromthebrink]

Apparently in Canada anything over 8mg has to be rx'd..

Generally the same in the UK....8mg with paracetamol but for some reason 12.8mg when with ibuprofen.

But we can also get DHC 8mg with paracetamol...they're a fair bit more expensive though....2-3 times more than normal codeine phosphate 8mg and paracetamol.

 

[thatrandomdude]

In the UK they only make the 15, 30 and I believe 60mg codeine phosphate tablets...

DHC I believe there is also a 120mg XR tablet...in fact for many years these were uses instead of methadone and subs for ORT in British prisons.

I think you and I were once discussing lope used as a bridge in between scripts and I mentioned that I had used it occasionally back in the day for that purpose...I think you said sonething along the lines if why not just use CWE codeine instead since I'm from the UK.. While that would obviously be safer than high dose lope (which I think was your point), it just doesn't cut it at all when your on any if the heavy hitter opioids like morph, oxy, fent etc...but lope can..Unfortunately it involves doses that are inherently very unsafe (around the 200mg range...with potentiators/inhibitors on top).

I would have thought that if one was "only" on DHC though, codeine would at least be able to stave off WDs...it's weaker for sure but not that much weaker...and to stave off withdrawls you're not trying to match the potency of the original compound in terms of its analgesic effect...just mitigate the withdrawl that comes from its absence...and for DHC I would have though that codeine would be able to do that

Yeah that's what I thought, and that is all I take DHC tabs in their 30mg form, but codeine seemed to have next to no effect on staving off the withdrawals. Maybe it's because I usually dose about 300mg at first of DHC then have another 200-300mg over the rest of the day? Or maybe because it was in cough syrup form (5ml - 15mg)? I didn't think that should make any difference though.

DHC is definitely stronger than codeine, for sure 1.5x i'd even go as far to say 2x for me personally, everyone metabolizes at a different rate though and I guess some are more effective than others.

True that DHC and codeine are both weak opioids - but I am down from taking oxy to DHC so it's a big improvement for me anyway, hoping to get off them all together at some point but until then.

Also I would just usually do CWE if I ever wanted to take some codeine to go with my DHC, (codeine definitely seems to add an extra buzz if i'm already taking DHC), but I had no DHC at all and needed something to supplement, and since the co-codamol tablets if you CWE'd a full packet would only equate to 256mg codeine, where as the codeine linctus equates to 600mg codeine and is only a bit more expensive, I went with the linctus

edit: Also with lope you mean loperamide? I've never heard of anyone using that to help with opiate wd's, how does it help? I know DHC isn't around the oxy / morphine mark as far as potency goes, but codeine definitely didn't help much if at all with the wd's, and I don't really want to go back to taking anything stronger, but I don't think there's anything else around the same potency as DHC.

I know loperamide helps with the stomach issues that can come with wd's, but that part of the wd's is never really an issue for me

Also what do you guys do for the leg pain? Or should that be a new thread?
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