Methadone Potentiation

[mickenator]

Swim was wondering if anyone knows of a way to increase the effects of methadone or to make it last longer. Can swim just use the grapefruit and tums route, or is it just not possible to do. Any help would be gratefully received.

[Forthesevenlakes]

SWIM believes (but has not tried his) that dxm, and presumably grapefruit juice and tums would work as well. he has read reports that dxm works, so he'd assume the other two methods mentioned would work as well. just be very careful about re-dosing on the methadone or taking an initial dose thats too high, since it can take a while to set in.

[kailey_elise]

DXM (dextromethorphan) is very good at increasing the effects of methadone; I've heard this from both chronic pain patients and methadone maintenance therapy. Apparently, one would want to take a relatively "normal" dose of DXM (15-60mg; more isn't always better, though!) anywhere from an hour before methadone dosing right up to at the same time as methadone dosing.

It's been said that the most effective OTC way to potentiate methadone with DXM is to procure the generic version of Robatussin Cough Gels, squeeze the gel inside into fast-dissolving gelcaps and take them with the methadone. Next best is to use the cough syrup at the same time as the methadone dose; next in line would be to take either the name brand or generic cough gels about an hour before dosing (they take longer to dissolve in your stomach, the Robatussin brand taking longer than generic).

Sources state that not only does the methadone dose feel stronger, but the "peak" is longer, up to two hours in some people (compared to 10 minutes without the DXM).

It also seems that having taken the DXM at low doses for a period of time has lowered the methadone tolerance somewhat for at least one person, even if DXM is not taken with the dose; however, this avenue hasn't been explored fully yet.

Long winded way of saying, some people I know would recommend 30-45mg of DXM to feel more effects from methadone. ;-)

~K.Elise

Originally Posted by mickenator

Swim was wondering if anyone knows of a way to increase the effects of methadone or to make it last longer. Can swim just use the grapefruit and tums route, or is it just not possible to do. Any help would be gratefully received.

[t1rex]

Swim takes Cimetidin or omeprazole, pantoprazole, all stomach medicines that work via inhibiting cyp450 enzym in your liver and of course Potassiumhydrogencarbonate wich lowers your ph in the stomach and prolongs the duration of action of methadone very well. Take it all bevor the metha!

[merseyloyalist]

an other way swim hears to potentiate the effects of methadone good style is to take cyclizine the travel sickness tablets with it

[BANGINCOLOR]

First of all, methadone is a VERY misleading drug. The people that die from taking it do so because when they take methadone, they are expecting a result similar to morphine or oxycontin which they won't ever get. So they take more and more until it's bye-bye.....6 feet under time!!

Why would you want to potentiate something that, really doesn't get SWIY "high" at all??

Methadone is VERY, VERY dangerous territory. Google "One pill can kill" and methadone in general and I think you will change your mind quite rapidly on the idea of potentiation of methadone. God speed.

[Forthesevenlakes]

SWIM begs to differ, he had an experience with methadone a few weeks ago which definitely got him high. For many long-term users of opioids (and probably a fair amount of people with little opioid experience), methadone would probably not provide much of a subjective high, either due to high tolerance, or the different nature of the drug. Some people do manage to get high from it, even at lower doses, hence why they'd want to potentiate it. But SWIM agrees, methadone can be extremely dangerous, and due to the long latency time (at least in SWIM's experience) between taking the drug and experiencing its effect, this only increases the danger. Waiting an hour or so, feeling nothing, and then re-dosing is a quick way to wind up in the ER or dead. SWIM would reccomend that anyone using this drug should start with a low dose, and wait a few hours before passing a judgment on whether it's working for them or not.

[BANGINCOLOR]

SWIM found great pain relief using methadone and it is God awful cheap too but, no euphoria. Just kept nodding off all day.

[merseyloyalist]

methadone is bad news for the turkey swim has done a complete cold tukey while doing a 6 month prison sentence with nothing to help at all,this was off heroin only and lasted about 2 weeks one week without sleep tho.But swim could never contemplate a cold turkey off methdone with nothing,it's bad news to put it mildly.Just watch don't get a meth habit.

[baron samedi]

SWIM has just started a similar thread on methadone potentiation. DXM does not sound a great idea to SWIM, given that it causes brain damage.
Can anyone expand on the stomach medicines/travel sickness pills method which is mentioned earlier in this thread? Do they actually work?
As an aside, does a meth peak really last for only 10 minutes normally? Given it's such a long-lasting opioid this would surprise SWIM, but maybe the person is talking about it in comparison to a heroin peak or something?

