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 Post subject: Half life
PostPosted: Sun Feb 28, 2010 1:55 pm 
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I am a new member to this forum and have found it very informational and you fellow posters very knowledgable. Reading some posts has only raised more questions for me.

I am dosed at 32mg per day, 16am and 16pm. If the half life is 24-60 hours that means by the 2nd and 3rd day I have way more than the 32mg in my system. Does this mean that it's just going to waste or could I take a few days off and it would take awhile to get back down to the 32mg level? I guess I don't know if the extra above the ceiling effect is a total waste. I don't think I probably don't need this much medication and would like to speak to my doctor about why the dose is so high after all I've read.

Thanks for all your information, I'm soaking all of it up.


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PostPosted: Sun Feb 28, 2010 4:29 pm 
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I don't know if anyone here will be able to give you a definitive answer and have any sort of "science" in terms of research studies that they can back it up with. That being said, I'll try to give you a few points to consider in drawing your own conclusion.

1. The manufacturer of Suboxone has released a best practice guideline for a while now that says for most patients, the largest daily dose needed is 16 mg.

2. There are a lot of patients that are very comfortable and achieve very good drug affect in a dose range between 4 mg and 16 mg.

3. Patients who attempt to reduce their daily dose most often do so without any symptoms, or with very minor symptoms, when they are dropping from pretty much anywhere in the double digit dose range to a lower double digit dose.

4. Almost any patient that I have seen write about this has been able to drop from 32 mg each day to 24 mg each day without being able to notice pretty much any change. The same goes for dropping further down to 16 mg, 12 mg and even 8 mg. It is only at the 8 mg range and more so at 6 mg or 4 mg where patients start to report feeling withdrawal symptoms of any significance.

5. You are correct on the half-life information that you reported.

So, given all of these things, if it were me personally, I would look to dropping your dose all the way to 24 mg and staying there for a little while followed by dropping to 16 mg and staying there. I can tell you personally that when I went from 16mg to 12 mg I had no problems whatsoever. I am very willing to bet that you'll be able to get to 24 mg and not even know the difference. And if you do, yes, unfortunately, you have been wasting some amount of Suboxone on such a high dose.


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PostPosted: Sun Feb 28, 2010 4:33 pm 
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When I dropped from 24mg to 20mg it was no problem. I also had no problem from 20mg to 16mg. But 16mg to 12mg was annoying to me. Not physically but psychologically I didn't like it. I felt on edge a lot of the time. Like I said, a lot of it I am sure was in my head but to me that can be just as powerful or more than the physical. So I suggest taking it slow and if you get uncomfortable then hike it back up - all the while talking to your doctor. Just my opinion.


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PostPosted: Sun Feb 28, 2010 6:53 pm 
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Thanks so much for your suggestions and I am going to call my doc tomorrow and leave him a message of my intentions. I know the reason he has me on this higher dose and why its twice a day is for my chronic pain issues. I think I read somewhere on here that the pain control part of suboxone doesn't last all day so will aim at going to 8mg twice per day but will do it slowly.

Thanks again everyone, you are the best!!

Chris


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PostPosted: Sun Feb 28, 2010 7:50 pm 
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The fact that you are also treating pain with your Suboxone use was a pretty important piece to have left out. Then again, I should have considered asking or commenting about that as well, I guess. Now knowing this important piece, it may very well change things for you. I don't know a lot about using Suboxone for treating pain. Of what I have read, it doesn't seem to be one of the better medications to treat pain with, but in some cases it may at least help to some level. It does sound like those who use it for pain may actually benefit from dosing more than twice a day. Some claim to only get pain relief for a short period of time after taking their Suboxone - therefore requiring more frequent doses throughout the day. This may also require patients to exceed that "Best Practice" daily dose of 16 mg. While you may still not need as much as 32 mg per day, you may actually need to split that up into a couple of extra doses throughout the day. By that, I mean that you may benefit from taking three doses of about 10 mg a day or four doses of 8 mg each day. Then again, if it is handling your pain for you, why not just keep doing what works?

This is really something that you need to speak with your physician about. It may also be something that your physician may have to research about. Because Suboxone is first and foremost an addiction medicine, using it for pain management may not be fully understood by the typical addiction physician.

In any event, taking Suboxone in part or in full for pain management really does change things - and it is something that you really should keep in mind when you discuss this topic.

Good luck and let us know what your doc has to say.


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PostPosted: Sun Feb 28, 2010 8:49 pm 
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I totally agree with donh. In my opinion, for my pain, I was better at 16mg than I was at 12mg. I had never thought about splitting it throughout the day even more as I was taking it twice but I think that is a good idea. It is at least worth a shot. I do know that for my pain, I did like taking it in the mornings because then at least the first few hours of work were ok. Then I would have about 3 hours where I started getting uncomfortable. I would take a half in the afternoon which got me through. Then I would take another half in the evenings which would allow me to move around at home and get certain things done when I needed to. When I wasn't in pain I just took it twice per day. I will say that twice per day made me not even know I had peripheral neuropathy and that was from 24mg all the way down to 12mg. I will say that at 12mg I was noticing I couldn't feel my feet and thought that was odd. But I didn't have the PAIN I have now with nothing on board. Except neurontin just in case someone wants to call me out. But the neurontin only works for so long. Talk with the doc about it.


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PostPosted: Tue Mar 02, 2010 12:05 pm 
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I did get a call back from my doctor yesterday morning. He said if I want to lower my dose and try it that it's ok with him and if I want to take it 3 times a day with lower amounts he wasn't against it. I see him in 3 weeks so will play around with lowering the dose and see how I do. I apologized I didn't mention the chronic pain issues in my first post. I also have addicton issues. I was going to a pain management clinic for years and was prescribed a cocktail of morphine, hydrocodone and oxycodone. I abused them to the point that all that wasn't enough and started ordering on the interenet. When I went into treatement I was taking up to 90 vicodin a day plus the other stuff. I don't understand why I'm not dead but God must have had a plan for me. That was over 3 years ago. I absolutely cannot take full antagonist narcotics. I've been on the suboxone for 3 years and it helps my pain and I have no desire to use any of the other narcotics. This is also helped by my working my program and paying it forward to help others. Maybe now that you know a little more about me you understand where I'm coming from.

I've been taking the suboxone 4 times a day for 2 days. I take 8mg then 4, then 8 then 4 and so far I can't tell any difference. Next week I'm going to try 4,4,4,4 and see how I do. That would cut my dose in half. It may not work for the pain but won't know until I try and would prefer to only be on as mucn as I need.

I also take Neurontin and Lyrica for the pain. I've never heard of that combination having any issues but then I never connected taking Suboxone and my feet swelling as having a connection either. I found that facinating because my feet swell terribly and have cankles by the time I get home from work.

Thanks for all your posts, I'm soaking up all this information like a sponge.

Chris


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