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disket haze

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  • dannw87
    My name is dann white, I am a methadone patient (hi-dose) at a very repressive clinic. I am active in the cause of methadone advocacy and looking to become
    Message 1 of 15 , Jan 1, 2004
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      My name is dann white, I am a methadone patient (hi-dose) at a very
      repressive clinic. I am active in the cause of methadone advocacy
      and looking to become moreso.

      Our clinic just started using some cheap round orange or peach
      biscuits with numbers on them- they are hard to read but it looks
      like they say 63 or s3-3xxx on them. Has anyone ever seen these
      before? Do you know where I can find photos of the different
      varieties out there?

      Looking forward to knowing you

      Dann
      (and wife Elizabeth)
    • claude
      Dann, what you describe sounds like a generic version of the original lilly diskette which those were sort of square shape. This is a debate that has been
      Message 2 of 15 , Jan 1, 2004
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        Dann,
        what you describe sounds like a generic version of the original lilly diskette which those were sort of square shape. This is a debate that has been going on forever but the active ingredient is methadone hcl and regardless of the brand 100mg is a 100mg, however some use different inert ingredients and in some people it may effect the way it's metabolized. Go to www.methadone.org which is nama's website and there are lots of data on the subject.

        claude

        ps also type in methadone in the googles search engine

        dannw87 <no_reply@yahoogroups.com> wrote:
        My name is dann white, I am a methadone patient (hi-dose) at a very
        repressive clinic. I am active in the cause of methadone advocacy
        and looking to become moreso.

        Our clinic just started using some cheap round orange or peach
        biscuits with numbers on them- they are hard to read but it looks
        like they say 63 or s3-3xxx on them. Has anyone ever seen these
        before? Do you know where I can find photos of the different
        varieties out there?

        Looking forward to knowing you

        Dann
        (and wife Elizabeth)



        ---------------------------------
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        claude Hopkins cma
        Nama/NJ
        njadvocates.org
        claude@...
        Nama web site


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      • dannw87
        Thanks for the reply Claude, and your e so rite; a guy told me the other day that the problem with our clinic is that they use METHADOSE not METHADONE and
        Message 3 of 15 , Jan 2, 2004
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          Thanks for the reply Claude, and your'e so rite; a guy told me the
          other day that the problem with our clinic is that they
          use "METHADOSE" not "METHADONE" and I explained the contents were
          methadone hcl (incidentally also known as amidone)BUT....There is a
          big and I mean big difference in performance. For years I took
          dolophine by prescription and after twice recieving 10mg MethadoSe
          tabs I refused to purchase them they were inferior by at least 40%
          of the Dolophine(Roxane)tabs. In liquids by far I found the purple
          concentrate that came with a pump mechanism so much more potent than
          any other form of the drug. I promise these are tried and true
          opinions gathered over my methadone career (1970 to present), I'm
          not bragging by the way all that experience shows nothing but how
          hard-headed I am.

          Good to hear from you I don't know why my email isn't on the forum
          but it is dannw87@... - keep in touch

          Dann................................................................

          --- In DOLOPHINEA_CAFE@yahoogroups.com, claude <hopjr2@y...> wrote:
          > Dann,
          > what you describe sounds like a generic version of the
          original lilly diskette which those were sort of square shape. This
          is a debate that has been going on forever but the active ingredient
          is methadone hcl and regardless of the brand 100mg is a 100mg,
          however some use different inert ingredients and in some people it
          may effect the way it's metabolized. Go to www.methadone.org which
          is nama's website and there are lots of data on the subject.
          >
          > claude
          >
          > ps also type in methadone in the googles search engine
          >
          > dannw87 <no_reply@yahoogroups.com> wrote:
          > My name is dann white, I am a methadone patient (hi-dose) at a
          very
          > repressive clinic. I am active in the cause of methadone advocacy
          > and looking to become moreso.
          >
          > Our clinic just started using some cheap round orange or peach
          > biscuits with numbers on them- they are hard to read but it looks
          > like they say 63 or s3-3xxx on them. Has anyone ever seen these
          > before? Do you know where I can find photos of the different
          > varieties out there?
          >
          > Looking forward to knowing you
          >
          > Dann
          > (and wife Elizabeth)
          >
          >
          >
          > ---------------------------------
          > Yahoo! Groups Links
          >
          > To visit your group on the web, go to:
          > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
          >
          > To unsubscribe from this group, send an email to:
          > DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com
          >
          > Your use of Yahoo! Groups is subject to the Yahoo! Terms of
          Service.
          >
          >
          >
          > claude Hopkins cma
          > Nama/NJ
          > njadvocates.org
          > claude@n...
          > Nama web site
          >
          >
          > ---------------------------------
          > Do you Yahoo!?
          > Find out what made the Top Yahoo! Searches of 2003
          >
          > [Non-text portions of this message have been removed]
        • claude
          Dann, I too are one of the old timers,I think that s a good thing,we ll still around! Lol The fed regs state that if a clinic changes their formular they must
          Message 4 of 15 , Jan 2, 2004
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            Dann, I too are one of the old timers,I think that's a good thing,we'll still around! Lol
            The fed regs state that if a clinic changes their formular they must give patients an opportunity to adjust their dose whether that requires an increase or decrease. What state are you in?

            claude

            dannw87 <no_reply@yahoogroups.com> wrote:

            Thanks for the reply Claude, and your'e so rite; a guy told me the
            other day that the problem with our clinic is that they
            use "METHADOSE" not "METHADONE" and I explained the contents were
            methadone hcl (incidentally also known as amidone)BUT....There is a
            big and I mean big difference in performance. For years I took
            dolophine by prescription and after twice recieving 10mg MethadoSe
            tabs I refused to purchase them they were inferior by at least 40%
            of the Dolophine(Roxane)tabs. In liquids by far I found the purple
            concentrate that came with a pump mechanism so much more potent than
            any other form of the drug. I promise these are tried and true
            opinions gathered over my methadone career (1970 to present), I'm
            not bragging by the way all that experience shows nothing but how
            hard-headed I am.

            Good to hear from you I don't know why my email isn't on the forum
            but it is dannw87@... - keep in touch

            Dann................................................................

            --- In DOLOPHINEA_CAFE@yahoogroups.com, claude <hopjr2@y...> wrote:
            > Dann,
            > what you describe sounds like a generic version of the
            original lilly diskette which those were sort of square shape. This
            is a debate that has been going on forever but the active ingredient
            is methadone hcl and regardless of the brand 100mg is a 100mg,
            however some use different inert ingredients and in some people it
            may effect the way it's metabolized. Go to www.methadone.org which
            is nama's website and there are lots of data on the subject.
            >
            > claude
            >
            > ps also type in methadone in the googles search engine
            >
            > dannw87 <no_reply@yahoogroups.com> wrote:
            > My name is dann white, I am a methadone patient (hi-dose) at a
            very
            > repressive clinic. I am active in the cause of methadone advocacy
            > and looking to become moreso.
            >
            > Our clinic just started using some cheap round orange or peach
            > biscuits with numbers on them- they are hard to read but it looks
            > like they say 63 or s3-3xxx on them. Has anyone ever seen these
            > before? Do you know where I can find photos of the different
            > varieties out there?
            >
            > Looking forward to knowing you
            >
            > Dann
            > (and wife Elizabeth)
            >
            >
            >
            > ---------------------------------
            > Yahoo! Groups Links
            >
            > To visit your group on the web, go to:
            > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
            >
            > To unsubscribe from this group, send an email to:
            > DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com
            >
            > Your use of Yahoo! Groups is subject to the Yahoo! Terms of
            Service.
            >
            >
            >
            > claude Hopkins cma
            > Nama/NJ
            > njadvocates.org
            > claude@n...
            > Nama web site
            >
            >
            > ---------------------------------
            > Do you Yahoo!?
            > Find out what made the Top Yahoo! Searches of 2003
            >
            > [Non-text portions of this message have been removed]


            Yahoo! Groups SponsorADVERTISEMENT


            ---------------------------------
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            To visit your group on the web, go to:
            http://groups.yahoo.com/group/DOLOPHINEA_CAFE/

            To unsubscribe from this group, send an email to:
            DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com

            Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.



            claude Hopkins cma
            Nama/NJ
            njadvocates.org
            claude@...
            Nama web site


            ---------------------------------
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            [Non-text portions of this message have been removed]
          • Mark4wdw@aol.com
            Are these the disks you were referring to? If so I get them prescribed by my doctor and they are generic for the Lilly 40 mgs and I have had many types of
            Message 5 of 15 , Jan 2, 2004
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              Are these the disks you were referring to? If so I get them prescribed by my
              doctor and they are generic for the Lilly 40 mgs and I have had many types of
              Methadone and Methadose. These work fine in my opinion.


