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change from Buprenx to MS Contin

Discussion in 'Detoxing From Buprenorphine/Subutex/Suboxone' started by dvo, Jun 10, 2008.

  1. dvo

    dvo Member

    Need a doctors advice. Need to change from Buprenex to MS Contin for intractable pain. Question/advice: Can i just change to the MS Contin from 0.60mg of Buprenex 4x/day. Reason I need to change to MS Contin is need to use new drug that is used to regain bowel movements for opiate dependent patients (new drug is methylnaltrexone/Relistor.

    Relistor doesnt make me have bm's while on buprenex, so wanting to switch to MS contin which is a pure opiate vs Buprenex which a mixed opiate --- thus, Relistor doesnt work to restore BM's if using methlnaltrexone, but i know methylnaltrexone/Relistor does work to restore bm's if I am using in MS Contin.

    I assume methylnaltrexone doesnt work for Buprenex due to naltrexone/naloxne/narcan doesnt work to reverse buprenex.

    Need help Please! Advise is really needed. --- thanks in advance ... dvo
  2. KB

    KB Well-Known Member

    ok, you want to go on morphine just to have a bowel movement??? that is a strange predicament you're in. why were you on bupe? if it was for opiate addiction--going back on morphine isn't a real good idea! i guess you have to decide what is more important--your addiction or your bowels?? there are many laxatives that can be taken while on bupe. have you tried any? is bupe not controlling your pain?? we need more details!

  3. mmaj

    mmaj New Member

    To DVO...I would do some more research before asking your doctor to switch you from Buprenex to MS Contin. I really do understand what your delema is being that myself I am on Suboxone and suffer from severe constipation. None of the medications and remedies I have tried for opioid induced constipation have worked, with the exception of Enulose (Lactulose). Have you ever given that a try? Also, I was curious to know if the Relistor reduced the analgesic effect of Buprenex? If it did I would suggest that the combination MS Contin/Relistor might do the same. I understand Buprenex, which a mixed opiate, is different from MS Contin which is a pure opiate so to speak so in theory your assumption for wanting to switch sounds very valid. Best of luck! I would be interested to hear any patients input on this.

    In response to KB's post, "ok, you want to go on morphine just to have a bowel movement??? that is a strange predicament you're in. why were you on bupe? if it was for opiate addiction--going back on morphine isn't a real good idea! i guess you have to decide what is more important--your addiction or your bowels?? there are many laxatives that can be taken while on bupe. have you tried any? is bupe not controlling your pain?? we need more details!"

    DVO states he/she is prescribed for intractable pain. My understanding is that Buprenex is never prescribed for addiction in an outpatient setting, but Suboxone is. Two different drugs with the same active ingredient.

    Just my opinion. I don't believe all the hype from 'big pharma' companies and their claims about what is shown from their studies. I haven't seen any real positive claims from actual patients yet other. From Wikipedia: Methylnaltrexone - Wikipedia, the free encyclopedia

    Methylnaltrexone (MNTX, trade name Relistor) is one of the newer agents of peripherally-acting μ-opioid antagonists that act to reverse some of the side effects of opioid drugs such as constipation without affecting analgesia or precipitating withdrawals. Because it contains a permanently charged tetravalent nitrogen atom, it cannot cross the blood-brain barrier, and so has antagonist effects throughout the body, counteracting effects such as itching and constipation, but without affecting opioid effects in the brain such as analgesia.[1] However, since a significant fraction (up to 60 %) of opioid analgesia can be mediated by opioid receptors on peripheral sensory neurons, particularly in inflammatory conditions such as arthritis, traumatic or surgical pain, [2] MNTX may increase pain under such circumstances.

