BlackCat
Old Hand
Reged: 09/22/03
Posts: 403
Loc: Bed
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In preparing for a 3 week hydro/oxy holiday, I bought several boxes of generic Immodium online for a very good price. (96 2mg capsules to a box).
I recall reading on here a while ago that one person with severe withdrawals coming off alot of hydro took 25mg (12 capsules) of Immodium 3 times per day to help their withdrawal symptoms.
I also remember some people questioning that dosage level, but don't recall any other experience or alternative suggestions.
What is the Immodium dosing others have used or read or heard about that will help alleviate w/d pains to make things go easier.
I have Xanax, Ultram, Sonata and am able to prescribe 3 weeks of bed rest for myself, so this is my last question before I plan the tapering schedule.
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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It really depends on your tolerance and how opiates affect your bowls individually. Some people may be fine with 3-4 Immodium every 4-6 hours, others need 10 of them every 3-4 hours.
I would titrate your dosage based on your tolerance, you're not going to hurt yourself with Immodium (unless you dramatically overdo it and get excessive constipation, but I doubt that will be the case).
To give you some idea, if you were taking hypothetically 40 mg 3 times a day of hydro, I'd suggest starting with 5-6 in a dose and seeing how you react, then adjust accordingly.
Good luck.
-yawkaw
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johng
Board Addict
Reged: 02/13/03
Posts: 355
Loc: great lakes
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from what I have done was 12 mg 2-3 times a day. Very important to drink plenty of water......
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Ask and it will be given to you Matthew 7:7
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Fiver
Member
Reged: 10/02/03
Posts: 104
Loc: Michigan
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BlackCat, it sounds like you've planned this out very well, especially with the Sonata for sleep and Xanax to take the edge off and hopefully keep your blood pressure down. The only thing I would mention is a reminder of the inevitable depression that's gonna hit you when you no longer have opiates in your system. I would add a B-Complex vitamin, especially B-6 and also an amino acid, L-Tyrosine which can be bought at GNC or Wal-Mart, K-Mart or similar places. The majority of folks who stop taking opiates after a long period of time (that is, long enough to require a taper) say that the physical withdrawal is the easy part; it's the mental part that bites you in the fanny. Please remember that just because you might jones for it doesn't mean you're a weak person - it just means your endorphins aren't back up to speed yet.
Good luck, BC, I wish you all the best.
-Fiver
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shadowrose40
Stranger
Reged: 10/23/03
Posts: 21
Loc: NC
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HI
Do you realize that you are risking an overdose with the ammounts of immodium you are discussing?
Immodium is a CNS depressant- too much can cause CNS problems as well as vomiting.
The Physicians Desk Reference even recommends that a person be monitored for 24 hours due to the potential CNS effects. It says that no more than 4 caplets per day be taken, and then for only two days.
There are safer ways to avoid withdrawl- taper off the med slowly.
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Please help promote fibromyalgia awareness. Visit http://www.fibrofoglights.org today 
Edited by shadowrose40 (11/06/03 04:19 PM)
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BlackCat
Old Hand
Reged: 09/22/03
Posts: 403
Loc: Bed
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Thanks Fiver - I've got things pretty well prepared and even have the anti-depressant covered (Zoloft) that I've been on and plan to start increasing 4 weeks prior. (I have to do this when I have time alone with no responsibilities or people around who don't know how bad this could be).
In terms of the other post about overdosing on Immodium, Yawkaw3 seems to think I won't have any trouble as long as I start with minimum doses like 5-6 caplets (10-12 mg) a few times a day and build from there depending upon the effect if needed.
The maximum of 4, 2mg caplets in a 24 hour period is also printed on a box I have as the officially quoted maximum for diareah relief. Since I'm not taking it for this, and taking it for other w/d symptom relief (other than diareah), I've been told to take much more than this recommended max. of 4 tabs per 24 hrs.
What kind of side effects could you get from too much Immodium for a few weeks anyway? I guess I'll have to use natural laxatives, fiber and stool softener and drink alot of water, but anything else? Do you know Yawkaw3?