              [Non-text portions of this message have been removed]
            • RG
              I have heard rumors that eating thirty minutes after your dose and taking Cimetioine (Tagament) before dosing will increase the blood concentration of your
              Message 6 of 15 , Jan 4, 2004
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                I have heard rumors that eating thirty minutes after your dose and taking
                Cimetioine (Tagament) before dosing will increase the blood concentration of
                your medicine. Is any of this correct?

                Thanks,



                From: DOLOPHINEA_CAFE@yahoogroups.com
                Date: Friday, January 02, 2004 6:41:35 AM
                To: DOLOPHINEA_CAFE@yahoogroups.com
                Subject: [METHADONIA ] Re: disket haze


                Thanks for the reply Claude, and your'e so rite; a guy told me the
                other day that the problem with our clinic is that they
                use "METHADOSE" not "METHADONE" and I explained the contents were
                methadone hcl (incidentally also known as amidone)BUT....There is a
                big and I mean big difference in performance. For years I took
                dolophine by prescription and after twice recieving 10mg MethadoSe
                tabs I refused to purchase them they were inferior by at least 40%
                of the Dolophine(Roxane)tabs. In liquids by far I found the purple
                concentrate that came with a pump mechanism so much more potent than
                any other form of the drug. I promise these are tried and true
                opinions gathered over my methadone career (1970 to present), I'm
                not bragging by the way all that experience shows nothing but how
                hard-headed I am.

                Good to hear from you I don't know why my email isn't on the forum
                but it is dannw87@... - keep in touch

                Dann................................................................

                --- In DOLOPHINEA_CAFE@yahoogroups.com, claude <hopjr2@y...> wrote:
                > Dann,
                > what you describe sounds like a generic version of the
                original lilly diskette which those were sort of square shape. This
                is a debate that has been going on forever but the active ingredient
                is methadone hcl and regardless of the brand 100mg is a 100mg,
                however some use different inert ingredients and in some people it
                may effect the way it's metabolized. Go to www.methadone.org which
                is nama's website and there are lots of data on the subject.
                >
                > claude
                >
                > ps also type in methadone in the googles search engine
                >
                > dannw87 <no_reply@yahoogroups.com> wrote:
                > My name is dann white, I am a methadone patient (hi-dose) at a
                very
                > repressive clinic. I am active in the cause of methadone advocacy
                > and looking to become moreso.
                >
                > Our clinic just started using some cheap round orange or peach
                > biscuits with numbers on them- they are hard to read but it looks
                > like they say 63 or s3-3xxx on them. Has anyone ever seen these
                > before? Do you know where I can find photos of the different
                > varieties out there?
                >
                > Looking forward to knowing you
                >
                > Dann
                > (and wife Elizabeth)
                >
                >
                >
                > ---------------------------------
                > Yahoo! Groups Links
                >
                > To visit your group on the web, go to:
                > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
                >
                > To unsubscribe from this group, send an email to:
                > DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com
                >
                > Your use of Yahoo! Groups is subject to the Yahoo! Terms of
                Service.
                >
                >
                >
                > claude Hopkins cma
                > Nama/NJ
                > njadvocates.org
                > claude@n...
                > Nama web site
                >
                >
                > ---------------------------------
                > Do you Yahoo!?
                > Find out what made the Top Yahoo! Searches of 2003
                >
                > [Non-text portions of this message have been removed]


                Yahoo! Groups Sponsor
                ADVERTISEMENT






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                To visit your group on the web, go to:
                http://groups.yahoo.com/group/DOLOPHINEA_CAFE/

                To unsubscribe from this group, send an email to:
                DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com

                Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.




                [Non-text portions of this message have been removed]
              • Dann White
                I ve heard a million rumors and I don t put a lot of stock in addict chemistry, my wife read in a pamphlet that drinking grapefruit juice (in her case,
                Message 7 of 15 , Jan 4, 2004
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                  I've heard a million rumors and I don't put a lot of stock in addict chemistry, my wife read in a pamphlet that drinking grapefruit juice (in her case, Tropicana Ruby Red) with your dose makes it climb on quicker. By the way this wasn't a methadone pamphlet it was in general about pain meds

                  Dann


                  ----- Original Message -----
                  From: RG
                  To: DOLOPHINEA_CAFE@yahoogroups.com
                  Sent: 1/4/2004 2:46:16 PM
                  Subject: Re: [METHADONIA ] Re: disket haze



                  I have heard rumors that eating thirty minutes after your dose and taking
                  Cimetioine (Tagament) before dosing will increase the blood concentration of
                  your medicine. Is any of this correct?

                  Thanks,



                  From: DOLOPHINEA_CAFE@yahoogroups.com
                  Date: Friday, January 02, 2004 6:41:35 AM
                  To: DOLOPHINEA_CAFE@yahoogroups.com
                  Subject: [METHADONIA ] Re: disket haze


                  Thanks for the reply Claude, and your'e so rite; a guy told me the
                  other day that the problem with our clinic is that they
                  use "METHADOSE" not "METHADONE" and I explained the contents were
                  methadone hcl (incidentally also known as amidone)BUT....There is a
                  big and I mean big difference in performance. For years I took
                  dolophine by prescription and after twice recieving 10mg MethadoSe
                  tabs I refused to purchase them they were inferior by at least 40%
                  of the Dolophine(Roxane)tabs. In liquids by far I found the purple
                  concentrate that came with a pump mechanism so much more potent than
                  any other form of the drug. I promise these are tried and true
                  opinions gathered over my methadone career (1970 to present), I'm
                  not bragging by the way all that experience shows nothing but how
                  hard-headed I am.

                  Good to hear from you I don't know why my email isn't on the forum
                  but it is dannw87@... - keep in touch

                  Dann................................................................

