Opioids Tapentadol - is this dose going to kill me?

[Artificial Emotion]

I take 800mg twice per day and I wanted to try and double dose, taking 1.6g in one dose to see what it feels like but I am hesitant because it's a high dose and usually people aren't prescribed more than 600mg per day. It inhibits reuptake of noradrenaline so it's not a just a u-opioid receptor agnonist.

I read there's no ceiling dose but I don't want to do something that's going to harm me. This is the exact sort of thing this site exists for so hopefully someone can help.

I take duloxetine 120mg per day, an SNRI for peripheral neuropathy.

 

[Artificial Emotion]

From wikipedia:

Due to its actions on norepinephrine, and to a lesser extent serotonin, a Tapentadol overdose may produce symptoms which are not typically present in opioid overdoses (symptoms of serotonin syndrome and adrenergic syndrome). This risk is greater if Tapentadol has been taken with other drugs of similar mechanisms.[37] These additional symptoms should be addressed and treated symptomatically (after treating for mu-opioid agonism) if they are presented and must be taken into consideration prior to the administration of any medication.[43]

Thoughts anyone?

 

[Picnic_Johnson]

That is a very high dose, along with duloxetine, IMO you are taking enough risk at 800mg twice per day, more could be deadly.

 

[Mad Dash]

I have heard nothing but nightmare stories from this medication... I have zero experience with it, but I have seen a lot of threads since it was released and they are not very flattering, some people have felt awful, almost a sick type of feeling while nodding out uncontrollably.

 

[Artificial Emotion]

I've read loads of threads too and they are definitely mixed (not all negative). Some people hate it, some even compare it to oxycodone although I can't imagine I would go that far.

An adrenergic storm is a sudden and dramatic increase in serum levels of the catecholamines adrenalin and noradrenalin (also known as epinephrine and norepinephrine respectively), with a less significant increase in dopamine transmission. It is a life-threatening condition because of extreme tachycardia and hypertension, and is especially dire for those with prior heart problems. If treatment is prompt, prognosis is good; typically large amounts of diazepam or other benzodiazepines are administered alongside beta blockers. Beta blockers are contraindicated in some patients, so other anti-hypertensive medication such as clonidine may be used. It is usually caused by overdose of stimulants, especially cocaine, but can also arise from improper eating habits while taking monoamine oxidase inhibitors. A subarachnoid hemorrhage can also cause an adrenergic storm, and catecholamine storm is part of the normal course of Rabies infection, and is responsible for the severe feelings of agitation, terror, and dysautonomia present in the pre-coma stage of the disease.

I take a benzo dialy (etizolam/diclazepam) and 80mg extended release propranolol. Maybe this is why I haven't had any issues.

 

[namnoc16]

I've taken it along with various other opiates/opiods and can tell you from my experience there is nothing of recreation to be had from this drug. I would get a nod but no euphoria.I literally would blink then when I'd open my eyes it would be 10 min later. I was prescribed 100mg 3 x a day and had my doc take me off immediately. You are doing 800 mgs a day,why? That shit is garbage if I wanted to be a zombie and get no euphoria I'd pop a bunch of my wifes xannax.

 

[Artificial Emotion]

You are doing 800 mgs a day,why?

Because I'm in agony.

 

[namnoc16]

Because I'm in agony.

You re taking them for legit pain? The reason I ask is they helped with my pain,very well actually just couldn't keep my eyes open. If you are using that high of a dose they aren't doing it for you anymore.Have you tried switching up on your meds?I've learned that if I stay on one med to ong my tolerance builds and they are no longer doing it for me so me and doc have an understanding to switch me u every so often.Same with my muscle relaxers.

I'd talk to your doctor but I wouldn't mention how far you are exceeding your dose. I'm not trying to give you ideas on how to cop scripts but if you are in genuine pain and you tell your doctor how much you are taking he will cut you off!

 

[Artificial Emotion]

Yeah I've somewhat begrudgingly realised this is just not a drug I can abuse. That's probably a good thing though.

