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Thread: Dangerous Combos FAQ
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1.
Dangerous Combos FAQ
#1
Griff
Bluelighter
Join Date
Dec 2001
Location
Atlanta, Ga
Posts
598
15-02-2001 14:20
OK, I'm going to need everyone's help on this. We are putting together a
FAQ listing every known dangerous drug combo. I need everyone (with
time) to post the bad drug mixes that they are aware of with as much
supporting evidence as possible. If you are going to post a
dangerous/deadly combo, please include any fatality info, how to avoid
the combo, and what to do if you've mixed two drugs that don't interact
well.
Here is an example to get us started, I'm not including sources as I don't
have time to look up my references.
MDMA+DXM
MDMA inhibits the body's ability to regulate it's temperature, often
overheating the user. DXM inhibits sweating and when combined with
MDMA can induce hyperthermia.
Also, DXM and MDMA are broken down by the same enzyme in the
liver. When both drugs are taken, the enzyme can't break them both
down and liver damage may occur.
http://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=545571&viewfull=1#post545571http://www.bluelight.ru/vb/members/26695-Griffhttp://www.bluelight.ru/vb/members/26695-Griffhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ#tophttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=545571&viewfull=1#post545571http://www.bluelight.ru/vb/members/26695-Griff -
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Combining these drugs may also result in a potentially fatal condition
called Serotonin Syndrome. Symptoms may include high body
temperature, increased heart rate and seizure.
Ways to avoid this combo:
Don't roll if you have been using cold medicines with DXM in them.Don't mix brands of pills that haven't been EZ-Tested.
If you've taken this combo, stay cool. If you are in a rave or party, go to
an outside chill area. Drink enough water to stay hydrated, but no more
than 2 liters per hour.
[This message has been edited by Griff (edited 15 February 2001).]
[This message has been edited by Kyk (edited 17 March 2001).]
[Edit: fixed vB coding in all posts after upgrade, deleted some
redundant/irrelevant posts - Orlando]
Last edited by dokomo; 28-04-2011 at 06:14.
2.
#2
Neural_Shock
Bluelighter
Join Date
Dec 1999
LocationUniverse
Posts
1,900
15-02-2001 18:02
The FAQ at http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml
confirms the above. Also on the subject of DXM, do not mix DXM with:
o Antidepressants of any kind. MAOIs (monoamine oxidase
inhibitors) are the worst; DXM + a MAOI will kill you. DXM
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with other antidepressants can cause serotonin syndrome, an
unpleasant and occasionally fatal condition.
o Diet drugs like phentermine, fenfluramine (Redux), or phen-fen.
Again, a risk of serotonin syndrome.
o
Non-drowsy antihistamines (allergy medicines) like Allegra,Seldane, or Hisminal.
Also mentioned in
http://www.erowid.org/chemicals/dxm/...g.shtml#toc.13 are the
contraindications:
o DXM & barbiturates
o DXM & moderate or more benzodiazpeines
o DXM & amphetamines - high blood pressure
o DXM & opiates - risk of respiratory failure
o DXM & yohimbine or any other alpha-2 adrenergic antagonist -
Olney's Lesions
[This message has been edited by Griff (edited 18 March 2001).]
[Edit: the erowid FAQ linked to was originally hosted on Frognet.
However, Frognet has crashed, and looks like it will be down
permanently. I've therefore edited the original links to point to the erowid
versions - Simon]
[ 21 February 2003: Message edited by: Simon ]
Last edited by Orlando; 18-03-2003 at 17:17.
3.
#3
Neural_Shock
Bluelighter
http://www.erowid.org/chemicals/dxm/faq/dxm_mixing.shtml#toc.13http://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=545573&viewfull=1#post545573http://www.bluelight.ru/vb/members/1883-Neural_Shockhttp://www.bluelight.ru/vb/members/1883-Neural_Shockhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ#tophttp://www.erowid.org/chemicals/dxm/faq/dxm_mixing.shtml#toc.13http://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=545573&viewfull=1#post545573http://www.bluelight.ru/vb/members/1883-Neural_Shock -
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Join Date
Dec 1999
Location
Universe
Posts
1,900
15-02-2001 18:10
MAOIs
Drugs to avoid when taking MAOIs, and two weeks after stopping
MAOIs are:
o All SSRIs (prozac, zoloft, and several other anti-depressants)
SSRIs block the reuptake of serotonin in the brain. Because
MAOIs inhibit the breakdown of serotonin, the combination of
MAOIs and SSRIs can lead to dangerously high levels ofserotonin in the brain (serotonin syndrome). Symptoms of
serotonin syndrome include nausea, vomiting, blackouts, memory
loss, increased blood pressure and increased heart rate.
