Potentiating morphine

Discussion in 'Morphine' started by bob78, Sep 8, 2006.

  1. bob78

    bob78 Silver Member

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    I have read on these forums about potentiating opiates through using grapefruit juice and antacids.
    I would to know is it possible to potentiate Sevredol and MST the same way or any other way??
     
  2. Forthesevenlakes

    Forthesevenlakes Platinum Member

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    sevredol, I am recalling from swiy's last post, is a morphine preparation. grapefruit juice can potentiate morphine by inhibiting its breakdown in the liver (thus increasing the time that its in the system) and antacids do so by basifying the stomach environment (so more gets absorbed there). the antacid cimetadine (marketed as tagamet) is particularly effective since it both inhibits one of the cytochrome p450 enzymes that break down morphine, and functions as an antacid.

    a low dose of dxm can be used to potentiate opiates/opioids. 30-60 mg is generally used, since it gives a potentiation effect without becoming a dxm trip.

    quinidine found in tonic water should have a similar effect as the grapefruit juice.

    this thread may also have other ideas.
    happy potentiating!


    also, I am thinking of making this thread into one big potentiation megathread and trying to merge it with the thread he linked to. so if anyone else has ideas for potentiation of opiates please post them here.
     
    1. 4/5,
      Helpful link.
      Feb 2, 2015
  3. bob78

    bob78 Silver Member

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    Again You has helped out swim, cheers.
    I notice that Tagamet is mentioned, I take Losec (omeprazole) and wonders whether it could be used as well?

    It would be great if we had all the potentiation posts in one thread.

    Cheers again.
     
  4. Forthesevenlakes

    Forthesevenlakes Platinum Member

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    omeprazole could be tried, but I do not think it would work. omeprazole is a proton pump inhibitor, and somehow can help with ulcers that way. it does not seem to be a true antacid.

    tagamet works because it an antacid, but it is also unique (to swim's knowledge anyway) in that it inhibits a cytochrome p450 enzyme that would normally metabolize morphine as well. most antacids and other ulcer medications do not do that. thats why swim mentioned tagamet specifically.

    however, I has never tried omeprazole, and maybe it would work, although I do not see theoretically how it could do so.
     
  5. jbnugget

    jbnugget Newbie

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    I recently read that the ONLY H2 blocker that works is cimetidine. It's also mentioned in the patient info given out by pharmacies in the US.
     
  6. enhancion01

    enhancion01 Silver Member

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    Metoclopramide is a dopamine antagonist. So I think this would possibly potentiate morphine.

    It is also used as a anti nausia med for chemotherapy patients.
    So I think it would probably help with any nausia that comes along with taking opiates.

    Not absolutly sure though any other info would be appretiated
     
    1. 4/5,
      Interesting view that could benefit from further investigation.
      Feb 2, 2015
  7. blackie

    blackie Silver Member

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    Bob is due to start taking metoclopramide next week, so will let you know if there is any fun to be had
     
  8. hobbes1651

    hobbes1651 Silver Member

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    Swim ran cimetidine (tagament) through the drug interactions checker using

    Interactions between your selected drugs cimetidine and MS Contin (morphine) (Moderate Drug-Drug)

    MONITOR: Cimetidine may increase the action of narcotic analgesics. Cases of respiratory depression and apnea have been reported. The mechanism is unknown.
    MANAGEMENT: Patients' vital signs should be closely monitored while receiving this combination. If clinically significant respiratory depression occurs, the drugs should be withdrawn. The use of a narcotic antagonist, such as naloxone, may be needed.

    Drugs interaction checker is a great source of info on drug interactions and possible potentiators. The most obvious once being CNS depressants however when you go down that road you begin to play with fire. I wouldn't advise anyone to do it, but people can make their own decisions.

    However when Swim ran dextromorphan through Drugs it did not pop up as having a drug interaction. Swim thinks if anything its simply due to Dextro's own ability to cause a CNS reaction not a direct interaction with morphine. I have been about every pain medicine out there. I have a tethered spinal cord as the result of a spinal tumor. Swim's combo if he chooses to mix is a benzo and ms contin or dilaudid. However swim if he is going to look for euphoria tends to use the opioid only as the benzo opioid interaction tends to lead to more drowsiness than is desired.

    Disclaimer: I have been prescribed 150 mcg of Duragesic an hour plus break through meds usually MSIR 30mg as needed (Yes two different patches). Swim's tolerance is extremely high due to 4 separate major surgeries. He has been on and off pain medicine for 8 years for nerve pain due to his tethered cord. I wouldn't recommend starting on a high dose of anything or using potentiation until You knows their basic tolerance. It's best to play it safe!

    hobbes1651 added 4 Minutes and 33 Seconds later...

    metoclopramide and morphine (Minor Drug-Drug)
    Concomitant administration of metoclopramide and sustained-release morphine may decrease the time required to achieve peak morphine serum concentrations. In the acute clinical setting, this effect may be accompanied by an increased level of sedation and earlier onset. In patients being treated chronically, the interaction does not appear to have clinical significance.

    It looks like it simply decreases the time it takes for morphine to reach its peak effects. It does not look like it will increase the "strength" of morphine.
     
    Last edited: Apr 24, 2009
    1. 4/5,
      Helpful info
      Feb 2, 2015
    2. 3/5,
      Brilliant post from a technical aspect.
      Oct 5, 2010
  9. V i c

    V i c Newbie

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    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1987063/
    Potentiation of morphine analgesia by caffeine.

    http://www.ncbi.nlm.nih.gov/pubmed/15525615
    Dextromethorphan potentiates morphine antinociception at the spinal level in rats.

    V i c added 15 Minutes and 27 Seconds later...

    My buddy I took 6,000mg of cimetidine with a huge glass of yellow grapefruit juice. Forty-five minutes after dosing on the cimetidine he takes a few tums and fifteen minutes later he swallows 300 mg of 30mg MS IR (morphine instant release). He says it takes a lot longer for any drug to kick in when taken with cimetidine so luckily he'll leave before he becomes a zombie on my couch for six hours or worse, but he never nods off. Not even at that suicidal dose. After I showed him that caffeine article in my previous post. He is now on his second can of Mountain Dew as he approaches the door. It's sad to see your childhood friends lives go to shit, but we've done everything you can do for him. I don't think he's going to make a great "lab rat" for the caffeine, but I will let you know if he notices anything because he's done this routine at least a thousand times. That is if anyone wants to know.
     
    Last edited: May 25, 2013
  10. sserdyuk

    sserdyuk Newbie

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    Morphine in small dose 1 mg orally produced hyperalgesia in heat test in volunteers . Sorbitol 1,5% -100 ml orally 30 min before morphine not decreased morphine-induced hyperalgesia. Sorbitol 30%- 100 ml orally 30 min before morphine caused full elimination morphine-induced hyperalgesia in volunteers. We can suggest,that stimulation of gastric osmoreceptor of vagal afferent by hypertonic solution of sorbitol eliminate morphine-induced hyperalgesia