[samuraigecko]

From rxlist

In vitro results suggest that methadone undergoes hepatic N-demethylation by cytochrome P450 enzymes, principally CYP3A4, CYP2B6, CYP2C19 and to a lesser extent by CYP2C9 and CYP2D6. Coadministration of methadone with CYP inducers of these enzymes may result in a more rapid metabolism and potential for decreased effects of methadone, whereas administration with CYP inhibitors may reduce metabolism and potentiate methadone's effects. Although antiretroviral drugs such as efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination are known to inhibit CYPs, they are shown to reduce the plasma levels of methadone, possibly due to their CYP induction activity. Therefore, drugs administered concomitantly with methadone should be evaluated for interaction potential; clinicians are advised to evaluate individual response to drug therapy.

Just something one found the other night when he was researching the same question.

[baron samedi]

Could anyone give SWIM a rough list of possible CYP inhibitors?
Would SWIM use several at the same time or just 1 kind?
Also, could anyone inform SWIM as to what tums actually are? He has heard them mentioned, and assumes they are a stomach med of some type, but is that the brand name or a nickname?
And if SWIM was to experiment with DXM, how easy would it be for him to acquire? Is it true that it can cause brain damage if used in conjunction with anti-pscychotic medication (olanzapine)?

[Daytona71]

Didn't get SWIM any direct info here. SWIM has this given at 90mgs. a day along with 96mgs. of hydromorphone. SWIM knows the hydromorphone is bioavailable at 51% insufflated where an oral dose is 33% bioavailable. Still nothing concrete ion the methadone though?

[baron samedi]

The following drugs increase the potency of Methadone:

Fluconazole (Diflucan), a synthetic triazole antifungal agent, can raise methadone levels by 30%.

Ketaconazole (Nizoral), indicated for fungal infections.

The antidepressants Amitriptyline (Elavil) and Fluvoxamine (Luvox)

Diazepam (Valium) and similar anti-anxiety drugs like Xanax or Halcion.

Cimetidine (Tagamet), used in the treatment of ulcers and acid reflux heartburn.

Urinary alkalinizers (Bicitra, Polycitra) used to treat gout and kidney stones.

Hydroxyzine (Vistaril), a sedative antihistamine, boosts potency by 50%.

The following drugs decrease the potency of Methadone:

Rifampin

Viramune (Nevirapine)

Carbamazepine (Tegretol) and Phenytoin (Dilantin)

Vitamin C

Hi all,
This is just some info on the topic that SWIM picked up elsewhere. He believes it originated from the now deceased coldwaterworld.com.
Hope others in SWIM's position find it of help.
Being a responsible SWIMMER, he should add that it is for informational purposes only, and those seeking to follow any of the tips should be VERY careful and be aware that they may be playing with fire!
SWIM is going to try the Tamaget and Vistoril methods. Has anyone used either of those for opioid/opiate potentiation in the past? He could do with knowing when he should actually take said drugs, in order for them to work properly with the meth. Any tips?

[Daytona71]

THX for the info. The same probably works for SWIM's hydromorphone though the nasal route is about 50% better than oral as SWIM understands potentiating hydromorphone. SWIM is already taking diazepam so no need to do anything with the methadone. Dextroamphetamine potentiation with baking soda seems to work a bit and this is still on subject for the SWIM as this is another medication SWIM uses but has found NO EUPHORIA much to SWIM's dismay. Back in the day one "Black Beauty", 10mgs dextro and 10mgs levo-amp was so strong that SWIM could not believe they ewere legal! LOL Now 50mgs. of straight dextroamps do not provide any of that. SWIM will go to the amp section again.

[MEKONE]

From the American Cancer Society(ACS)