o Demerol
o Cold preparations (tablets, capsules, or liquids such as Comtrex)
o Cough medications containing decongestants or Demerol (Plain
Robitussin is OK)
o Sinus medications
o Nose drops or nasal sprays
o Nasal decongestants
o Hay fever medications
o Diet pills
o Amphetamines --- speed
o MDMA --- Ecstasy
o MDE, MDA, and other "MD" compounds
o Cocaine --- crack
This is sourced from Erowid
Also avoid DXM at recreational doses, as mentioned in the above reply.
Reversible MAOIs, such as Syrian Rue will potentiate LSAs,
Psilocybin/Psilocin, DMT, Mescaline, various other phenethylamines &tryptamines. It's possible to overdose by going overboard with MAOI
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potentiation.
Finally, there are foods to be avoided with MAOIs, detailed at Erowid
[Edit: Fixed broken links - Simon]
Last edited by Orlando; 18-03-2003 at 17:38.
4.
#4
Neural_Shock
Bluelighter
Join Date
Dec 1999
Location
Universe
Posts
1,900
15-02-2001 18:19
GHB
Do not take GHB if you are taking:
o benzodiazepines ("minor tranquillisers" such as Valium and
Xanax)o phenothiazines ("major tranquillisers" like Thorazine and
Stellazine)
o various painkillers (barbiturates and opiates)
o alcohol
o anticonvulsants (Dilantin and phenobarbital)
o many over-the-counter allergy and sleep remedies
o any other CNS depressants
http://www.erowid.org/chemicals/maois/maois_info2.shtmlhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=545574&viewfull=1#post545574http://www.bluelight.ru/vb/members/1883-Neural_Shockhttp://www.bluelight.ru/vb/members/1883-Neural_Shockhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ#tophttp://www.erowid.org/chemicals/maois/maois_info2.shtmlhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=545574&viewfull=1#post545574http://www.bluelight.ru/vb/members/1883-Neural_Shock -
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The absolute minimum time between taking GHB and taking alcohol is
four hours, and you should make it six-eight hours if you are really drunk
. GHB's effects last maximum 3 hours unless you boost of course.
Also, do not take GHB if you suffer from any of the following
conditions:
o severe illness of any kind
o epilepsy
o convulsions
o bradycardia or slowed heart-beat
o Cushing's syndrome
o severe cardiovascular disease
o severe hypertension.
I got this info from a supplier, so I can't post the link . I'll find other
links if I can. Anyone with any more detail on the above should post it. I
want to find more detail on the over-the-counter allergy and sleep-
remedy bits.
[This message has been edited by Neural_Shock (edited 15 February
2001).]
Last edited by Orlando; 18-03-2003 at 17:18.
5.
#5
Borii
Bluelighter
Join Date
Feb 2001Posts
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4
15-02-2001 21:00
DXM inhibits sweating
Incorrect.
The DXM faq section 6.1.5 states:
Diaphoresis (sweating)
Category: Frequent
Many DXM users note sweating both while on DXM and for several
hours after coming down. Some have noted a peculiar odor to the sweat,
which may be metabolites of DXM or may simply be a consequence of
enhanced sense of smell. In any case, just drink lots of water and you
should be fine.
I can also tell you this from first hand experience. I also doubt that it
inhibits sweating while combined mdma. The DXM faq states that one of
the symptoms of seretonin syndrome is sweating.
I just wanted to bring this to your attention, becuase some posters on
usenet weren't too happy about Dancesafe putting out this bogus info. I
believe Dancesafe have corrected this.
MDMA and DXM isn't a safe combo, but it's due to the other two factors
stated in the original post.
I just discovered this board last week it seems like a great place with alot
of cool people.
Last edited by Orlando; 18-03-2003 at 17:18.
6.
#6
PoMo
Bluelighter
Join Date
Sep 2000
LocationToronto
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Posts
326
16-02-2001 03:52
Alcohol + anything, including itself.
70% of emergency room visits have alcohol involved. And most
overdoses of drugs include alcohol.
