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PostPosted: Fri Oct 22, 2010 5:59 pm 
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I am the guy who has the kidney stone.

Well, on Oct 1st, I abruptly stopped my 10mg dose of subutech and switched to Oxycodone HCL. For the first few days, it helped my pain, and I had no wthdrawl symptoms from the sub whatsoever. Things were looking good.

My ultimate plan would be to eventually go off the oxy after the surgery, and never take subutech again.

Well here is what I learned.

The half-life theory doesn't always apply to everyone. If your body has been on it for years, like me, this is more like the equation.

For subutech every 2 weeks, about 3/4 of it leaves your body. If you do the math, this means the following:

If you were on 10mg of subutech: (O.3 of Bupmorph = 10mg of Morphine affinity or agonism)

After 2 weeks of stopping: 2.5mg left (0.3 of bup = 10mg of morphine, so this is equal 75 mg of morphine)
After 4 weeks: 0.6 of Sub Left (Equal to 20mg of Morphine)
After 6 Weeks: .015 of Sub left (Equal to 6mg of Morphine)
After 8 Weeks: .001 of sub left (Equal to 3.3 mg of morphine)
After 10 Weeks: We can say the we're talking decimals, the sub is out)


At day 15 for me on Oxycodone, I starting getting palpitations. Heart clenching, debilitating chest tightness. After 4 hours of taking the oxycodone, this wore off.

So I though maybe it was the oxycodone I was sensitive to.

So I tried Norco. Same thing. Heart Palps.

So I tried MS Contin. Same thing. Heart palps.

COnclusion, after being on subutech for YEARS, your body may become super duper sensitive to narcotics. Especially since I went right from sub to oxycodone with zero break.

I am no opiate sensitive and have surgery possibly coming up.

This is an incredible conclusion that may not apply to everyone, but made my life miserable. My body hates opiates no.

I went back on 2mg of subutech after waiting 12 hours of my last dose of oxycodone (4mg), and suffered heart palpitations for 12 hours, then took 2 mg of subutech.

Palpitations gone. Feel more normal.

Anybody have this experience with narcotics after going off sub ?


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PostPosted: Fri Oct 22, 2010 6:56 pm 
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I am confused where you got this equation information? I am just curious because I like to take in as much info as I can but I want to make sure it is correct!

I have had heart palpitations with opiates in the past but have not taken them after being on sub.

I am glad you are feeling better!

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PostPosted: Fri Oct 22, 2010 7:29 pm 
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I'm sorry, but, you totally lost me after "I am the guy who has the kidney stone." That part I understand. I don't at all follow the rest of it. Perhaps it's me. Can someone translate or perhaps can you try again with all of this?


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PostPosted: Sat Oct 23, 2010 1:22 pm 
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donh wrote:
I'm sorry, but, you totally lost me after "I am the guy who has the kidney stone." That part I understand. I don't at all follow the rest of it. Perhaps it's me. Can someone translate or perhaps can you try again with all of this?


I was attempted to explain the metabolism of subutech based on a pharmacologist's testing. He was on sub, and then stopped. And every 2 weeks had blood tests to test for what levels she still had left. From this experiment, she was able to determine that every 2 weeks 75% leaves your body. Thats the essence of the post.

I just went ahead and did the math, so you could see at 2 week intervals, how much is left.

It seems like for a person on it for years, it could take more than 2-3 months to fully clear it from your body.

Again, this was based on 1 person, not 1,000. So, it's just her unique body's metabolism with sub.

My point was to show that this stuff takes a LONG TIME to leave your body, NOT 36 HOURS.


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PostPosted: Sat Oct 23, 2010 2:42 pm 
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Who is this one person? Is this information published somewhere? Where did you get this information from? I can assure you that the published half-life of Suboxone is likely to be accurate. Say what you want about the FDA but it's not often that after all of the hoops they put out there for a drug company that something as standard as drug half-life would be so grossly incorrect as to be published as 37 hours when it is actually more like 150 or 200 hours. Having Subxone show up in a urine test, let alone a blood test, two weeks after the last dose is extremely rare. Please let us know where this information comes from or where this is published so we too can read it for ourselves. Thanks.