                  --- In DOLOPHINEA_CAFE@yahoogroups.com, claude <hopjr2@y...> wrote:
                  > Dann,
                  > what you describe sounds like a generic version of the
                  original lilly diskette which those were sort of square shape. This
                  is a debate that has been going on forever but the active ingredient
                  is methadone hcl and regardless of the brand 100mg is a 100mg,
                  however some use different inert ingredients and in some people it
                  may effect the way it's metabolized. Go to www.methadone.org which
                  is nama's website and there are lots of data on the subject.
                  >
                  > claude
                  >
                  > ps also type in methadone in the googles search engine
                  >
                  > dannw87 <no_reply@yahoogroups.com> wrote:
                  > My name is dann white, I am a methadone patient (hi-dose) at a
                  very
                  > repressive clinic. I am active in the cause of methadone advocacy
                  > and looking to become moreso.
                  >
                  > Our clinic just started using some cheap round orange or peach
                  > biscuits with numbers on them- they are hard to read but it looks
                  > like they say 63 or s3-3xxx on them. Has anyone ever seen these
                  > before? Do you know where I can find photos of the different
                  > varieties out there?
                  >
                  > Looking forward to knowing you
                  >
                  > Dann
                  > (and wife Elizabeth)
                  >
                  >
                  >
                  > ---------------------------------
                  > Yahoo! Groups Links
                  >
                  > To visit your group on the web, go to:
                  > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
                  >
                  > To unsubscribe from this group, send an email to:
                  > DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com
                  >
                  > Your use of Yahoo! Groups is subject to the Yahoo! Terms of
                  Service.
                  >
                  >
                  >
                  > claude Hopkins cma
                  > Nama/NJ
                  > njadvocates.org
                  > claude@n...
                  > Nama web site
                  >
                  >
                  > ---------------------------------
                  > Do you Yahoo!?
                  > Find out what made the Top Yahoo! Searches of 2003
                  >
                  > [Non-text portions of this message have been removed]


                  Yahoo! Groups Sponsor
                  ADVERTISEMENT






                  Yahoo! Groups Links

                  To visit your group on the web, go to:
                  http://groups.yahoo.com/group/DOLOPHINEA_CAFE/

                  To unsubscribe from this group, send an email to:
                  DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com

                  Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.




                  [Non-text portions of this message have been removed]




                  Yahoo! Groups Links

                  To visit your group on the web, go to:
                  http://groups.yahoo.com/group/DOLOPHINEA_CAFE/

                  To unsubscribe from this group, send an email to:
                  DOLOPHINEA_CAFE-unsubscribe@yahoogroups.com

                  Your use of Yahoo! Groups is subject to the Yahoo! Terms of Service.

                  [Non-text portions of this message have been removed]
                • Stephanie Vazquez
                  Hello Dann, Is this what you are talking about?? Go to this groups site: http://groups.yahoo.com/group/DOLOPHINEA_CAFE/ There is a picture of Lilly s diskette
                  Message 8 of 15 , Jan 6, 2004
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                    Hello Dann,
                    Is this what you are talking about??
                    Go to this groups site:
                    http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
                    There is a picture of Lilly's diskette with "U53" on it.

                    The topic of which brand of methadone works best, will be around
                    forever! :)
                    The active portion of methadone, regardless of what brand, all comes
                    from the same place. However, different brands use different fillers.
                    For example, this is what the package inserts state for these 2
                    brands of methadone:

                    Roxane brand:

                    Each Disket contains 40 mg(0.116 mmol)methadone hydrochloride.
                    Each tablet also contains mycrocrystalline cellulose, pregelatinized
                    starch, potassium phosphate monobasic, colloidal silicon dioxide,
                    stearic acid, magnesium stearate, orange lake
                    color and orange-pineapple flavor.

                    Methadose brand:

                    Each Methadose Dispersible Tablet contains: 40 mg(0.116mmol)Methadone
                    Hydrochlorise, USP.
                    Each tablet also contains Diabasic Calcium Phosphate USP,
                    Mycrocrystalline Cellulose NF, Magnesium Stearate NF, Colloidal Silicon
                    Dioxide NF, Pregelatinized Starch NF, and Stearic Acid NF.


                    Patients can respond differently to the different fillers...they can
                    metabolize them differently.

                    Take care,
                    Stephanie V.
                    NY NAMA
                    Brooklyn, New York
                    ssv55@...
                    http://www.methadone.org
                    Together We Can Make a Difference

                    > > dannw87 wrote:
                    > > My name is dann white, I am a methadone patient (hi-dose) at a
                    > very
                    > > repressive clinic. I am active in the cause of methadone advocacy
                    > > and looking to become moreso.
                    > >
                    > > Our clinic just started using some cheap round orange or peach
                    > > biscuits with numbers on them- they are hard to read but it looks
                    > > like they say 63 or s3-3xxx on them. Has anyone ever seen these
                    > > before? Do you know where I can find photos of the different
                    > > varieties out there?
                    > >
                    > > Looking forward to knowing you
                    > >
                    > > Dann
                    > > (and wife Elizabeth)


                    > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/


                    [Non-text portions of this message have been removed]
                  • odubya
                    Hey Dan~ I get the same kind you do. They have 5 4/ 883, on one side and scored on the other..I don t know what brand they are, I guess a generic. Oats GULF
                    Message 9 of 15 , Jan 7, 2004
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                      Hey Dan~ I get the same kind you do. They have 5 4/ 883, on one side
                      and scored on the other..I don't know what brand they are, I guess a
                      generic. Oats GULF COAST NAMA


                      --- In DOLOPHINEA_CAFE@yahoogroups.com, Stephanie Vazquez
                      <ssv55@e...> wrote:
                      > Hello Dann,
                      > Is this what you are talking about??
                      > Go to this groups site:
                      > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
                      > There is a picture of Lilly's diskette with "U53" on it.
                      >
                      > The topic of which brand of methadone works best, will be around
                      > forever! :)
                      > The active portion of methadone, regardless of what brand, all
                      comes
                      > from the same place. However, different brands use different
                      fillers.
                      > For example, this is what the package inserts state for these 2
                      > brands of methadone:
                      >
                      > Roxane brand:
                      >
                      > Each Disket contains 40 mg(0.116 mmol)methadone hydrochloride.
                      > Each tablet also contains mycrocrystalline cellulose, pregelatinized
                      > starch, potassium phosphate monobasic, colloidal silicon dioxide,
                      > stearic acid, magnesium stearate, orange lake
                      > color and orange-pineapple flavor.
                      >
                      > Methadose brand:
                      >
                      > Each Methadose Dispersible Tablet contains: 40 mg(0.116mmol)
                      Methadone
                      > Hydrochlorise, USP.
                      > Each tablet also contains Diabasic Calcium Phosphate USP,
                      > Mycrocrystalline Cellulose NF, Magnesium Stearate NF, Colloidal
                      Silicon
                      > Dioxide NF, Pregelatinized Starch NF, and Stearic Acid NF.
                      >
                      >
                      > Patients can respond differently to the different fillers...they
                      can
                      > metabolize them differently.
                      >
                      > Take care,
                      > Stephanie V.
                      > NY NAMA
                      > Brooklyn, New York
                      > ssv55@e...
                      > http://www.methadone.org
                      > Together We Can Make a Difference
                      >
                      > > > dannw87 wrote:
                      > > > My name is dann white, I am a methadone patient (hi-dose) at a
                      > > very
                      > > > repressive clinic. I am active in the cause of methadone
                      advocacy
                      > > > and looking to become moreso.
                      > > >
                      > > > Our clinic just started using some cheap round orange or peach
                      > > > biscuits with numbers on them- they are hard to read but it
                      looks
                      > > > like they say 63 or s3-3xxx on them. Has anyone ever seen these
                      > > > before? Do you know where I can find photos of the different
                      > > > varieties out there?
                      > > >
                      > > > Looking forward to knowing you
                      > > >
                      > > > Dann
                      > > > (and wife Elizabeth)
                      >
                      >
                      > > http://groups.yahoo.com/group/DOLOPHINEA_CAFE/
                      >
                      >
                      > [Non-text portions of this message have been removed]
                    • pamila hogan
                      FYI....the methadone disk that are orange and square are from the co. Roxanne. Eli Lilly was the original co. to manufacture methadone via the goverment. The
                      Message 10 of 15 , Jan 8, 2004
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                        FYI....the methadone disk that are orange and square are from the co. Roxanne. Eli Lilly was the original co. to manufacture methadone via the goverment. The round white disk have methadose on them and are truly generic shit. There is a difference in the feeling and the length of time that it last in your system and Roxanne's orange are the closest to the original that you can get. Roxanne bought the rights to manufacture the same from Eli Lilly.How do I know this...I'm a nurse and have been on methadone for several years from my pain management doctor. swtbear2001

                        ---------------------------------
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                        [Non-text portions of this message have been removed]
                      • ssv55@earthlink.net
                        Hello Dann and RG, White grapefruit juice also affects drug metabolism. Some patients have had good results potentiating an inadequate dose by drinking 8 ozs.
                        Message 11 of 15 , Jan 15, 2004
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                          Hello Dann and RG,
                          White grapefruit juice also affects drug metabolism. Some patients
                          have had
                          good results potentiating an inadequate dose by drinking 8 ozs. of
                          WHITE
                          grapefruit juice when dosing.  I found this info at the following
                          URL:

                          http://www.vhpharmsci.com/document/Article22.htm

                          When ingested together, grapefruit juice can interact with various
                          medications, resulting in potentially toxic drug levels and
                          adverse effects.

