Dyhydrocodeine and the heart.

[kq501]

Hi, SWIM has been taking dihydrocodeine, (both 30mg tabs and 60mg tabs) for over 5 years now. SWIM now takes anywhere between 20-30 x 30mg tabs a day, due to a constant supply. It's more greed than anything else I think. I reckon SWIM is taking this amount due to having such a high supply in their hands at the moment.

How dangerous an amount is this even for someone with such a high tolerance to opiates?

Recently SWIM has been feeling very anxious while trying to sleep, and is complaining about hearing their heart beating very clearly at nights, sometimes even the heart seems to be getting quicker and irregular.

Could SWIM be having an affect to such high doses constantly, or could SWIM be having another problem such as high blood pressure, as SWIMs family is rife with high blood pressure? SWIM is nearly 30.

thanks to anyone who helps.

[Solinari]

That is a LOT of tablets, so i would be concerned with the sheer number of tablets if taken every day, maybe the other fillers and stuff are building up and causing toxic effects.

If there is concern about some ones heart then best get these things checked out. As it happens i have been getting a bit paranoid about my heart too, noticing it more when it beats hard and fast, but i suppose when you have that concern then you notice it more than you otherwise would. I got a heart monitor fitted for a few days and everything seemed fine.

Anyway, if i were you and had these concerns then i would get it checked out. If it turns out there is a problem, what ever it may be, then i think it would be better to mention the DHC. That said, if mentioning the DHC in the first place is not a problem (admitting there is a problem with addiction to a doctor) then it would be best to tell them at the start.

I had a quick look at Wikipedia's Dihydrocodeine article and searched for the words "cardio" and "heart", there were no results. Never the less having a look at some patient information leaflets or searching some more on Google might not be a bad idea. As far as i know there shouldn't be any toxic effects on organs like most other opioids, but i imagine some will, so best to check these things out.

[sarbanes]

Originally Posted by kq501

Hi, SWIM has been taking dihydrocodeine, (both 30mg tabs and 60mg tabs) for over 5 years now. SWIM now takes anywhere between 20-30 x 30mg tabs a day, due to a constant supply. It's more greed than anything else I think. I reckon SWIM is taking this amount due to having such a high supply in their hands at the moment.

How dangerous an amount is this even for someone with such a high tolerance to opiates?

Recently SWIM has been feeling very anxious while trying to sleep, and is complaining about hearing their heart beating very clearly at nights, sometimes even the heart seems to be getting quicker and irregular.

Could SWIM be having an affect to such high doses constantly, or could SWIM be having another problem such as high blood pressure, as SWIMs family is rife with high blood pressure? SWIM is nearly 30.

thanks to anyone who helps.

Wanye (AKA Wayne); Biotran,
First, let me say, the information is very sparse. Let's start off by saying there has been anecdotal evidence that the
O-methyl morphinan (skelton) ethers have a speedier effect than their analogous phenol, and are more prone to causing convulsions. What has been shown even with the classical opioids (not just meperidine and tramadol), is that the serotonergic system is intimately involved here and that what you may be experiencing (at such high, daily doses), are symptoms related to serotonin syndrome (check out (Parfitt Casey)). There also is some contribution from liver enzyme (underactivation effect), and the role of MAO-b (short term, reversible, and interaction with norepinephrine. NOW: A simple experiment my monkey has heard some have success with: he is assuming you cut out most alcohol LONG AGO (since 5 years, when you started having access to your opioids). This is a BAD thing. You must have small amts. of, say, red wine, every few days, and then many of your complaints will disappear. Remember, both oripavine and thebaine are very pro-convulsive, and both have additional methyl ethers in symmetrical areas (as compared to codeine, DHC, oxycodone, hydrocodone, etc.). All follow the ortho demethylation pathway. Also, might want to try ordering some Phenytoin, and taking ~50mg BID (before major dosing). Your problems are arising because of constant, daily use. Bet that if you stop for even 2 days, you get nice nod again. Bet now, your nods aren't completely disappeared, but just once in a blue moon, and you can't predict it. FYI: stay away from grapefruit-that will only exacerbate the negative effects of the DHC you are experiencing. Also WORK OUT! Force yourself to do that. Having all the DHC you want isn’t really the issue - the problem are the side effects you are having, and its partly due to your brain, and partly due to your liver. Drink a little red wine every other day, work out, and stay away from grapefruit. Consider phenytoin.

[Solinari]

I know that serotonin syndrome can be very dangerous but i don't know anything about what could be causing it in terms of the pharmacology of dihydrocodeine.

20-30 tablets is a hell of a lot of tablets to be taking every day and i would try and cut it out or at least cut the dosage gradually. Up to 900mg a day of dihydrocodeine really can't be healthy and i am not surprised there are some side effects. I know it's not a massive dose for someone with tolerance (i take 90mg of methadone daily) but it is still a huge dose and if it effects serotonin levels sufficient enough to cause serotonin syndrome then something has to be done.

Reputation Comments on this post:

please remember to swim even if its prescribed.

[kq501]

Thanks for replies guys.

SWIM went for the same cardio tests and they came back negative, turns out it was caffeine intake. SWIMs body just started to react badly to coffee and tea. Once cut out SWIMs problem went away.

That said SWIM has had other problems since. They have been taking still around 20 MAX a day, cutting down to 12 every couple days. SWIM has been having side pain... only when being active. SWIm isn't able to tell if it gets worse after the DHC... as it is an effective pain killer!!! The pain is difficult to pin point. May be their back... may be their stomach. It is getting progressively worse though. Walking long distances quickly inflames it. Can DHC have finally taken it's toll on SWIMs liver or kidneys? SWIM was under the impression that DHC passed through the liver quite well... is this false?

SWIM who isn't me has known friends with the same problem to have been taking DHC or tramadol for a lot longer (10 years or more) and had no problems to opiates in this way.

Any help again much appreciated. Sorry I took so long to reply back, but work takes up most of my energy.

kq501 added 3 Minutes and 25 Seconds later...

Originally Posted by kq501

SWIM who isn't me has known friends with the same problem to have been taking DHC or tramadol for a lot longer (10 years or more) and had no problems to opiates in this way.

.

Sorry this sounds like SWIm has had friends with similar pain... I meant friends with similar addiction, but with no similar pain. Hope this is clear?

[robshaka]

If Swiy is worried he could get a blood test that can tell if anything is wrong with his kidneys, liver, stomach all in the one test. SWIM can't remeber the name of it. He was getting stomach and kidney pains a year or so ago and the doc did a blood test and it came back fine. Swim still occasionally gets it though.

[Solinari]

Someone gave me negative rep for the above post saying "please remember to swim even if its prescribed." -4 they gave me, which was very unfair especially THREE months after i posted it.

The rules were followed and there was no self incrimination and if there was then it would be for a mod or admin to reprimand me, not someone that disagrees with the way i post. Would it have been different if i was talking about antibiotics?