MOST drugs (except GHB) have a very high safety margin, if ingested
alone. My advice: stay away from combos.
Last edited by Orlando; 18-03-2003 at 17:18.
7.
#7
mouse
Bluelighter
Join Date
Dec 1999
Location
Milwaukee, WI, USA
Posts
307
16-02-2001 06:48
Does anyone know of possible interactions with SSRE's such asTianeptine(Stablon)? Also since the half life of Tianeptine is only 2.5
hours does that mean it wouldn't cause problems after that?
8.
#8
Banquo
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Bluelight Crew
Join Date
Dec 1999
Location
USA
Posts
5,753
18-02-2001 08:32
Central Nervous System [CNS] Depressants
Central nervous system [CNS] depressants are drugs that slow downbrain activity. CNS depressants include a wide range of drugs such as
alcohol, barbiturates (Amytal, Nembutal, Seconal), benzodiazepines
(Ativan, Halcion, Librium, Valium, Xanax), chloral hydrate, GHB, GBL,
methaqualone (Quaaludes), buspirone (Buspar), and zolpidem (Ambien).
CNS depressants can cause confusion and dizziness, and impair
judgment, memory, intellectual performance, and motor coordination,
especially when taken in excess and combined with one another. When
mixed together, CNS depressants amplify each other's effects, which can
cause severely reduced heart rate and even death. Overdoses of
depressants produce effects that are the same as alcohol overdoses. The
person becomes extremely drowsy and passes out. Their heartbeat slowsand respiration will become shallow. Their skin may feel cold and
clammy, and death may result from respiratory failure. CNS depressants
are also dangerous when combined with opiates and opioids (like
codeine, hydrocodone, oxycodone, and heroin).
Opiates and Opioids
This is a class of drugs that includes opium, heroin, morphine (MS
Contin), codeine (Tylenol 2, Tylenol 3, Tylenol 4), hydromorphone
(Dilaudid), oxycodone (Percodan, Percocet, and Oxycontin), meperidine
(Demerol), hydrocodone (Vicodin, Norco, Lortab), propxyphene
(Darvocet and Darvon), fentanyl (Duragesic and Actiq), and others. Like
alcohol, opiates are dangerous when used in combination with drugs that
suppress breathing. These include alcohol, barbiturates, benzodiazepines
(Xanax, Valium, Ativan), CNS depressants (see above) and GHB.
Combining opiates with other drugs that make you sleepy can basically
lead the user into a sleep from which they will never wake up. It should
be noted that opiate overdose is easily treatable and can be counteracted
with Narcan available at your local emergency room.
Hallucinogens
This is a class of drugs that includes LSD, PCP, ketamine, mushrooms,mescaline, and Ecstasy. The most dangerous combination is the
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combination of PCP-like drugs with alcohol or other sedatives. This
combination can kill you. Taking atropine-like drugs with anything that
stimulates the cardiovascular system or raises the body temperature (like
Ecstasy) can lead to dangerous disturbances of heart rhythms or
increased body temperature. Hallucinogens with amphetamine-like
actions (like mescaline) can be dangerous when taken in combinationwith other stimulants. This goes for Ecstasy (MDMA) also. MDMA,
which has stimulant properties, may cause a user's heart rate to rise to
dangerous levels when used in combination with other stimulants, like
cocaine or methamphetamine (also see Stimulants below). Reactions
may vary from person to person. As always, err on the side of caution.
Ketamine
As noted, using ketamine and alcohol is a dangerous combination. At
lower levels, nausea and sickness will result. At higher levels serious
health problems can occur. Ketamine, by itself, is valuable in a medical
setting since it slows breathing at a lower rate than other anaesthetics.But combining ketamine with another CNS depressant, including GHB,
can slow down breathing to a dangerously low or even fatal level (see
CNS Depressant section). PCP (phencyclidine), like ketamine, is also an
NMDA antagonist. As such, combinations with ketamine, alcohol, and
other CNS depressants can also lead to negative health consequences.
MAOIs
Monoamine oxidase inhibitors (MAOIs) can cause a dangerous or lethal
increase in heart pressure when combined with Ecstasy. Nardil
(phenelzine), Parnate (tranylcypromine), pargyline, Marplan
(isocarboxazid), Eldepryl (l-deprenyl), and Aurorix / Manerix
(moclobemide), Ayahuasca also contains MAOIs (harmine and
harmaline). Combining MDMA and MAOIs has been pushed by some,
usually the uninformed, as means for increasing Ecstasy's effects.