methadone
Trade/other name(s)
Dolophine, Methadose
Methadone is used to treat severe pain. It may also be used for other purposes. How does this drug work?
Methadone is a synthetic opioid pain reliever and works similarly to morphine. It binds to opioid receptors in the brain and central nervous system (CNS), which reduces both the perception of and emotional response to pain.
Interactions with other drugs
Buprenorphine, dezocine, nalbuphine, or pentazocine may reduce the effectiveness of methadone. Several different medicines can cause the blood level of methadone to go very high and increase the risk of serious side effects. The antibiotic erythromycin; the antifungals itraconazole, ketoconazole, and voriconazole; the antidepressant nefazodone; and the HIV medicines ritonavir, indinavir, and nelfinavir can all do this. Verapamil and diltiazem (calcium channel blockers used to help the heart and lower blood pressure) can cause the same problem. When methadone is taken with any of these medicines, your dose of methadone may need to be lowered to avoid serious side effects.
Some medicines cause the blood level of methadone to be lowered, so that you don't get enough of it to work. Anti-seizure medicines such as phenobarbital, carbamazepine, and phenytoin; the TB medicine rifampin, and dexamethasone are some of the drugs that can cause this problem. Your medicine may be changed or the dose adjusted.
Carbamazepine, phenytoin, and rifampin can make the body get rid of methadone faster. This can make methadone less effective in controlling pain, although doses can be adjusted if you are taking the medicines regularly.
Antidepressants of the older MAO inhibitor type (such as isocarboxazid, phenelzine, procarbazine, selegiline, and tranylcypromine) may cause coma, slow or shallow breathing, low blood pressure, excitability, seizures, or shock if methadone is given within 2 weeks of the last MAO inhibitor dose.
Tricyclic antidepressants (another type of older antidepressant, such as amitriptyline, nortriptyline, desiprimine, and doxepin) may add to the effects of methadone. In addition, methadone can cause desipramine to build up in the body and increase your risk of side effects from it.
Naltrexone will prevent methadone from working.
Medicines that slow down the brain or nervous system, such as other pain relievers, tranquilizers, sedatives, sleeping pills, antidepressants, muscle relaxers, antihistamines, phenothiazines, anesthetic medicines, and alcohol can cause worse side effects, such as slowed breathing, low blood pressure, extreme sleepiness, coma, or even death if taken with methadone.
Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.
Interactions with foods
Grapefruit or grapefruit juice may raise the level of this drug in your body. This can worsen any bad effects the drug may have on you and may increase its action in a harmful way.
Precautions
This medicine can cause drowsiness and lightheadedness. Do not drive, operate machinery, or perform other activities that require alertness until you know how you react to this medicine. Be careful getting up, changing position, or walking. Get up slowly and hold onto something or someone to keep you steady. If you feel lightheaded or dizzy, it may help to lie down. It is best to have a responsible adult with you for the first 2 or 3 days after starting the methadone or after any increase in dose, until you know how you will respond to it.
Since methadone affects the central nervous system, you should not take other drugs or substances that slow down the brain or nervous system such as alcohol, sedatives, muscle relaxers, and sleeping medicines unless your doctor tells you to do so. Combining these drugs with methadone can slow down breathing and lower blood pressure even more.

In SWIM's experience Methadone can cause SOME "feelings"especially for a new user that are given a dose higher than what they are usually used to taking.These "Effects"may not be euphoric and like mentioned above,that is how many abusers get into trouble by thinking if they take more it will cause a greater euphoric effect.Methadone builds up in the body and has a very LONG halflife meaning it takes much longer to get out of your systen.In short SWIM does not recomend Methadone for recreational use but one can get GREAT pain relief from it.

[Daytona71]

Well then SWIM will leave it as is due to the Diazepam, carisopradol and Ambien that are taken with it. Sounds like it is good DSWIM has a tolerance.

[MEKONE]

SWIM has taken(prescribed) Diazapam,Xanax,and Ambien along with methadone with good medicinal redults but as far as using Done recreationaly in SWIM's oppinion it's not worth it.Good Luck!!!

[YellowViolet]

I wrote the post "I'm officially screwed" - the doctor yesterday so thoughtfully offered to give me methadone instead of my needed meds. I've never taken it and don't know anything about it ... I decided to take him up on his offer but told him I may change my mind and may not get the prescription filled. After looking it up I don't think I want it.

Used for pain (moderately severe to severe) I understand it works? Does it make one sleepy, groggy, what? The grogginess and sleepiness is the side effect of my regular meds that I hate - I feel like I waste the days away being tired and sleeping. If I could get pain relief without the groggy feeling I might really like that.

[MEKONE]

Like SWIM mentioned earlier,your inital doses of Done MAY make you have that groggy feeling depending on what type/mg of med your used to taking.This does go away once the Done stabilizes in SWIY's body.Done is not like other meds that gives you that "feeling" and then it fades away until you dose again insted it builds up and provides LONG lasting relief for PN patients.

The only thing that SWIM noticed while they were on it was that after awhile the dose may need to be increased but that wasn't for some time after he started taking it.SWIM's was worried about taking such a high dose of Done so his Dr then switched him to Morphine to trigger a diffrent PN relief effect,which worked for SWIM and he has been on Morph. along with BTM ever since.

SWIM would advise SWIY (if the Dr. prescribed it) to give it a shot,who knows SWIY might get very good relief from it as many others have.Just remember it might take some time to build up in SWIY's system.Good Luck!!!