                          Certain bioflavonoids contained in citrus juices can affect drug
                          metabolism.
                          The major bioflavonoid in grapefruit juice is naringin, which is
                          partially metabolized
                          by enteral bacteria to form naringenin.1,2 Naringenin is a potent
                          inhibitor of the
                          cytochrome p450 liver enzymes: CYP1A2, CYP3A3 and CYP3A4. There is
                          however,considerable inter-individual variability in the effects of
                          grapefruit juice on
                          drug metabolism, in part due to :
                          1) amount of naringenin formed by an individual,
                          2) amount of naringin present in a brand of grapefruit juice,
                          3) dilution of grapefruit juice used, and
                          4) other substances in grapefruit juice accounting for the
                          interaction.

                          Table 4 lists drugs whose levels may significantly increase if given
                          concomitantly with grapefruit juice. CSU Pharmaceutical Sciences will
                          place a label
                          stating "Do not take with grapefruit juice" if a patient is ordered
                          any drug listed
                          below.

                          Table 4. Grapefruit Juice-Drug Interactions

                          Drug
                                                     
                                     
                          Dihydropyridine Calcium Channel Blockers:
                          -amlodipine†
                          -felodipine
                          -nicardipine
                          -nifedipine†
                          AVOID grapefruit juice OR monitor for decreased BP, increased HR if
                          taken together

                          Terfenadine
                          AVOID grapefruit juice as may result in cardiotoxicity (prolonged QT
                          interval)

                          Cyclosporine†
                           AVOID grapefruit juice, unless prescribed to specifically
                          increase cyclosporine levels

                          HMG-CoA Reductase Inhibitors (Statins)‡:
                          -atorvastatin
                          -cerivastatin
                          -lovastatin
                          -simvastatin†
                          AVOID grapefruit juice as potential for myopathy or
                          rhabdomyolysis¶

                          Cisapride†
                           AVOID grapefruit juice as potential for cardiotoxicity (torsades
                          de pointes, prolonged
                          QT interval)¶

                          Benzodiazepines
                          -triazolam
                          -oral midazolam†
                          AVOID grapefruit juice or monitor for increased sedation if used
                          together

                          Quinidine†
                          AVOID; significance unknown

                          Saquinavir
                          AVOID; signficance unknown

                          Estrogens
                          -ethinyl estradiol†
                          -17ß estradiol
                          AVOID - significance unknown
                          ====================================================
                          ====================================================
                           http://www.atforum.com/pages/current_pastissues
                          /Vol6s97.html#anchor649123



                          OTC Drugs, Juice, Vitamins
                          John St. Peter, PharmD, BCPS - Pharmacist in Charge for HFA, and
                          Assistant Professor,
                          College of Pharmacy at the University of Minnesota - has previously
                          expressed
                          concern in Addiction Treatment Forum (Vol. IV, #2) about the
                          potential interactions of
                          methadone with OTC medications, tobacco, and caffeine. He noted, for
                          example, that
                          acetaminophen (e.g., Excedrin®, Tylenol®) has inherent
                          toxicities which can affect
                          hepatic drug metabolism and impact methadone blood levels.
                          St. Peter and his clinical team have also observed that there are
                          drug metabolism
                          differences between ethnic groups, such as Asians, Caucasians, and
                          African-
                          Americans. Age also plays a role affecting changes in drug
                          metabolism. Other sources
                          have noted that some persons are naturally "aberrant metabolizers"
                          and "burn away"
                          methadone up to four times faster than others. The specific roles of
                          these differences
                          regarding methadone metabolism, however, are still under
                          investigation by the HFA
                          team.
                          There has been some mention, often anecdotally, of grapefruit juice
                          intensifying
                          methadone's effects when the two are regularly taken together.
                          According to
                          Andersen and Payte, grapefruit juice appears to inhibit certain
                          enzymes (CYP-450
                          activity) that metabolize methadone in the liver, thus slowing its
                          breakdown. Hence,
                          higher blood plasma levels of methadone than expected might possibly
                          result. Some
                          sources have attributed naturally high concentrations of flavonoids
                          in grapefruit juice
                          as producing this effect.
                          Contrary to current myth, there is no accepted evidence that orange
                          juice produces
                          similar potentiating effects. However, Payte mentions that large
                          doses of vitamin C
                          (the amount might vary by individual) could create a more acidic
                          urine leading to
                          decreased methadone blood levels. This is because the acidic
                          condition inhibits
                          reabsorption of methadone by the kidneys, so more of the drug is lost
                          in the urine.
                          The plasma half-life of methadone could be reduced to as little as
                          16-20 hours in an
                          acid urine. Conversely, in an alkaline urine (pH 7.8) a half-life of
                          42.1 +/- 8.8 hours
                          has been reported
                          ====================================================

                          I have also read that Tagament can increase the blood concentration
                          of methadone,
                          however, I cannot find any documentation at this moment.
                          Take care,
                          Stephanie
                          NY NAMA
                          http://www.methadone.org
                          ssv55@...
                          Together We Can Make a Difference

                          --- In DOLOPHINEA_CAFE@yahoogroups.com, "Dann White" <dannw87@e...>
                          wrote:

                          > I've heard a million rumors and I don't put a lot of stock in
                          addict chemistry, my
                          wife read in a pamphlet that drinking grapefruit juice (in her case,
                          Tropicana Ruby
                          Red) with your dose makes it climb on quicker. By the way this wasn't
                          a methadone
                          pamphlet it was in general about pain meds
                          > Dann
                          > ----- Original Message -----
                          > From: RG
                          > To: DOLOPHINEA_CAFE@yahoogroups.com
                          > Sent: 1/4/2004 2:46:16 PM
                          > Subject: Re: [METHADONIA ] Re: disket haze
                          > I have heard rumors that eating thirty minutes after your dose and
                          taking
                          > Cimetioine (Tagament) before dosing will increase the blood
                          concentration of
                          > your medicine. Is any of this correct?
                          > Thanks,
                        • James
                          Now there Ms.ssv55 this is indeed some wonderfull news if it s true,I thank you for the post of the month and will give a follow up Sunday and tell all if
                          Message 12 of 15 , Jan 15, 2004
                          • 0 Attachment
                            Now there Ms.ssv55 this is indeed some wonderfull news
                            if it's true,I thank you for the 'post of the month'
                            and will give a follow up Sunday and tell all if
                            indeed this "white grapefruit " advice did in fact
                            work on me !
                            Thanks,
                            Jim/friendlyfarmer2001