However, this is an extremely dangerous and potentially lethal
combination.
Alcohol
It is dangerous to combine anything with alcohol that makes you sleepy
(see CNS section). This includes opiates/opiods (heroin, morphine,
Demerol, Percocet, Oxycontin), barbiturates, benzodiazepines (Xanax,Valium, Ativan) and GHB. It should also be noted that a large
percentage of deaths and hospitalizations associated with Ecstasy have
usually involved a combination with alcohol.
Marijuana
Possible dangerous combinations include a mix of marijuana with heart
or blood pressure medication or with drugs that supress the function of
the immune system. One recent study shows that the combination of
marijuana with cocaine can lead to very dangerous effects on the heart.
StimulantsThis is a class of drugs that includes cocaine, methamphetamine
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(Desoxsyn), amphetamine (Adderall), MDMA (ecstasy -- which has
hallucinogen and stimulant characteristics), dextroamphetamine
(Dexedrine), methylphenidate (Ritalin), and dexmethylphenidate
(Focalin). Stimulants can be dangerous when taken in combination with
over-the-counter cold remedies that contain decogestants because the
combined effect of the two can raise blood pressure to a dangerous level.Stimulants can also be dangerous when taken in combination with
MAOIs. Cocaine is dangerous in combination with anything that makes
people more sensitive to seizures, such as the prescription medication
buspirone or extremly high levels of xanithines, like caffeine or
theophylline. Stimulants are also dangerous when taken in combination
with one another. Negative effects include heart attack, stroke, and death.
People with a history of hypertension or other heart problems are
especially susceptible problems associated stimulant and stimulant
combinations.
BenzodiazepinesThis is a class of drugs that is intended for the relief of short-term
anxiety. Alprazolam (Xanax), bromazepam (Lexotan), clobazam
(Frisium), clonazepam (Klonopin), diazepam (Valium), lorazepam
(Ativan), prazeman (Centrex), oxazepam (Serenid), flunitrazepam
(Rophynol), temazepam (Euhypnos), and Triazolam (Halcion) are all
benzodiazepines. While these drugs are not particularly toxic by
themselves, at certain doses, amnesia-like side effects result in reduced
inhibition, impaired judgment, poor coordination, and slower reaction
time. All of these things can lead to unsafe behavior. When combined
with other CNS depressants (see above), like alcohol, and/or opiates,
benzodiazepines can lead to shallow breathing, respiratory failure, and
even death.
Methadone
Methadone magnifies the effects of alcohol and other central nervous
system [CNS] depressants, such as antihistamines, cold medicines,
sedatives, tranquilizers, other prescription and over-the-counter (OTC)
pain medications, barbiturates, seizure medications, muscle relaxants,
other opiates, and certain anesthetics including some dental anesthetics.
Some dentists use a drug called Stadol (butorphanol artrate) which is a
narcotic agonist/antagonist that reportedly will send a methadone userinto acute withdrawl. Opioid partial agonist and agonist/antagonist drugs
such as Buprenex, Talwin, Stadol, and Nubaine should never be used in
the methadone-tolerant individual. Severe opiate withdrawal syndrome
can be precipitated by drugs of this type. Alcohol and other central
nervous system depressants should not be taken or consumed while
methadone is being taken. Combinations taken in excess can lead to
shallow breathing, respiratory failure, and, ultimately, death.
Tramadol
Reports have indicated that tramadol (Ultram and Ultracet) is more likely
to induce seizure activity when given together with a selective serotoninreuptake inhibitor (SSRI [see list below]). Use of tramadol with MAO
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inhibitors or SSRIs increases the risk of adverse events, including
seizure, serotonin syndrome, and even death. Use of tramadol with CNS
depressants increases the rate of respiratory depression.