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PostPosted: Tue Oct 26, 2010 9:22 pm 
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I was taught that the half-life of a drug is the time taken for the plasma concentration to fall to half its original value. It is generally agreed that the half-life of buprenorphine is 20-73 hours, (depending upon where you look) or around 37 hours. This can depend on the function of the patient’s liver as well, since most drugs are metabolized by the liver, and the clearance is related to hepatic blood flow.

There are many complicated mathematical formulas for determining this data. The fact that 0.3 mg of buprenorphine is equianalgesic to 10 mg of morphine is moot.

I was taught that in general, the time required for a drug concentration to reach a steady state is determined by the drug's half-life. It takes one half-life to reach 50%, 2 half-lives to reach 75%, 3 half-lives to reach 87.5%, 3.3 half-lives to reach 90%, and 4 half-lives to reach 93.75% of steady state. With most medications, a steady state can be assumed after 3-5 half-lives. The same number of 3-5 half-lives are used to calculate the elimination of the drug.

Buprenorphine's half-life number is 37 hours, that would be 37 hours x 5 = 185 hours = 7.7083333 days. Using the above principle, it takes around 8 days for Buprenorphine to build to full strength in the blood stream and likewise it would take approximately the same amount of time for it to be cleared. Again, it depends upon the patient’s metabolism, and there certainly may still be some traces of the drug left after that time. However, I would think that after 4 weeks the drug would almost certainly be cleared from one’s system.

If I am wrong about this please feel free to correct me! I haven’t worked in acute care in a very long time, and I could be mistaken, but just in the interest of getting the correct information out there, I am offering this opinion.


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PostPosted: Wed Oct 27, 2010 1:48 pm 
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I am currently developing a web site for my suboxone prescriber, so we are in fairly regular communication via email. I copied and pasted this in an email to him this morning:


========================================================================
For subutech every 2 weeks, about 3/4 of it leaves your body. If you do the math, this means the following:

If you were on 10mg of subutech: (O.3 of Bupmorph = 10mg of Morphine affinity or agonism)

After 2 weeks of stopping: 2.5mg left (0.3 of bup = 10mg of morphine, so this is equal 75 mg of morphine)
After 4 weeks: 0.6 of Sub Left (Equal to 20mg of Morphine)
After 6 Weeks: .015 of Sub left (Equal to 6mg of Morphine)
After 8 Weeks: .001 of sub left (Equal to 3.3 mg of morphine)
After 10 Weeks: We can say the we're talking decimals, the sub is out)
========================================================================


He told me:

"I would be astonished if there were ANY measurable buprenorphine left in the bloodstream of a person 4 weeks after their last dose, regardless of the duration of treatment."

My doctor has been prescribing suboxone since about 6 weeks after it became legal in the United States.


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PostPosted: Wed Oct 27, 2010 2:45 pm 
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I totally agree with your doctor Junkie. I admittedly don't really follow what in the heck all of these equations are doing in the first place, but the premise is based upon the relationship of "O.3 of Bupmorph = 10mg of Morphine affinity or agonism" It doesn't say 0.3 milligrams (mg) but I'm pretty sure that's what is meant. The thing is, this relationship compares IV doses of both drugs. They are saying that 0.3 mg IV of Bup is roughly equal to 10mg of morphine IV. Everything changes when the Bup is taken sublingual. In fact that change is large as we all know that the amount of Bup that actually gets into the bloodstream via the sublingual route is minuscule to the amount from an IV dose.

Very impressive Rossma. I'm guessing that you learned all of this about drug half-life as part of your education in nursing school? Very interesting.


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PostPosted: Wed Oct 27, 2010 8:28 pm 
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When I first started taking sub years ago, I ordered several of the buprenorphine drug test strips off the internet to help me in my eventual taper. I figured it would let me know how low I was getting in my taper...well it didn't work. Those things are so sensitive they kept going positive immediately...and I only tapered down to 2mg before I quit.

Anyway, I had several left over when I quit and decided to test every day until sub was no longer present in my system...after 4 days it was very weakly positive and day 5 I had a full blown negative (I still have it in a zip lock bag...my trophy! :) ).

The test strips measured 10ng/ml? So by day 5 I was under 10ng/ml.

I wonder what kind of test this other person was using to detect sub after months...a mass spectrometer??


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PostPosted: Thu Oct 28, 2010 10:34 am 
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Dear Donh,

Yes - I have always been very passionate about pharmacology, for some reason. (LOL!!!)

~Rossma


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