Opioids Safe to take Naltraxone on Loperamide?

[ElroyH]

Hi I'm currently doing a 14 night inpatient straight heroin detox of which I'm on the last couple of days. I've been trying to stop taking everything and got my lofexidine right down to 0.8mg day but on night 12 and really struggling with stomach / diarrhea so had to take some loperamide, is still safe to take my first Naltraxone dose tomorrow? I know it's not an opiate but it is related and I'm not sure how true it not crossing the bbb is Thanks.

 

[Slow_Mobius]

It would probably be safe, but it might make your GI issues much worse. I would either use a different diarrhea med or see if you can skip the naltrexone until you're feeling better

 

[ElroyH]

Thanks that was my thoughts, the nurses here say will be fine but the doctor isn't back until Monday.

 

[Slow_Mobius]

if they try to force it on you, tell them that loperamide is an opioid that doesn't cross the BBB, and naltrexone is an opioid antagonist. Opposing forces

 

[ElroyH]

OK will do, as far as I know the only other med they give is for stomach cramps and called. Buscopan but I could see if that helps with the diareah?

 

[Slow_Mobius]

I could be wrong, but i don't think that's a diarreah med, and the naltrexone is almost certainly going to make it worse.

 

[ElroyH]

OK mate thanks for all the help, basically very limited to what meds can have in here.

 

[kleinerkiffer]

Buscopan=Butylscopolaminbromid is an antispasmodic that'll help with stomach cramps via muscarinic acetylcholine receptor antagonism and ime it slows down the gut so it can help a little with diarrhea

 

[dopemaster]

It's not gonna help with your stomach situation.

You are supposed to be done with wds cuz you are basically purging your system entirely of opiates and there are probably still a lil somewhere in you.

This is really something yoi should talk to your doctor about. I don't think taking lopermide for even wd shits is going to affect your drug treatment but I think getting the shot too soon by not providing accurate information could be really unpleasant.

I don't have any personal experience with naltrexone except overdosing and having to act like I considered it a treatment option.

The stuff is in Suboxone strips too and I have taken those and I never really liked naltrexone and have pretty bad reactions and my guess would be that it pirged the residual opiates still clinging to my brain.

Lopermide is classified as a straight up opiate and is actually pretty strong, it doesn't cross the bbb and therefore works only on the stomach muscles so I would guess your stomach would feel the naltrexone.

I don't remember the time span for being opiate free in the brochures I read with my PO and I said there was no way I was doing that unless she felt like commuting my sentence and she just laughed and said I was fine with what I doing for treatment.

 

[ElroyH]

I just spoke to the nurse, tomorrow is a half test dose but they seem pretty adament I'll be fine. It's hard to know what to do for the best. I'd rather leave this place with the naltraxone started if I can. Especially struggling now the lofexidine has been cut right down. Only allowed 2 x 0.2 pills tomorrow so I'm going to ask if I can split into half's so can have my usual 4 doses spaced out over the day. 2 days ago was taking 3 pills x 4 times a day.

 

[Slow_Mobius]

Buscopan=Butylscopolaminbromid is an antispasmodic that'll help with stomach cramps via muscarinic acetylcholine receptor antagonism and ime it slows down the gut so it can help a little with diarrhea

Good info. In that case, you could try stopping the loperamide and just using the buscopan. My bet is that the naltrexone still worsens your GI issues but it might be at least bearable. Good luck

 

[kleinerkiffer]

Good info. In that case, you could try stopping the loperamide and just using the buscopan. My bet is that the naltrexone still worsens your GI issues but it might be at least bearable. Good luck

This
The naltrexone will most likely kick the lope from your opioid receptors in your GI tract due to higher affinity, so you'll most likely experience worse GI problems

Ime 20mg buscopane stops my GI tract completely the next day (but I suffer from IBS and I'm pretty sure normal people won't react this way), so you may get some relief using it

 

[tacodude]

Just clearing up a statement made earlier, but nalaxone is in Suboxone not naltraxone a completely different medication

 

[LucidSDreamr]

^ not totaly different as they are both antagonists. but i believe naloxone is much more effective one.

I'm surprised you are still having acute WD 14 days clean, must have been a heck of a habit no?

 

[ElroyH]

Yeah I was hoping to be feeling better by now as I get out in the morning but feeling like this is gonna last another couple weeks, still yawning sneezing restless legs eyes watering goosebumps and incredible anxiety. Had got to around half ounce a week but the last 18months or been getting really strong gear also. Still im well well past the worse, nothing I can't handle. Determined to quit this time!

 

[kleinerkiffer]

^ not totaly different as they are both antagonists. but i believe naloxone is much more effective one.

Naltrexone has a higher binding affinity, slightly higher BA and longer half life

 

[Da Chemist]

High doses pass the BBB. Loperamide should only be temporary to get someone off the Oxycontin, and other opiates. It's bad for the heart. Don't stay on that garbage. I know it stops opiate withdrawal but Loperamide is addictive in the long run.

 

[tacodude]

Another misstatement, but all doses of lope pass the BBB only to immediately be pumped by something known as PGP. The only reason high doses are able to create CNS effect is due to some of the lope binding in the CNS while past the blood brain barrier before the overwhelmed PGP can pump it back out.

It's not that confusing people get it right