                            --- ssv55@... wrote:
                            > Hello Dann and RG,
                            > White grapefruit juice also affects drug metabolism.
                            > Some patients
                            > have had
                            > good results potentiating an inadequate dose by
                            > drinking 8 ozs. of
                            > WHITE
                            > grapefruit juice when dosing. �I found this info at
                            > the following
                            > URL:
                            >
                            > http://www.vhpharmsci.com/document/Article22.htm
                            >
                            > When ingested together, grapefruit juice can
                            > interact with various
                            > medications, resulting in potentially toxic drug
                            > levels and
                            > adverse effects.
                            >
                            > Certain bioflavonoids contained in citrus juices can
                            > affect drug
                            > metabolism.
                            > The major bioflavonoid in grapefruit juice is
                            > naringin, which is
                            > partially metabolized
                            > by enteral bacteria to form naringenin.1,2
                            > Naringenin is a potent
                            > inhibitor of the
                            > cytochrome p450 liver enzymes: CYP1A2, CYP3A3 and
                            > CYP3A4. There is
                            > however,considerable inter-individual variability in
                            > the effects of
                            > grapefruit juice on
                            > drug metabolism, in part due to :
                            > 1) amount of naringenin formed by an individual,
                            > 2) amount of naringin present in a brand of
                            > grapefruit juice,
                            > 3) dilution of grapefruit juice used, and
                            > 4) other substances in grapefruit juice accounting
                            > for the
                            > interaction.
                            >
                            > Table 4 lists drugs whose levels may significantly
                            > increase if given
                            > concomitantly with grapefruit juice. CSU
                            > Pharmaceutical Sciences will
                            > place a label
                            > stating "Do not take with grapefruit juice" if a
                            > patient is ordered
                            > any drug listed
                            > below.
                            >
                            > Table 4. Grapefruit Juice-Drug Interactions
                            >
                            > Drug
                            > � � � � � � � � � � � � � �
                            > � � � � � �
                            > Dihydropyridine Calcium Channel Blockers:
                            > -amlodipine�
                            > -felodipine
                            > -nicardipine
                            > -nifedipine�
                            > AVOID grapefruit juice OR monitor for decreased BP,
                            > increased HR if
                            > taken together
                            >
                            > Terfenadine
                            > AVOID grapefruit juice as may result in
                            > cardiotoxicity (prolonged QT
                            > interval)
                            >
                            > Cyclosporine�
                            > �AVOID grapefruit juice, unless prescribed to
                            > specifically
                            > increase cyclosporine levels
                            >
                            > HMG-CoA Reductase Inhibitors (Statins)�:
                            > -atorvastatin
                            > -cerivastatin
                            > -lovastatin
                            > -simvastatin�
                            > AVOID grapefruit juice as potential for myopathy or
                            > rhabdomyolysis�
                            >
                            > Cisapride�
                            > �AVOID grapefruit juice as potential for
                            > cardiotoxicity (torsades
                            > de pointes, prolonged
                            > QT interval)�
                            >
                            > Benzodiazepines
                            > -triazolam
                            > -oral midazolam�
                            > AVOID grapefruit juice or monitor for increased
                            > sedation if used
                            > together
                            >
                            > Quinidine�
                            > AVOID; significance unknown
                            >
                            > Saquinavir
                            > AVOID; signficance unknown
                            >
                            > Estrogens
                            > -ethinyl estradiol�
                            > -17� estradiol
                            > AVOID - significance unknown
                            > ====================================================
                            > ====================================================
                            >  http://www.atforum.com/pages/current_pastissues
                            > /Vol6s97.html#anchor649123
                            >
                            >
                            >
                            >
                            >
                            >
                            >
                            > OTC Drugs, Juice, Vitamins
                            > John St. Peter, PharmD, BCPS - Pharmacist in Charge
                            > for HFA, and
                            > Assistant Professor,
                            > College of Pharmacy at the University of Minnesota -
                            > has previously
                            > expressed
                            > concern in Addiction Treatment Forum (Vol. IV, #2)
                            > about the
                            > potential interactions of
                            > methadone with OTC medications, tobacco, and
                            > caffeine. He noted, for
                            > example, that
                            > acetaminophen (e.g., Excedrin�, Tylenol�) has
                            > inherent
                            > toxicities which can affect
                            > hepatic drug metabolism and impact methadone blood
                            > levels.
                            > St. Peter and his clinical team have also observed
                            > that there are
                            > drug metabolism
                            > differences between ethnic groups, such as Asians,
                            > Caucasians, and
                            > African-
                            > Americans. Age also plays a role affecting changes
                            > in drug
                            > metabolism. Other sources
                            > have noted that some persons are naturally "aberrant
                            > metabolizers"
                            > and "burn away"
                            > methadone up to four times faster than others. The
                            > specific roles of
                            > these differences
                            > regarding methadone metabolism, however, are still
                            > under
                            > investigation by the HFA
                            > team.
                            > There has been some mention, often anecdotally, of
                            > grapefruit juice
                            > intensifying
                            > methadone's effects when the two are regularly taken
                            > together.
                            > According to
                            > Andersen and Payte, grapefruit juice appears to
                            > inhibit certain
                            > enzymes (CYP-450
                            > activity) that metabolize methadone in the liver,
                            > thus slowing its
                            > breakdown. Hence,
                            > higher blood plasma levels of methadone than
                            > expected might possibly
                            > result. Some
                            > sources have attributed naturally high
                            > concentrations of flavonoids
                            > in grapefruit juice
                            > as producing this effect.
                            > Contrary to current myth, there is no accepted
                            > evidence that orange
                            > juice produces
                            > similar potentiating effects. However, Payte
                            > mentions that large
                            > doses of vitamin C
                            > (the amount might vary by individual) could create a
                            > more acidic
                            > urine leading to
                            > decreased methadone blood levels. This is because
                            > the acidic
                            > condition inhibits
                            > reabsorption of methadone by the kidneys, so more of
                            > the drug is lost
                            > in the urine.
                            > The plasma half-life of methadone could be reduced
                            > to as little as
                            > 16-20 hours in an
                            > acid urine. Conversely, in an alkaline urine (pH
                            > 7.8) a half-life of
                            > 42.1 +/- 8.8 hours
                            > has been reported
                            > ====================================================
                            >
                            > I have also read that Tagament can increase the
                            > blood concentration
                            > of methadone,
                            >
                            === message truncated ===


                            __________________________________
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                            Yahoo! Hotjobs: Enter the "Signing Bonus" Sweepstakes
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                          • Dann White
                            Well my Mrs. certainly must have known what she was talking about-she likes the Ruby Red Tropicana but that is white GF juice with Grape juice added for
                            Message 13 of 15 , Jan 16, 2004
                            • 0 Attachment
                              Well my Mrs. certainly must have known what she was talking about-she likes
                              the Ruby Red Tropicana but that is white GF juice with Grape juice added
                              for color-didn't know such an offhand remark could get such a response

                              Dann and Elizabeth (The Florida Grapefruit Juice Girl)