[baron samedi]

To update on SWIM's experiments with methadone potentiation, he has tried Tagamet once with almost no success, and Hydroxyzine a couple of times with very little difference noted.
However, he has found that taking 10mg Diazapam, just before his Methadone dose, is very effective, whether it's potentiation or synergy. It seems to make the methadone peak last a lot longer, whilst also making it more enjoyable for SWIM. Apparently, diazapam is the 1 benzo which has a special relationship with methadone, although the action is unknown.
On SWIM's earlier post in this thread, the list of potential potentiators, it mentions that Vitamin C decreases the effects of methadone. This makes SWIM wonder whether GFJ as a potentiator really works or not. Maybe one needs to consume lots of Vit C for this to happen. It also makes SWIM wonder whether it is a good idea to drink fruit juice/smoothies while taking Done. Do people think this is really something to worry about?

[Dickon]

Let me just add a quick note of caution on the potentiating methadone with benzodiazepines (valium/diazepam, Xanax/alprazolam, temazepam, etc. etc.). This has two potentially grave risks. The first is overdose and death. I think methadone/benzo/alcohol combos are inherently dangerous as they combine CNS depresants. The benzos and alcohol reduce inhibitions and sense so that subsequent doses are more likely to be taken in a stupefied state. That is not to say stupid amounts of all three cannot be taken together once tolerance is established. My cat has gone down this route. He used to have to take temazepam (a sleeping pill) to get out of bed in the morning to get his methadone, then would take benzos and drink throughout the day, only to repeat the whole thing the next day. He was not happy.

This stores up the second major problem, and that is the w.d. Cat decided to quit the benzo cold turkey and had a fit in fron of his father. Not good. He went back on a lower dose of benzos and finally quit methadone, benzos and alcohol (he drank a lot almost every day) in a rehab. Coming off 200mg methadone in 2 days, and doing a 10 day benzo taper (and quitting drinking cold too) with only a few clonidine pills was not an experience I'd wish on any of you here. Cat is a cheerful soul, and despite physical hardship, he put on a brave face, smiled his happiest smile through gritted teath and decided not to "let the bastards get him down". Sadly a little shy of two years later cat returned to bad ways again. All I can say is thank fuck he's behaving himself again now!

Be careful. Benzos and methadone are a common combination but really take you into the world of "hard core" addiction. Also the positive effects of benzos on methadone are soon outweighed by the negatives. Please think, and think hard before pursuing this method of "potentiation".

Love and happy feelings to all

Dickon

[baron samedi]

Yes, SWIM knows full well the dangers of combining the 2, but as SWIDickon knows from another thread SWIM is on only 30mg of methadone, so combining it with 10mg diazapam presents very little risk for him personally. He speaks only about his own position and advises others to follow SWIDickon's advice carefully.
The sad thing for SWIM would be from going from a daily poppy pod habit, which he needed nothing for in terms of potentiation, to be being put on such a poxy dose of methadone that he develops an addiction to valium as well. This to me would indicate a failure by his drugworkers to take his pleas for a higher dose of methadone seriously, even if they have his interests at heart. He never felt remotely inclined to take benzos with his poppies, but at 30mg of Methadone, Diazapam gives him definate mental benefits (for now, at least).

[Daytona71]

SWIM is taking 90mgs. of Methadone daily along with 96mgs. of Hydromorphone, 40mgs. of diazepam, an Ambien CR at bedtime and would at least like to get the Hydromorphone potentiated without resorting to needles but there seems no way as all say to inject. Probably why the Dextroamphetamine is not giving a euphoric effect buy keeps SWIM awake while driving a car. Can't find a way to take the d-amp to the next level either though SWIM read it was easy to do, probably rubbish, nothing is easy.
Morphine pump removed as it acted up so the 25mgs. of morphine directly to the spine is gone with no replacement so potentitation is of interest until new pumpis in place. SWIM just wants to feel healthy again.

[chukbzle]

I know methadone kills pain and might make ya feel like MAYBE a low vicoden with nodding off especially if the person is taking more to get a buzz i agree its too dangerous and it wont seem like it.thats one of the many addicting things of opiates is that unlike most drug usally takin a lot makes u sick before u take TOO TOO much ,but opiates can have u way past safety before u notice or like millions do and die in ur sleep from breathing prob, swim would rather just take dxm to have fun and leave methadone to its main purpose "To stop getting high" i dont understand ppl who wanna quit but get high off their detox meds lol i kno its not everyones story .but y take methadone over even tramadol unless u need to?

Reputation Comments on this post:

youve been here long enough to know to avoid self incrimination by now.