SSRI List
(These drugs can be dangerous when combined with tramadol. Seeabove.)
o Citalopram (Celexa, Cipramil, Emocal, Sepram)
o Escitalopram oxalate (Lexapro, Cipralex)
o Fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem)
o Fluvoxamine maleate (Luvox, Faverin)
o Paroxetine (Paxil, Seroxat, Aropax, Deroxat)
o Sertraline (Zoloft, Lustral, Serlain)
BL Drug Combo Fatality Reports
Methadone + Xanax
Tramadol + SSRI
Morphine + Xanax
Opiates + benzodiazepines (coma)
***REMEMBER***
Please note that while some may use one of the dangerous drug
combinations listed above at low doses without negative consequences,
even a small step up in dose can multiply the health risk by a greater
factor where drug combinations are concerned. A person in an altered
state of consciousness does not always use the best judgment so please
be careful and ALWAYS error on the side of caution.
Information gathered and quoted from:
Cynthia Kuhn, Scott Swartwelder, and Wilkie Wilson from the Duke
University Medical Center and their book "Buzzed" W.W. Norton and
Co., 1999; web sources; and Bluelight members.
Last edited by Banquo; 07-10-2007 at 01:37.
9.
#9
atomica
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Bluelighter
Join Date
Feb 2000Location
melbourne, AU
Posts
856
18-02-2001 22:43
Prozac is a SSRI (selective serotonin reuptake inhibiter) - ie it blocks the
reuptake transporters to keep serotonin in the synapse.
MAOI stands for monoamine oxidase inhibitor. MAO is the stuff thatbreaks down serotonin and other neurotransmiters (like dopamine) after
they get sucked back into the cell thru the reuptake trasporters.
SSRIs and MAOIs are very different. these two should not be combined.
mdma and MAOIs should not be combined. SSRIs should not be taken at
the height of a roll, but can protect the serotonin system following a roll.
Last edited by Orlando; 18-03-2003 at 17:24.
10.
#10
Thelazer
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Location
Buffalo NY.. but known to visit CFL now and then.
Posts
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18-03-2001 18:07
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Originally posted by: fairnymph
posted 18 March 2001 04:35 AM
Remeron (mirtazapine) and mushrooms
-No medical evidence, just my own personal experience.
- I had extreme difficulty breathing for 1-2 hours, irregular, slowed heartrate. I almost went to the ER, but fortunately I got through the breathing
bit. It may be because I run daily that my heart got me through, so I
expect that for normal people the interaction would be even worse.
Last edited by Orlando; 18-03-2003 at 17:28.
11.
#11
Roches
Bluelighter
Join DateMay 2001
Posts
851
03-09-2001 06:07
This is mostly a list of cytochrome P450-2D6 inhibitors, which i
suggested for addition here earlier. It mostly applies to DXM, but note
that mixing any two drugs on the list may potentially be dangerous, since
mixing a drug with potentially harmful effects (like DXM) with even
small amounts of another cyp-2D6 inhibitor can cause both drugs toaccumulate to dangerous levels in the body (since they can't be broken
down). There's also some other stuff about MAOIs.
MAOIs
DXM + an MAOI is a dangerous combination; Robitussin DM is not
okay, probably not even in normal doses. for a while, i took Manerix
(moclobemide), which is a reversible MAOI, and was expressly warned
never to mix it with cough medicines containing DXM. even though the
dietary limitations for tyramine intake (like, no tomatoes, no cheese)
don't apply to reversible MAOIs, there are still a few restrictions: no
more than 300 g of aged cheese or 1000 g of any cheese, and no productsderived from yeast, like Marmite and Vegemite. you also cannotmix
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them with DXM.
to many people, this may be irrelevant, because there are no reversible
MAOIs approved for use in the US.
CYP-2D6 Inhibitors
There are a large number of drugs that inhibit the action of the liveroxidoreductase enzyme cyp-2d6 (cytochrome p450-2d6). This enzyme is
responsible for metabolizing a number of drugs, including MDMA and
methamphetamine. Mixing a cyp-2d6 inhibitor with MDMA or crystal,
or mixing two or more inhibitors, is considered highly dangerous
because it prevents you from eliminating the drug, meaning that it will be
present in higher concentrations for a longer time.