                              > [Original Message]
                              > From: James <friendlyfarmer2001@...>
                              > To: <DOLOPHINEA_CAFE@yahoogroups.com>
                              > Cc: <friendlyfarmer2001@...>
                              > Date: 1/15/2004 3:39:15 PM
                              > Subject: Re: [METHADONIA ] grapefruit juice and methadone
                              >
                              > Now there Ms.ssv55 this is indeed some wonderfull news
                              > if it's true,I thank you for the 'post of the month'
                              > and will give a follow up Sunday and tell all if
                              > indeed this "white grapefruit " advice did in fact
                              > work on me !
                              > Thanks,
                              > Jim/friendlyfarmer2001
                              >
                              > --- ssv55@... wrote:
                              > > Hello Dann and RG,
                              > > White grapefruit juice also affects drug metabolism.
                              > > Some patients
                              > > have had
                              > > good results potentiating an inadequate dose by
                              > > drinking 8 ozs. of
                              > > WHITE
                              > > grapefruit juice when dosing. �I found this info at
                              > > the following
                              > > URL:
                              > >
                              > > http://www.vhpharmsci.com/document/Article22.htm
                              > >
                              > > When ingested together, grapefruit juice can
                              > > interact with various
                              > > medications, resulting in potentially toxic drug
                              > > levels and
                              > > adverse effects.
                              > >
                              > > Certain bioflavonoids contained in citrus juices can
                              > > affect drug
                              > > metabolism.
                              > > The major bioflavonoid in grapefruit juice is
                              > > naringin, which is
                              > > partially metabolized
                              > > by enteral bacteria to form naringenin.1,2
                              > > Naringenin is a potent
                              > > inhibitor of the
                              > > cytochrome p450 liver enzymes: CYP1A2, CYP3A3 and
                              > > CYP3A4. There is
                              > > however,considerable inter-individual variability in
                              > > the effects of
                              > > grapefruit juice on
                              > > drug metabolism, in part due to :
                              > > 1) amount of naringenin formed by an individual,
                              > > 2) amount of naringin present in a brand of
                              > > grapefruit juice,
                              > > 3) dilution of grapefruit juice used, and
                              > > 4) other substances in grapefruit juice accounting
                              > > for the
                              > > interaction.
                              > >
                              > > Table 4 lists drugs whose levels may significantly
                              > > increase if given
                              > > concomitantly with grapefruit juice. CSU
                              > > Pharmaceutical Sciences will
                              > > place a label
                              > > stating "Do not take with grapefruit juice" if a
                              > > patient is ordered
                              > > any drug listed
                              > > below.
                              > >
                              > > Table 4. Grapefruit Juice-Drug Interactions
                              > >
                              > > Drug
                              > > � � � � � � � � � � � � � �
                              > > � � � � � �
                              > > Dihydropyridine Calcium Channel Blockers:
                              > > -amlodipine�
                              > > -felodipine
                              > > -nicardipine
                              > > -nifedipine�
                              > > AVOID grapefruit juice OR monitor for decreased BP,
                              > > increased HR if
                              > > taken together
                              > >
                              > > Terfenadine
                              > > AVOID grapefruit juice as may result in
                              > > cardiotoxicity (prolonged QT
                              > > interval)
                              > >
                              > > Cyclosporine�
                              > > �AVOID grapefruit juice, unless prescribed to
                              > > specifically
                              > > increase cyclosporine levels
                              > >
                              > > HMG-CoA Reductase Inhibitors (Statins)�:
                              > > -atorvastatin
                              > > -cerivastatin
                              > > -lovastatin
                              > > -simvastatin�
                              > > AVOID grapefruit juice as potential for myopathy or
                              > > rhabdomyolysis�
                              > >
                              > > Cisapride�
                              > > �AVOID grapefruit juice as potential for
                              > > cardiotoxicity (torsades
                              > > de pointes, prolonged
                              > > QT interval)�
                              > >
                              > > Benzodiazepines
                              > > -triazolam
                              > > -oral midazolam�
                              > > AVOID grapefruit juice or monitor for increased
                              > > sedation if used
                              > > together
                              > >
                              > > Quinidine�
                              > > AVOID; significance unknown
                              > >
                              > > Saquinavir
                              > > AVOID; signficance unknown
                              > >
                              > > Estrogens
                              > > -ethinyl estradiol�
                              > > -17� estradiol
                              > > AVOID - significance unknown
                              > > ====================================================
                              > > ====================================================
                              > >  http://www.atforum.com/pages/current_pastissues
                              > > /Vol6s97.html#anchor649123
                              > >
                              > >
                              > >
                              > >
                              > >
                              > >
                              > >
                              > > OTC Drugs, Juice, Vitamins
                              > > John St. Peter, PharmD, BCPS - Pharmacist in Charge
                              > > for HFA, and
                              > > Assistant Professor,
                              > > College of Pharmacy at the University of Minnesota -
                              > > has previously
                              > > expressed
                              > > concern in Addiction Treatment Forum (Vol. IV, #2)
                              > > about the
                              > > potential interactions of
                              > > methadone with OTC medications, tobacco, and
                              > > caffeine. He noted, for
                              > > example, that
                              > > acetaminophen (e.g., Excedrin�, Tylenol�) has
                              > > inherent
                              > > toxicities which can affect
                              > > hepatic drug metabolism and impact methadone blood
                              > > levels.
                              > > St. Peter and his clinical team have also observed
                              > > that there are
                              > > drug metabolism
                              > > differences between ethnic groups, such as Asians,
                              > > Caucasians, and
                              > > African-
                              > > Americans. Age also plays a role affecting changes
                              > > in drug
                              > > metabolism. Other sources
                              > > have noted that some persons are naturally "aberrant
                              > > metabolizers"
                              > > and "burn away"
                              > > methadone up to four times faster than others. The
                              > > specific roles of
                              > > these differences
                              > > regarding methadone metabolism, however, are still
                              > > under
                              > > investigation by the HFA
                              > > team.
                              > > There has been some mention, often anecdotally, of
                              > > grapefruit juice
                              > > intensifying
                              > > methadone's effects when the two are regularly taken
                              > > together.
                              > > According to
                              > > Andersen and Payte, grapefruit juice appears to
                              > > inhibit certain
                              > > enzymes (CYP-450
                              > > activity) that metabolize methadone in the liver,
                              > > thus slowing its
                              > > breakdown. Hence,
                              > > higher blood plasma levels of methadone than
                              > > expected might possibly
                              > > result. Some
                              > > sources have attributed naturally high
                              > > concentrations of flavonoids
                              > > in grapefruit juice
                              > > as producing this effect.
                              > > Contrary to current myth, there is no accepted
                              > > evidence that orange
                              > > juice produces
                              > > similar potentiating effects. However, Payte
                              > > mentions that large
                              > > doses of vitamin C
                              > > (the amount might vary by individual) could create a
                              > > more acidic
                              > > urine leading to
                              > > decreased methadone blood levels. This is because
                              > > the acidic
                              > > condition inhibits
                              > > reabsorption of methadone by the kidneys, so more of
                              > > the drug is lost
                              > > in the urine.
                              > > The plasma half-life of methadone could be reduced
                              > > to as little as
                              > > 16-20 hours in an
                              > > acid urine. Conversely, in an alkaline urine (pH
                              > > 7.8) a half-life of
                              > > 42.1 +/- 8.8 hours
                              > > has been reported
                              > > ====================================================
                              > >
                              > > I have also read that Tagament can increase the
                              > > blood concentration
                              > > of methadone,
                              > >
                              > === message truncated ===
                              >
                              >
                              > __________________________________
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                            • odubya
                              Hey Folks~ While we are finsihing up with this topic I felt I might as well contribute some more that has to do with the subject of affecting your dose
                              Message 14 of 15 , Jan 19, 2004
                              • 0 Attachment
                                Hey Folks~ While we are finsihing up with this topic I felt I might
                                as well contribute some more that has to do with the subject of
                                affecting your dose positively..( that IS the point of this, isn't
                                it?) OH, and a very special thanks to the poster who put all the
                                technical information about this on the board. There's a soul close
                                to my heart! OK, since almost the onset of mmt I heard about Tagamet
                                (Cimethedine) affecting your dose. When someone I know was refused a
                                needed increase in their methadone they started taking these on a
                                daily basis. They DO increase the strength of your dose from my
                                experience. Each person is different but they were taking 10 tablets
                                15 minutes before dosing. That was probably more than enough. When
                                they first started taking them they had different effects depending
                                on the time they took them. Sometimes they got sleepy if they took
                                them too early or too late. But that went away with time. The only
                                negative effect they got from taking all these was it messed with
                                their blood cell levels. THis was found out from a blood test. They
                                finally got the increase and didn't have to take them anymore and
                                everything returned to normal(as far as the blood cells) So this does
                                work but the timing and amount will change from person to
                                person..Just use caution as with everything..Have a great day! OW