Bottom line, I take way more hydro, oxy and apap than is "officially recommended" and I view taking alot of Immodium to help with RLS or other symptoms for a short period of time to be a much lesser evil than the hydro, oxy, APAP overdosing.
I'm also open to hearing other personal experiences with Immodium when coming off hydro and/or oxy. (Doses, etc. and what sorts of things it helps with.)
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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Be careful with the PDR, it lists every possible thing that occurred to anyone during the clinical trials of the drug.
A person with a tolerance to opiates does not have to worry about OD'ing on Immodium. If you can handle over 50 mg of hydro per day, which is not much, then you can handle any dose of Immodium you would consider taking and then some.
BlackCat,
How well Immodium will work for you depends on the length and size of your habit. It really works best for the gastrointestinal withdrawal symptoms, it will give you normal bowel movements and alleviate the stomach cramps to some extent. That is mainly what I have found it to be effective for. As far as the other symptoms go, that is really an individual thing, for some people it does work, though it hasn't for me.
In your case, I think Immodium will work for the gastrointestinal withdrawal, and the Ultram is your best bet for the other withdrawal.
A better drug for withdrawal is Lomotil. You can ask for it by name from a doctor and tell them that you've taken it before for episodes of diarrhea. You just need to say you have bad diarrhea, and agree to give a stool sample even if you don't end up doing it. Refill the Lomotil as many times as you can. There is some more info about it on the boards, but a quick FYI, it contains a Demerol analog, diphenoxylate. It will bring the gastrointestinal withdrawal symptoms to a standstill, and it is effective for other withdrawal symptoms as well... but if you take enough to do that, you won't be having a bowel movement for a looong time. Keep in mind there is also atropine in it, so know how that affects you before adjusting your dosage too quickly (all it's ever done to me was give me a headache and make my eyes glassy, other people can have worse reactions).
If you are taking high doses to relieve the physical withdrawal, then you will need some kind of stool softener. I'd suggest Metamucil or Citrucel. They are really not that bad and they do work, when I take it I end up with one big bowel movement in the morning, and that's it. Water is important, but what is more important is maintaing a healthy electrolyte balance. Gatorade or Pedialyte will help with that, basically you want normal levels of potassium and fluids to prevent dehydration.
If you are going out shopping to add to your detox kit, you may also want to add:
-Some bottles of Ensure or another liquid meal. That way you will still be getting your nutrients even if you can't stand the sight of food.
-Advil/Aleve/Orudis KT plus any creams or gels that are effective for your type of pain.
-Rent a bunch of comedies and buy some magazines so the boredom does not eat you alive. Your mood is so much more labile during withdrawal, you really need to stick with comedies.
-Cola Syrup/Ginger Ale/Emetrol/whatever works for nausea for you.
-Multivitamins if you don't already take them, now is a good time to start. Also if you have been overdoing the APAP lately, some milk thistle may be a smart idea. There are a variety of other herbs and vitamins individual people have found helpful, though I've never tried myself. L-Tyrosine, Phenylalanine (but make sure you buy the right isomer, I forget if D-, L-, or racemic is what you want), a ton of others I'm not familiar with.
-Porn
It sounds like you are well-prepared and will make this as painless as possible. What has always helped me during withdrawal is to remember that what I am feeling and thinking is not me, it is the effect of the opiates leaving my brain, and not to take anything negative/depressing that I think/feel seriously.
Good luck and feel free to PM me if you want to talk in private.
-yawkaw
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shadowrose40
Stranger
Reged: 10/23/03
Posts: 21
Loc: NC
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Hi
I fully understand that one can take 'more' than recommended on any medication without ill effects SOMETIMES.
But CNS depression is nothing to ignore. The person asked what could happen.
Easy answer: DEATH
It's just plain risky- when tapering is a much more reasonable alternative and a whole heck of a lot safer!
If one stops the intestinal tract from operating properly- you risk the chance of obstruction (which in and of itself can be fatal)
As an EMT, I've been to way too many OD's not to inject a little caution here.