This list of CYP-2D6 and CYP-3A inhibitors is from the DXM FAQ,
with some annotations:
o ajmalicine 2D6 strongest (164)o carbon monoxide poison 2D6 (160)
o chloroquine antiparasitic 2D6 med-low (172)
o chlorpheniramine (found in some cough medicines and anti-
allergic preparations) antihistamine 2D med-high (151)
o citalopram antidepressant 2D6 med-low (166)
o clozapine antipsychotic 2D6 low (171)
o desipramine tricyclic antidepressant 2D6 low (152)
o diphenhydramine (Dramamine, Gravol, Benadryl)
antihistamine 2D med-high (151)
o doxorubicin anticancer 2D6 med-low (165)
o fluoxetine (Prozac) antidepressant 2D6 med-high (152)
o fluvoxamine (Luvox) antidepressant 2D6 med-high (152)
o imipramine tricyclic antidepressant 2D6 med (152)
o lomustine anticancer 2D6 med (165)
o mepyramine antihistamine 2D6 high (151)
methadone addiction treatment 2D6 med (162
o moclobemide (Manerix) MAO-A Inh. (reversible) 2D6, also
2C19, 1A2 (147)
o nortryptiline (Elavil) antidepressant 2D6 med-low (155)
o oxamniquine antiparasitic 2D6 med-low (172)
o paroxetine (Paxil) antidepressant 2D6 high (152)
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o PCP recreational 2D (150)
- if this is true, then ketamine may be an inhibitor as well.
o primaquine antiparasitic 2D6 med-low (172)
o propranolol beta-blocker 2D6 low (156)
o quinidine 2D6 (148)
o quinine antiparasitic 2D (151)
o sertraline antidepressant 2D6 med-high (167)
o triprolidine antihistamine 2D med-high (151)
o vinblastine anticancer 2D6 med-low (165)
o vinorelbine anticancer 2D6 med-low (165)
- Drug Uses P450-3A Enzymes Potency Ref
o 7,8-benzoflavone 3A4 (activator) (153)
o cannabidiol component of marijuana 3A med (161)
o cocaine recreational 3A low (157)
o clotrimazole agricultural fungicide 3A (activator) very high (154)
o cyclophosphamide 3A low? (158)
o ifosfamide 3A low? (158)
o ketoconazole 3A (145)
o pilocarpine cholinomimetic 3A low (149)
- Drug Uses P450-3A Enzymes Potency Ref
o 1-aminobenzotriazole Nonspecific med-high (159)
o chlorophyllin geriatric Nonspecific (146)
o general anaesthetics Nonspecific (163)
Last edited by Orlando; 18-03-2003 at 17:33.
12.
#12
PHD
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Fleshlighter
Join DateMar 2001
Posts
3,182
02-05-2003 03:22
Here are a few notes about interaction of recreational drugs with protease
inhibitors and other anti-HIV/AIDS medications. All information taken
from a 24 page booklet titled "Medical Drug Interactions with Street
Drugs." The author is Julie Klems and she is affiliated with a group
called Needle Exchange Emergency Distribution (NEED) out ofBerkeley, CA, USA.
Doing speed or ecstacy even once can be deadly when taking these
medications.
Anecdotally people say that you become very sensitive to speed, ecstasy
and ketamine when on protease inhibitors.
Alcohol and sedative tolerance is also lowered by these medications.
Anecdotally people say that heroin, marijuana and cocaine have
typical/usual reactions when taking anti-HIV/AIDS medications. Be
warned, however, that cocaine dramatically increases the proliferation of
the virus in your body. Avoid speedballs if at all possible; if you must get
a fix, try to use heroin by itself.
The interaction of GHB with these medications is unknown but people
are encouraged to exercise extreme caution.
13.
Grapefruit Juice v2.0 -- written by frizzantik
#13
PHD
Fleshlighter
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Join Date
Mar 2001
Posts
3,182
11-12-2004 12:40
This is not really about dangerous combinations, but anyone who'd read
this thread would probably be interested in this information...
Grapefruit Juice FAQ
Grapefruit juice can act as a potentiator for the following prescription
drugs sometimes used recreationally:
o codeine
o methadone
o oxycodone (OxyContin, Percoset)
o dextromethorphan (DXM)
o alprazolam (Xanax)
o clonazepam (Klonopin, Rivotril)
o midazolam (Versed)
o triazolam (Halcion)
Caution should be excercised if consuming grapefruit juice before or
while taking these drugs. Though most people report mild potentiation (if
any), if one is taking extremely large doses, any potentiation could be
dangerous.
Method of Action
Grapefruit juice can inhibit the gastrointestinal activity of two enzymes
known as cytochrome P450 CYP3A4 and CYP1A2, though the effect on
CYP1A2 is minimal. This causes elevated plasma levels of some drugs,
because they are able to pass into the bloodstream without being broken
down by enzymes in the intestine. Due to variations in enzyme levels in
the intestine from person to person, effects will vary.
