RX: 30mg Codeine. Want something better?

[Kpinman]

SWIM got a RX 4 days ago for 30mg Codeine/300mg acetaminophen. Got into a pretty bad ski fall. Nothing broken this time, thankfully.


SWIM doesn't think codeine is working very well. SWIM is able to sleep now and that is about as far as it goes. SWIM has taken a maximum of two of these Tylonal 3 pills.


SWIM has two questions:


1. Which is stronger for pain relief/abuse euphoria: Perocet or Codeine?
2. And if indeed Codeine is the weaker of the two -- what might SWIM say to doctor to get perocet? Might SWIM suggest a side effect that is common with codeine (but not perocet) that makes SWIM feeling unwell?


SWIM feels uneasy about directly stating he wants perocet. SWIM knows perocet works wonders when the wisdom teeth were removed years ago.


Thank you,

Kpin.

[ironmics]

Percocet is a ton stronger than codiene in most people. To put it in perspective most codiene preparations are schedule 5(tylenool 3 is schedule 3) percocet is schedule 2 and the strongest commonly prescribed opiate. There are ways to make codiene a lot stronger however through potentiation. The best(strongest not most fun) that my friend has found are cyclobenzaprine, grapefruit juice, and diphenhydramine. The diphen and cyclobenz are pretty similar and not a ton of fun but extremely strong. However, grapefruit juice is almost a must in his opinion and makes the experience so much better.

Grapefruit juice is an inhibitor of one of the 2 enzymes that convert codiene. The good thing is that it inhibits the bad one CYP3A4, so 2D6 is free to convert as much of it to morphine as possible. My friend actually prefers codiene with grapefruit juice to percocet because he has very high 2D6 activity.

Oh and on the talking to the doctor subject that's kinda tough, BUT if swiy caucasian then he could say that codiene does not relieve any pain whatsoever. Which is true for about 10% of caucasians. He may prescribe darvocet or vicodin however which can both be fun in their own way. If he prescribes tramadol instead say something about enzymes and codiene, and that might be the reason why it didnt't work right. Because codiene and tramadol work on the same enzyme.

[Kpinman]

Thank you for quick reply! Do you have the source about the 10% of caucasian's that do not respond to codeine? Why do they not respond? Is it just codeine?

I was told by doctor that codeine is stronger than vicodin (at least the 5/500's I think) so I hope doctor doesn't give me anything less than 1000.

[Kpinman]

Edit: I indeed found some research that shows it doesn't work for 10% of us. Thank you!

[ironmics]

Haha I think you need to do some reserach about apap. You want the second number to be as small as possible. The 5 in the 5/500 is the hydrocodone which is the opiate. The 500 is tylenol. Also your doctor was lying 5/500's are stronger than 30/300's of codiene.

[Kpinman]

Yeah, I know how awful that stuff is =/ CWE will work for vicodin as well as codeine?

[allyourbase]

codeine metabolizes to morphine which is by far the best opiate, perhaps not the strongest weight for weight but certainly the one with the highest thereputic and recreational cielings. codeine though, because it has its own vascular effects before being metabolized lowers its recreational value in multiples. something like 8% of the weight becomes morphine and 400 mg is the ceiling turning into at most 32 mg of morphine. percocet is a complex morphinone with that aromatized ring that gives it fairly free reign over the opiate receptors, at the cost of time, and it having that methyl that they gave it the codeine derivation of name for gives it a relatively low recreational cieling, not to mention its also far more addictive. however it would make you far less nautious than codeine, and more than likely raise your blood pressure less and probably has a bit higher of a recreational cieling than codeine, particularly were one to remove paracetemol from the equation.

[darkglobe]

Hey guys, I'd like to help out some more with your problem, but there are a few things I do not understand:

1) Perocet... what is it? Does anyone know the UK name?
2) Vicodin... what is it? Again, UK name/chemical name?

Thanks.

~Dark

[darkglobe]

Originally Posted by ironmics

However, grapefruit juice is almost a must in his opinion and makes the experience so much better.

Grapefruit juice is an inhibitor of one of the 2 enzymes that convert codiene. The good thing is that it inhibits the bad one CYP3A4, so 2D6 is free to convert as much of it to morphine as possible. My friend actually prefers codiene with grapefruit juice to percocet because he has very high 2D6 activity.

I'm sorry to disappoint but if you research this properly you will have found out that Grapefruit juice doesn in fact inihibit the enzyme which actually converts Codeine into Morphine.

The good news is, as ironmics correctly stated, it inhibits the enzyme which converts Codeine into Norcodeine (baaaad). The bad news is that it also inhibits the cytochrome enzyme that converts Codeine into Morphine (goooood).

It's actually pointless. Theoretically.... SWIM has had mixed experiences with it's use. SWIM also recommends you check out the Codeine Potentiators thread.

~Dark

[Abrad]

Originally Posted by dark_globe

Hey guys, I'd like to help out some more with your problem, but there are a few things I do not understand:

1) Perocet... what is it? Does anyone know the UK name?
2) Vicodin... what is it? Again, UK name/chemical name?

Thanks.

~Dark

You are unlikely to be prescribed either of these drugs in the UK, and certainly not as a step up from codeine.. Stronger painkillers are usually reserved for patients suffering from chronic pain. If SWIY goes back to his doctor complaining that the co-codamol is not effective he should expect to be offered tramadol I would think.

[ironmics]

Originally Posted by dark_globe

I'm sorry to disappoint but if you research this properly you will have found out that Grapefruit juice doesn in fact inihibit the enzyme which actually converts Codeine into Morphine.

The good news is, as ironmics correctly stated, it inhibits the enzyme which converts Codeine into Norcodeine (baaaad). The bad news is that it also inhibits the cytochrome enzyme that converts Codeine into Morphine (goooood).

It's actually pointless. Theoretically.... SWIM has had mixed experiences with it's use. SWIM also recommends you check out the Codeine Potentiators thread.

~Dark

Everything that I've researched and swims experienced say that it doesn't. Grapefruit juice only inhibits the enzyme CYP3A4. There is a lot of research out there that shows this. I know it's been back and forth on this board on whether or not it does work. Swim says it definitely does though, he took a 30mg dose with grapefruit juice and it felt like 10mg or so of morphine.

Sorry I was wrong it also slightly inhibits 1A2
http://www.findarticles.com/p/articl...01/ai_n9083616

[darkglobe]

Don't worry about it. Never regret, never apologise, my friend!

Lol. I wasn't out to argue anyway.

I've had mixed results from trying it. Probably due to anticipation or high expectations.

[darkglobe]

Originally Posted by Abrad

You are unlikely to be prescribed either of these drugs in the UK, and certainly not as a step up from codeine.. Stronger painkillers are usually reserved for patients suffering from chronic pain. If SWIY goes back to his doctor complaining that the co-codamol is not effective he should expect to be offered tramadol I would think.

Thank you.

__________________________________________________ ______
Nur I made my own signature thingy. Just wanted to say I'm now
making my posts shorter coz my hands hurt.

[ironmics]

Originally Posted by dark_globe

Don't worry about it. Never regret, never apologise, my friend!

Lol. I wasn't out to argue anyway.

I've had mixed results from trying it. Probably due to anticipation or high expectations.

Same I have no idea whether or not it works but my friend has never ruined an experience because of it so its worth a sho