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PostPosted: Wed Oct 24, 2012 10:09 pm 
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This was originally part of a reply to someone, but I wanted to start a thread on it:


I've been looking at opiod equivalent dosages (which only work for bupe at doses below the ceiling). Taking into account that only 30% (at most) of a sublingual dose is absorbed, the sources I used would put 0.75mg Sub as equivalent to 10mg Percocet. So that is definitely far less than going off a maintenance dose.  (A maintenance dose of bupe = roughly 60mg oxycodone).

A 0.375mg Sub is = to about 5mg Perc. If it were possible to taper off of oxycodone (which it's not) would people taper below 1 Percocet? Would they go to 1/2, 1/4, 1/8? I don't think so. The smallest dose that you can cut a Sub film down to easily is about 0.25mg. With that being equal to less than one 5mg Percocet, why would anyone want to taper lower? It would seem to only be for psychological reasons, and if that works for people then I say go for it. For those who will reply that bupe is given for pain in 0.08mg doses, please keep in mind that those are INJECTABLE doses - which are absorbed at 100%. A 0.08mg dose injected would be equal to about 0.24mg sublingual.

So I think staying at a very low dose (like 0.5mg) for several weeks is a good strategy. It gives the unoccupied receptors time to downregulate. Then when you do go off, it will be from a low tolerance. 

What does everyone think?


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PostPosted: Thu Oct 25, 2012 8:54 pm 
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Hi Lilly,
Thanks for the info. Always good to have a refresher for those of us who forgot or just don't know much about equivalent doses. I don't know I completely follow the equivalent dose thing for a couple reasons...and if you could help to clarify or put my concerns to rest, that would be great. I know it's probably too complicated for most anyone to understand or figure out due to a number of reasons.

One reason is the 37hr half life for bupe and the plateau effect it creates being much higher than typical opiates(excluding methadone). I read in the liquid taper thread that taking 1mg a day would create a plateau in your blood of about 2.8mg. Meaning when you stop from 1mg you're actually stopping from 2.8mg due to the amount that has built up over time...big difference.

Now I know the bioavailability(amount absorbed into your bloodstream) is roughly 30% for bupe taken sublingually. BUT are we taking into account the bioavailability of the percocet(oxycodone) as well? I know there is a different bioavailability for oxy for different types of use (oral, snorting, shooting, ect). Sorry, I know this is all confusing, I'm longwinded sometimes and a simple general rule of thumb is probably best...

That being said I have a hard time believing that .375mg of sub = 5mg of percocet....It might be true if you only took .375mg of sub for one day, but I'm not so sure about daily use. I'm taking .2mg of sub a day and definitely feel like I'm still taking more than 5mg of perc. SOME of this MAY be in my head, but physically I feel a lot more effects than 5mg of percocet which is why I'm tapering to a much lower dose. I've still felt noticeable w/d tapering at less than .5mg/day, not bad but I feel it every time.

Sorry for the long winded post and I'm most definitely not trying to stir the pot or sway anyone in any way shape or form...I'm just going from my experiences and I think the lower you taper the better....


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PostPosted: Fri Oct 26, 2012 1:13 pm 
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If you have a chance, read the blog posts on Dr. J's website about tapering and Sub withdrawal. He really explains things in an understandable way. One thing he said was that at low doses of Sub (under 2mg, I believe) the 36 hour half life doesn't apply and Sub acts like a short acting opiate. So when you first get to the low doses you have a lot built up in your system that will slowly decline over time. Once you have been at a low dose for a while the Sub doesn't stay in your system, which is why he suggests dosing twice a day at the end of a taper.
Also, some of what you are feeling as you are stopping Suboxone is due to the fact that your opiate receptors have to regenerate. (I'll post the link below). It's not strictly a factor of how much you have in your system.


Link: suboxonetalkzone.com/page/3/

The numbers I posted are just from mathematical calculations. I think how you feel on a particular dose is different for everybody. If you feel better tapering lower you definitely should.

Good luck with your taper,
Lilly


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