For my nerve pain I'm on 800mg pregabalin, 120mg duloxetine and the propranolol I mentioned above is for anxiety. So I'm at the end of the road in terms of what drugs can do for me and the only final option is cannabis of course. I'm am very cognisant of what not to say to doctors because I am in a lot of discomfort and they said if I abuse it I'll lose it. I'm on methadone as well for opioid dependency so it's amazing they actually prescribed this in the first place lol. I'm in real pain for sure, but I also like to get high sometimes. Unfortunately I hate to say it but I fear I'm going to have to make a one way trip to Switzerland in the next few years but until then I want to live a relatively normal life.

 

[namnoc16]

Well being on the methadone explains why you can handle so much of the tapentadol . Pease be careful man you are an overdose waiting to happen!

I don't get why the doctor would prescribe you tapentadol being on methadone if they were going to prescribe another opiate with it(at least in the states) it's usually oxycodone for break through pain. I know tapentadol has 2 formulations (IR,ER) but I'd never found it any good for BT pain even the IR!

Also maybe alone it doesn't have a ceiling but mixing it with methadone and benzos I'm sure the ceiling is there. If you wer in the U.S. the DEA would have shut your doctor down long ago.That's a bunch of shit!(on second thought,probably not I've seen crazy scripts here as well)

 

[Artificial Emotion]

Conventional classical opiates generally don't really touch neuropathic pain and tapentadol is unique in that it works on normal nociceptive pain but also uniquely treats neuropathic pain.

Thanks for your concern by the way, I'll be careful.

 

[namnoc16]

Conventional classical opiates generally don't really touch neuropathic pain and tapentadol is unique in that it works on normal nociceptive pain but also uniquely treats neuropathic pain.

Sorry for my ignorance, it appear you might have to find something else. Doesn't seem like the tapentadol is doing the trick either.I'm not being glib, I feel for you I am a pain suffer as well! Don't double your dose because even though it acts different in treating your pain the overdose is very similar to conventional opiates.

 

[Artificial Emotion]

Sorry a bit more info: I'm in the UK and am cross titrating from methadone to tapentadol but right now we're holding the methadone constant at 24mg and the tapentadol at 800mg. I started at 64mg methadone as the sole opioid.

 

[Artificial Emotion]

Well I ended up playing it safe and instead of taking my morning dose of 400mg I decided to take 500mg prolonged release tapentadol alongside my 24mg. Today the dose was upped to 800mg b.i.d. so in effect I'm taking 200mg over my usual dose. All I have to say is wow, this feels amazing!! Know that feeling you get in your teeth where you have the desire to bite down and put some pressure on your molar teeth, giving you a fleeting euphoric feeling in your teeth (maybe that's just me) or the feeling as you're taking a shit on the crapper which gives you goose pimples? It feels exactly like that with a feeling of warmth inside my chest. This is fucking amazing!

I know I can't up to dose over a certain limit so this drug is self limiting and it will prevent out of control dosing so this is a good thing. I've never tried oxycodone since you just can't get it over here in the UK, like meth. I'm sure someone gets it and even diverts their script but it's rare as a hen's teeth. Methadone is a drug I've been double dosing one day out of 14 because it allows me to get the energy to do things I wouldn't be up to doing otherwise and that's been working for me because I can get high and get shit done without worrying about an addiction spiralling out of control. I would skip a methadone dose and double dose the next morning with only minor issues if the previous methadone dose was late in the evening. Honestly it's completely safe despite fears doctors might have about overdose risk because I always stick to the same conservative dose and the benzos are taken at a fixed dose at the same time and they're only taken to stave WDs off, not used to add to the depressant effects on the central nervous system so the risks from the benzos on top are not an issue. I have been doing this since about 2006 with no harm to my ability to function.

 

[namnoc16]

Well I didn't want to add this but it's funny you mention your teeth. The only bit of euphoria I got from those nucyntas(tapentadol) was when I IVed them. It very dangerous and strongly don't recommend it to anyone because although I felt some euphoria it was over in minutes.Anyway when I injected them(many years ago 2010 I think) they gave me aweird cold chill running through my front teeth. I have never experienced this before and I didn't get the hard unpleasurable nod that I got when taking them the oral route.But as I said as the rush went so did any kind of high!