                                --- In DOLOPHINEA_CAFE@yahoogroups.com, "Dann White" <dannw87@e...>
                                wrote:
                                > Well my Mrs. certainly must have known what she was talking about-
                                she likes
                                > the Ruby Red Tropicana but that is white GF juice with Grape juice
                                added
                                > for color-didn't know such an offhand remark could get such a
                                response
                                >
                                > Dann and Elizabeth (The Florida Grapefruit Juice Girl)
                                >
                                >
                                > > [Original Message]
                                > > From: James <friendlyfarmer2001@y...>
                                > > To: <DOLOPHINEA_CAFE@yahoogroups.com>
                                > > Cc: <friendlyfarmer2001@y...>
                                > > Date: 1/15/2004 3:39:15 PM
                                > > Subject: Re: [METHADONIA ] grapefruit juice and methadone
                                > >
                                > > Now there Ms.ssv55 this is indeed some wonderfull news
                                > > if it's true,I thank you for the 'post of the month'
                                > > and will give a follow up Sunday and tell all if
                                > > indeed this "white grapefruit " advice did in fact
                                > > work on me !
                                > > Thanks,
                                > > Jim/friendlyfarmer2001
                                > >
                                > > --- ssv55@e... wrote:
                                > > > Hello Dann and RG,
                                > > > White grapefruit juice also affects drug metabolism.
                                > > > Some patients
                                > > > have had
                                > > > good results potentiating an inadequate dose by
                                > > > drinking 8 ozs. of
                                > > > WHITE
                                > > > grapefruit juice when dosing.  I found this info at
                                > > > the following
                                > > > URL:
                                > > >
                                > > > http://www.vhpharmsci.com/document/Article22.htm
                                > > >
                                > > > When ingested together, grapefruit juice can
                                > > > interact with various
                                > > > medications, resulting in potentially toxic drug
                                > > > levels and
                                > > > adverse effects.
                                > > >
                                > > > Certain bioflavonoids contained in citrus juices can
                                > > > affect drug
                                > > > metabolism.
                                > > > The major bioflavonoid in grapefruit juice is
                                > > > naringin, which is
                                > > > partially metabolized
                                > > > by enteral bacteria to form naringenin.1,2
                                > > > Naringenin is a potent
                                > > > inhibitor of the
                                > > > cytochrome p450 liver enzymes: CYP1A2, CYP3A3 and
                                > > > CYP3A4. There is
                                > > > however,considerable inter-individual variability in
                                > > > the effects of
                                > > > grapefruit juice on
                                > > > drug metabolism, in part due to :
                                > > > 1) amount of naringenin formed by an individual,
                                > > > 2) amount of naringin present in a brand of
                                > > > grapefruit juice,
                                > > > 3) dilution of grapefruit juice used, and
                                > > > 4) other substances in grapefruit juice accounting
                                > > > for the
                                > > > interaction.
                                > > >
                                > > > Table 4 lists drugs whose levels may significantly
                                > > > increase if given
                                > > > concomitantly with grapefruit juice. CSU
                                > > > Pharmaceutical Sciences will
                                > > > place a label
                                > > > stating "Do not take with grapefruit juice" if a
                                > > > patient is ordered
                                > > > any drug listed
                                > > > below.
                                > > >
                                > > > Table 4. Grapefruit Juice-Drug Interactions
                                > > >
                                > > > Drug
                                > > >                            
                                > > >            
                                > > > Dihydropyridine Calcium Channel Blockers:
                                > > > -amlodipine†
                                > > > -felodipine
                                > > > -nicardipine
                                > > > -nifedipine†
                                > > > AVOID grapefruit juice OR monitor for decreased BP,
                                > > > increased HR if
                                > > > taken together
                                > > >
                                > > > Terfenadine
                                > > > AVOID grapefruit juice as may result in
                                > > > cardiotoxicity (prolonged QT
                                > > > interval)
                                > > >
                                > > > Cyclosporine†
                                > > >  AVOID grapefruit juice, unless prescribed to
                                > > > specifically
                                > > > increase cyclosporine levels
                                > > >
                                > > > HMG-CoA Reductase Inhibitors (Statins)‡:
                                > > > -atorvastatin
                                > > > -cerivastatin
                                > > > -lovastatin
                                > > > -simvastatin†
                                > > > AVOID grapefruit juice as potential for myopathy or
                                > > > rhabdomyolysis¶
                                > > >
                                > > > Cisapride†
                                > > >  AVOID grapefruit juice as potential for
                                > > > cardiotoxicity (torsades
                                > > > de pointes, prolonged
                                > > > QT interval)¶
                                > > >
                                > > > Benzodiazepines
                                > > > -triazolam
                                > > > -oral midazolam†
                                > > > AVOID grapefruit juice or monitor for increased
                                > > > sedation if used
                                > > > together
                                > > >
                                > > > Quinidine†
                                > > > AVOID; significance unknown
                                > > >
                                > > > Saquinavir
                                > > > AVOID; signficance unknown
                                > > >
                                > > > Estrogens
                                > > > -ethinyl estradiol†
                                > > > -17ß estradiol
                                > > > AVOID - significance unknown
                                > > > ====================================================
                                > > > ====================================================
                                > > >  http://www.atforum.com/pages/current_pastissues
                                > > > /Vol6s97.html#anchor649123
                                > > >
                                > > >
                                > > >
                                > > >
                                > > >
                                > > >
                                > > >
                                > > > OTC Drugs, Juice, Vitamins
                                > > > John St. Peter, PharmD, BCPS - Pharmacist in Charge
                                > > > for HFA, and
                                > > > Assistant Professor,
                                > > > College of Pharmacy at the University of Minnesota -
                                > > > has previously
                                > > > expressed
                                > > > concern in Addiction Treatment Forum (Vol. IV, #2)
                                > > > about the
                                > > > potential interactions of
                                > > > methadone with OTC medications, tobacco, and
                                > > > caffeine. He noted, for
                                > > > example, that
                                > > > acetaminophen (e.g., Excedrin®, Tylenol®) has
                                > > > inherent
                                > > > toxicities which can affect
                                > > > hepatic drug metabolism and impact methadone blood
                                > > > levels.
                                > > > St. Peter and his clinical team have also observed
                                > > > that there are
                                > > > drug metabolism
                                > > > differences between ethnic groups, such as Asians,
                                > > > Caucasians, and
                                > > > African-
                                > > > Americans. Age also plays a role affecting changes
                                > > > in drug
                                > > > metabolism. Other sources
                                > > > have noted that some persons are naturally "aberrant
                                > > > metabolizers"
                                > > > and "burn away"
                                > > > methadone up to four times faster than others. The
                                > > > specific roles of
                                > > > these differences
                                > > > regarding methadone metabolism, however, are still
                                > > > under
                                > > > investigation by the HFA
                                > > > team.
                                > > > There has been some mention, often anecdotally, of
                                > > > grapefruit juice
                                > > > intensifying
                                > > > methadone's effects when the two are regularly taken
                                > > > together.
                                > > > According to
                                > > > Andersen and Payte, grapefruit juice appears to
                                > > > inhibit certain
                                > > > enzymes (CYP-450
                                > > > activity) that metabolize methadone in the liver,
                                > > > thus slowing its
                                > > > breakdown. Hence,
                                > > > higher blood plasma levels of methadone than
                                > > > expected might possibly
                                > > > result. Some
                                > > > sources have attributed naturally high
                                > > > concentrations of flavonoids
                                > > > in grapefruit juice
                                > > > as producing this effect.
                                > > > Contrary to current myth, there is no accepted
                                > > > evidence that orange
                                > > > juice produces
                                > > > similar potentiating effects. However, Payte
                                > > > mentions that large
                                > > > doses of vitamin C
                                > > > (the amount might vary by individual) could create a
                                > > > more acidic
                                > > > urine leading to
                                > > > decreased methadone blood levels. This is because
                                > > > the acidic
                                > > > condition inhibits
                                > > > reabsorption of methadone by the kidneys, so more of
                                > > > the drug is lost
                                > > > in the urine.
                                > > > The plasma half-life of methadone could be reduced
                                > > > to as little as
                                > > > 16-20 hours in an
                                > > > acid urine. Conversely, in an alkaline urine (pH
                                > > > 7.8) a half-life of
                                > > > 42.1 +/- 8.8 hours
                                > > > has been reported
                                > > > ====================================================
                                > > >
                                > > > I have also read that Tagament can increase the
                                > > > blood concentration
                                > > > of methadone,
                                > > >
                                > > === message truncated ===
                                > >
                                > >
                                > > __________________________________
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                              • gertrude gandala
                                I guess ssv55@earthlink.net wrote:Hello Dann and RG, White grapefruit juice also affects drug metabolism. Some patients have had good results potentiating an
                                Message 15 of 15 , Feb 25, 2004
                                • 0 Attachment
                                  I guess

