Buprenex Taper Schedule

Hi there.  I have been taking buprenex for about 6 months.  I need to taper down because I am having surgery for another reason.  I will require other pain mediations at that time and I understand the buprenex will interfere with the effectiveness of other opiates.  I am currently taking only 2mgs per day.  MY surgery is in 3 weeks.  Any advice on a taper schedule would be great.  Thanks in advance.

[hellc@mst]

i woulnt bother tapering for 3 weeks.the naloxone in bupe is minute and is only there to prevent snorting shooting.when u stop u will feel  able to enjoy the full effects of any opioid painkiller within 24hrs usually much sooner even.so a three week taper to ensure u will recieve pain relief is unneccesary.talk with a doc about it tho but in hospitals where pain patients are routinely transfered from one opioid 2 another im sure they dont leave them hanging in pain to make sure they dont precipitate wd.

[hellc@mst]

if so and so was hooked on bupe and that person decided to mix some other opiate  on top of bupe with its mixed agonist/antagonist actions they would feel no adverse reaction.no precipitated wd via this route.caution needs to b applied when done in reverse ie opiate to a bupe addict.bupe without narcan in addition to another opiate will get u smashed(even with mixd agonist/antagonist effect.bupe given to a heavy opiate addict will precipitate wd whetheq suboxone or subutex.

[abrahamlee]

I thought so too. I thought it was the ability of the bupe to bind to the receptors before anything else could get to them.  As I understand it has a half life of 36 hours.  So i'm wondering if 24 hours might be cutting it close. Maybe I don't need to taper for the entire three weeks but just for the last couple of days??

[hellc@mst]

buprenorphine is a mixed agonist/antagonists and it has phsycoactive affinity for 2 of the 3 endorphine receptor sites(at therapeutic doses).naloxone is a full agonist and has a non phsycoactive affinity with all three. endorphine receptor sites.these are the delta,kappa and mu receptors.bc the naloxone in bupe is tiny and it has a poor oral bioavalability it is unlikely after a few hours to hav ne substantial blocking effect on other opiates.
regards J

[hellc@mst]

bupe is a Mixed agonist/antagonist.this means that of the 3 main endorphine receptors it has a hi phsycoactive affinity with 2 of them(kappa,mu?)naloxone,a full agonist has a non phsycoactive affinity with all 3 receptors.fortunately naloxone has poor bio availability and a short(1-2)hours.so if u take these variable into accnt.of course u can feel other opiates.come on guys.research,research,research.

[hellc@mst]

please disregard my comments.i honestly think dtoxing off of the 4mgs of bupe is the best option if u want adequate pain relief after yr surgery.bupe antagonist properties can b overridden with enuff opioids but this is unsafe and ill advised.its possible since yr on a low dose that they may even use higher doses of subutex to treat yr pain.talk with a doc.this is best.i wish i could dlete my other posts.good luck
regards J

[lil_rab2005]

It was definitely the thought that counts and the support is always helpful.  It always helps me just to hear a response sometimes it doesn't matter what the response is, it's just nice to know that someone cares enough to post back.  Take care and god bless u, Lil.

[abrahamlee]

Thank you for your input. It is appreciated.  I am not concerned about withdrawals . I know that is only possible going from another opiate to the bupe.  also to clarify, I am taking straight buprenorphine, no naloxone in the mix.  I am taking 2mgs. daily- not a whole lot. My concern is that the bupe has the high affinity for binding AND has a long half life.  For instance, I was on a similar dose, stopped about 24hrs ago, had a root canal, and it took a BUNCH of vicodin to get any relief.  I do not want to have the same situation after this surgery.  If I should taper, how should I do it. My doc hasnt' been very helpful in the area. Thanks again.