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Please help promote fibromyalgia awareness. Visit http://www.fibrofoglights.org today
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TwG
Journeyman
Reged: 06/17/02
Posts: 68
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I have never heard of Immodium being a CNS depressant, it doesn't pass thru the blood/brain barrier which is why it doesn't work as a pain medication or a recreational drug. Also, Immodium doesn't work very well for detox, it is only good if you have a very low tolerence.
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DaggerEyez
Journeyman
Reged: 10/18/02
Posts: 50
Loc: USA
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I read somewhere that the liquid Immodium is better...
It is more expensive too.
Sorry I can't recall why... I just remember reading it in a thread.
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CeeBee
Member
Reged: 08/09/03
Posts: 186
Loc: garden state
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Black Cat, i read your post with great interest, as I feel I use way too much hydro also, and while I am not stopping completely, I am cutting way, way back starting tomorrow and am dreading it. I guess Immodium could help me also. Is it only for the cramping and pains in the stomach? I really don't have all those things on hand that you mentioned, just some clonezepam. So I guess i will try some Immodium (liquid Daggereze suggests). But good luck to you I hope you will be as comfortable as possible. 
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Harsl
Stranger
Reged: 05/14/03
Posts: 2
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Hello,
Newbie here. Also detoxed off hydro(pretty high doses) 3 times in past year. Also happen to be a RN. The imodium is basically for the diarrhea that accompanies the symptoms of withdrawl. There have been studies with monkeys addicted to morphine, and at very high levels may decrease sypmotoms of withdrawl, but you just gotta be careful with too high of a dose. Is there anyway to get some clonidine tabs?? That helped me the most, and I only used imodium for about 3-4 days max. Good Luck!!!
Harsl
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airman007
Stranger
Reged: 10/05/03
Posts: 13
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I usually just take 2-3 Immodiums every 4-6 hours as needed along with Ibuprofen or apap for the inevitable aches and pains you will be feeling during your hydro holiday. It's no picnic but it's really not as bad as most folks make it out to be. Keeping your mental spirits up is important. I usually feel pretty rough for the first few days, after 3 days usually start feeling better each day and by day 5 or 6 It's pretty much over. The nice thing about it is after cleaning yourself out your tolerance will be lower and the meds will work better again for awhile. Prayer and meditation along with hot baths or showers also seems to help. Good luck
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Shadow-
If you read in that PDR about any opiate medication, you will see something in there about standard dosages...the problem with "standard" doses for these types of medications is that people develop tolerance. For example, my high dose of methadone would have been lethal many times over to a non-tolerant adult male, yet I could take it without blinking. Most drugs are toxic at some dose, but it completely depends on the person using it.
PDRs are great resources, but drug manufacturers have culpability for the drugs they produce and must, therefore, list any problems during clinical trials. As always, the intent is to use the least amount of any medication to produce the desired results.
I'm certainly not trying to berate you, just wanted you to consider it from this perspective.
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Never underestimate the predictability of stupidity.
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shockstrap723
Stranger
Reged: 06/03/02
Posts: 8
Loc: usa
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Airman's experience is very close to mine, although it took 15-17 tabs of Immodium 3x day for the first 3 days to be able to go to work. Then I tapered off the Immodium. 2-3x the recommended does of DXM Robotussin (Cough only!) helps with the mental cravings alot. Don't take the Immodium after 6pm and the next morning you'll have a BM, for sure.
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BlackCat
Old Hand
Reged: 09/22/03
Posts: 403
Loc: Bed
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Thanks for all the help and info. above and beyond the immodium input I requested. I have a very high tolerance and take well beyond what any PDR would say for hydro limits. 
I'm gathering info., meds & supplements during November and reading as much as I can and learning from your experiences. I'm hoping to taper in December and detox in January for 3-4 weeks. The timing is great because my "significant other" will be vacationing in January and I'll be alone to work through this without breaking any necks or fighting.
After this I want to see how much relief I can get from non-narcotic pain relievers to decide how and whether to proceed with hydro.
Thanks again folks for the info and kind words of support. I've got about 2 months until January, so I'm just sort of dreading the unknown and doing my best to prepare.
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