                                  ssv55@... wrote:Hello Dann and RG,
                                  White grapefruit juice also affects drug metabolism. Some patients
                                  have had
                                  good results potentiating an inadequate dose by drinking 8 ozs. of
                                  WHITE
                                  grapefruit juice when dosing. I found this info at the following
                                  URL:

                                  http://www.vhpharmsci.com/document/Article22.htm

                                  When ingested together, grapefruit juice can interact with various
                                  medications, resulting in potentially toxic drug levels and
                                  adverse effects.

                                  Certain bioflavonoids contained in citrus juices can affect drug
                                  metabolism.
                                  The major bioflavonoid in grapefruit juice is naringin, which is
                                  partially metabolized
                                  by enteral bacteria to form naringenin.1,2 Naringenin is a potent
                                  inhibitor of the
                                  cytochrome p450 liver enzymes: CYP1A2, CYP3A3 and CYP3A4. There is
                                  however,considerable inter-individual variability in the effects of
                                  grapefruit juice on
                                  drug metabolism, in part due to :
                                  1) amount of naringenin formed by an individual,
                                  2) amount of naringin present in a brand of grapefruit juice,
                                  3) dilution of grapefruit juice used, and
                                  4) other substances in grapefruit juice accounting for the
                                  interaction.

                                  Table 4 lists drugs whose levels may significantly increase if given
                                  concomitantly with grapefruit juice. CSU Pharmaceutical Sciences will
                                  place a label
                                  stating "Do not take with grapefruit juice" if a patient is ordered
                                  any drug listed
                                  below.

                                  Table 4. Grapefruit Juice-Drug Interactions

                                  Drug


                                  Dihydropyridine Calcium Channel Blockers:
                                  -amlodipine�
                                  -felodipine
                                  -nicardipine
                                  -nifedipine�
                                  AVOID grapefruit juice OR monitor for decreased BP, increased HR if
                                  taken together

                                  Terfenadine
                                  AVOID grapefruit juice as may result in cardiotoxicity (prolonged QT
                                  interval)

                                  Cyclosporine�
                                  AVOID grapefruit juice, unless prescribed to specifically
                                  increase cyclosporine levels

                                  HMG-CoA Reductase Inhibitors (Statins)�:
                                  -atorvastatin
                                  -cerivastatin
                                  -lovastatin
                                  -simvastatin�
                                  AVOID grapefruit juice as potential for myopathy or
                                  rhabdomyolysis�

                                  Cisapride�
                                  AVOID grapefruit juice as potential for cardiotoxicity (torsades
                                  de pointes, prolonged
                                  QT interval)�

                                  Benzodiazepines
                                  -triazolam
                                  -oral midazolam�
                                  AVOID grapefruit juice or monitor for increased sedation if used
                                  together

                                  Quinidine�
                                  AVOID; significance unknown

                                  Saquinavir
                                  AVOID; signficance unknown

                                  Estrogens
                                  -ethinyl estradiol�
                                  -17� estradiol
                                  AVOID - significance unknown
                                  ====================================================
                                  ====================================================
                                   http://www.atforum.com/pages/current_pastissues
                                  /Vol6s97.html#anchor649123



                                  OTC Drugs, Juice, Vitamins
                                  John St. Peter, PharmD, BCPS - Pharmacist in Charge for HFA, and
                                  Assistant Professor,
                                  College of Pharmacy at the University of Minnesota - has previously
                                  expressed
                                  concern in Addiction Treatment Forum (Vol. IV, #2) about the
                                  potential interactions of
                                  methadone with OTC medications, tobacco, and caffeine. He noted, for
                                  example, that
                                  acetaminophen (e.g., Excedrin�, Tylenol�) has inherent
                                  toxicities which can affect
                                  hepatic drug metabolism and impact methadone blood levels.
                                  St. Peter and his clinical team have also observed that there are
                                  drug metabolism
                                  differences between ethnic groups, such as Asians, Caucasians, and
                                  African-
                                  Americans. Age also plays a role affecting changes in drug
                                  metabolism. Other sources
                                  have noted that some persons are naturally "aberrant metabolizers"
                                  and "burn away"
                                  methadone up to four times faster than others. The specific roles of
                                  these differences
                                  regarding methadone metabolism, however, are still under
                                  investigation by the HFA
                                  team.
                                  There has been some mention, often anecdotally, of grapefruit juice
                                  intensifying
                                  methadone's effects when the two are regularly taken together.
                                  According to
                                  Andersen and Payte, grapefruit juice appears to inhibit certain
                                  enzymes (CYP-450
                                  activity) that metabolize methadone in the liver, thus slowing its
                                  breakdown. Hence,
                                  higher blood plasma levels of methadone than expected might possibly
                                  result. Some
                                  sources have attributed naturally high concentrations of flavonoids
                                  in grapefruit juice
                                  as producing this effect.
                                  Contrary to current myth, there is no accepted evidence that orange
                                  juice produces
                                  similar potentiating effects. However, Payte mentions that large
                                  doses of vitamin C
                                  (the amount might vary by individual) could create a more acidic
                                  urine leading to
                                  decreased methadone blood levels. This is because the acidic
                                  condition inhibits
                                  reabsorption of methadone by the kidneys, so more of the drug is lost
                                  in the urine.
                                  The plasma half-life of methadone could be reduced to as little as
                                  16-20 hours in an
                                  acid urine. Conversely, in an alkaline urine (pH 7.8) a half-life of
                                  42.1 +/- 8.8 hours
                                  has been reported
                                  ====================================================

                                  I have also read that Tagament can increase the blood concentration
                                  of methadone,
                                  however, I cannot find any documentation at this moment.
                                  Take care,
                                  Stephanie
                                  NY NAMA
                                  http://www.methadone.org
                                  ssv55@...
                                  Together We Can Make a Difference

                                  --- In DOLOPHINEA_CAFE@yahoogroups.com, "Dann White" <dannw87@e...>
                                  wrote:

                                  > I've heard a million rumors and I don't put a lot of stock in
                                  addict chemistry, my
                                  wife read in a pamphlet that drinking grapefruit juice (in her case,
                                  Tropicana Ruby
                                  Red) with your dose makes it climb on quicker. By the way this wasn't
                                  a methadone
                                  pamphlet it was in general about pain meds
                                  > Dann
                                  > ----- Original Message -----
                                  > From: RG
                                  > To: DOLOPHINEA_CAFE@yahoogroups.com
                                  > Sent: 1/4/2004 2:46:16 PM
                                  > Subject: Re: [METHADONIA ] Re: disket haze
                                  > I have heard rumors that eating thirty minutes after your dose and
                                  taking
                                  > Cimetioine (Tagament) before dosing will increase the blood
                                  concentration of
                                  > your medicine. Is any of this correct?
                                  > Thanks,


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