The specific chemical responsible for this action is not known. There are
a few suspects including various flavonoids and other phytochemicals
called furanocoumarins. Concentrations of these compounds vary from
one batch of juice to another. Higher concentrations are found in white
juice compared to red, and the highest concentrations are found in the
pulp of the fresh fruit. One glass (200 ml) of fresh juice was found to be
equal in effect to two or three glasses of double strength reconstitutedfrozen juice. This suggests that store bought juice, which is often from
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concentrate, must be consumed in large quantites to for effects to be
noticed. Consuption of 6-8 glasses of fresh juice may lead to inhibition
of CYP3A4 in the liver. The potentiating effect of grapefuit juice may
last 5 or mores hours after ingestion.
A Note on Codeine & OxycodoneCodeine is metabolised by both CYP3A4 and CYP2D6. CYP3A4
metabolised codine into norcodine which isn't very active, while
CYP2D6 metabolises codiene into morphine which is responsible for
codiene's effect. When the CYP3A4 enzyme is inhibited by grapefruit
juice, more codiene may be metabolised by CYP2D6. This is theoretical
and is not supported by literature at this time.
Like codeine, oxycodone is metabolized by both CYP3A4 and CYP2D6,
with the more potent metabolite, oxymorphone, produced by CYP2D6.
When the CYP3A4 pathway is blocked, more oxycodone may be
metabolised by CYP2D6.
Grapefruit Juice and Cimetidine (Tagamet)
Cimetidine acts on a different enzyme than grapefruit juice, specifically
CYP2D6. CYP2D6 metabolises many opiates and opiods, but grapefruit
juice has no effect on CYP2D6.
Sources:
http://www.postgradmed.com/issues/19...99/cadieux.htm
http://www.powernetdesign.com/grapef...0abstract.html
http://www.mayo.edu/proceedings/2000/sep/7509r1.pdf
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract
http://www.tthhivclinic.com/pdf/Recdrug2.pdf
Last edited by PHD; 13-12-2004 at 10:44.
14.
#14
frizzantik
Bluelight Crew
Join DateSep 2002
http://www.postgradmed.com/issues/1999/11_99/cadieux.htmhttp://www.powernetdesign.com/grapefruit/references/ref80abstract.htmlhttp://www.mayo.edu/proceedings/2000/sep/7509r1.pdfhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10872589&dopt=Abstracthttp://www.tthhivclinic.com/pdf/Recdrug2.pdfhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=4124761&viewfull=1#post4124761http://www.bluelight.ru/vb/members/36846-frizzantikhttp://www.bluelight.ru/vb/members/36846-frizzantikhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ#tophttp://www.postgradmed.com/issues/1999/11_99/cadieux.htmhttp://www.powernetdesign.com/grapefruit/references/ref80abstract.htmlhttp://www.mayo.edu/proceedings/2000/sep/7509r1.pdfhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10872589&dopt=Abstracthttp://www.tthhivclinic.com/pdf/Recdrug2.pdfhttp://www.bluelight.ru/vb/threads/52825-Dangerous-Combos-FAQ?p=4124761&viewfull=1#post4124761http://www.bluelight.ru/vb/members/36846-frizzantik -
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Location
California
Posts
14,348
31-05-2006 10:12
The above FAQ states the method of action of grapefruit juice is
unknown, though furanocoumarins were suspected. It has now been
confirmed that furanocoumarins are the chemical responsible for the
CYP enzyme inhibition.
15.
#15
B9
Bluelight Crew
Join Date
Mar 2005
Location
wherever Chaos needs bringing to Order
Posts
36,675
07-02-2007 12:35
1000 g of any cheese
A horrifying thought to eat a kilo of cheese in the 12 hours max that
moclobemide is active , but there's nowt so queer as folk !
Any info on interactions between amlodopine and MAOI or other
commonly used psychedelics stims etceterta ?
16.
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#16
barry351
Bluelighter
Join Date
Jan 2010
Location
lynden wa state, where the heroin sucks and tar is all one can find
Posts
70
29-01-2010 04:44
thanks for the grapefruit juice idea I have heard of this in the past and
forgot it. I get 120 - 2 milligram klonopin (clonazepam) in january and
will put it to a test. I have an enormous tolerance to benzos maybe the
juice can help me with not taking so much.
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