    I think this is an interesting read for anyone interested in addiction medicine and OIC (Opioid induced constipation): New discoveries after Suboxone, continued | Suboxone Talk Zone: A Suboxone Blog
    dvo likes this.
  4. jdude

    jdude Well-Known Member

    Welcome to ODR mmaj.
    Not sure of your quest, or how we can help. Maybe you'd want to start your own thread?
    But chances are after 2 1/2 years, dvo may have found a solution?
  5. dvo

    dvo Member

  6. dvo

    dvo Member

    Mmaj. - It's been a long time since I posted my question, but your reply was exactly in line with what I was trying to achieve. That is change from 10 amps of buprenex IM/day to MS Contin. I used to be prescribed 240mg/day MS Contin, and I advised a program to my Doctor to switch from MS Contin to Buprenex back in Feb. 2000 due to OIC and addiction issues with MS Contin. As to eluded to my reason to switch back to MS Contin was so I could see if Relistor would help with OIC. Relistor doesn't work with buprenex due to Mu receptor with buprenex will not move due to buprenex being stronger than Relistor. Thus why there is no antidote for buprenex since Narcan, Naltrexone, Naloxone all will not move the Mu receptor from the opiate receptor site if taking buprenex. Relistor/Methylnaltrexone was not available when I was on the MS Contin. In 1999 Ir did trial Entereg/Alvimopan and it did work to produce SBMs. Relistor is the approved medication for OIC, BUT DOESN'T WORK if using buprenex. Entereg was only approved for in hospital use ONLY since it had some longer term issues. Entereg & Relistor work in similar ways to allow SBMs.

    I got all tied up with CLL & treatment for CLL thus why I haven't been back to this site. I've been a member on this site when it first started by the Dr who started it as a project while he was in med school. I used to help people switch off of Methodone, and other time release opiates, or short acting opiates to buprenex, then tapper off the buprenex and be clean. There are 2 different methods to do this depending on if using time release or short acting opiates. Regardless, it worked on numerous folks who were addicted due to various reasons, and wanted off since they didn't have pain issues. Many folks were over prescribed nasty aggressive OxyConin when it 1st came out and they got addicted, and had no help. They got OXYCONTIN usually for MIS knee surgery etc, etc. Regardless, I gave them the procedure to switch to buprenex, then get off all opiates since they had no pain issues. The switch to buprenex only involved 12 - 24 hours of detox at the maximum, thus why it works so well. OK, sorry for not getting back sooner. My CLL is under control now, so I'm back again looking into how best to switch to MS Contin from buprenex to see if Relistor will be a better way vs Buprenex since Relistor doesn't work with buprenex. Whew that's a lot. Regards.
  7. spring

    spring Administrator

    Wow Hello Dvo and welcome back! I don't think I remember you but I didn't come on the scene until around 2000/01.
    Doc Scott still owns the board but is way busy with his practice so doesn't come around much. He has generously been and still is footing the bill for this board all these years.

    Are you saying you're still using Buprenex? I didn't know they rxed that anymore even for pain issues since suboxone got approved, but I'm sorta out of the loop since I don't have chronic pain issues.
    And until now I have never heard of Relistor, had to look it up. Sounds like it reverses the constipating effects of opiods, but it doesn't work with bup? Interesting.

    Also until now, I have never seen this thread,
    I guess I should tell you that the site has been through many changes and growing pains over the years and has evolved into a focus on getting clean from all opiates (including Suboxone/Subutex) so you may not find much help here with your particular problem (but I hope someone comes along to help).
    We do have some members with chronic pain issues who still come around, but the ones who come here are looking to be free of it all and are especially having problems getting free from the Sub.. There are plenty here in need of tapering and detox schedules, hoping you might resume your role and offer your experience to help them.
    dvo likes this.
  8. dvo

    dvo Member

    Spring - Thank you for your reply, as well the other folks that have replied to my post -- seeking advice on how to switch from Buprenex back to MS Contin. I know exactly how to switch to Buprenex from MS Contin and/or Oxycontin. Again, I am a intractable pain patient (spinal fusions etc). I started on MS Contin in 1994 and my pain Dr allowed me to switch to Buprenex in an effort to maybe better manage my OIC. As I mentioned I trialed Entereg in 1999, and it did work to allow SBM, but it was never approved for OIC due to some cardio issues for long term use. Relistor was approved in 2008 for OIC, but it will not work for buprenex induced OIC. Buprenex binds to the mu receptor site and nothing can displace it, thus why there is no antidote for buprenorphine.

    As I mentioned I was all wrapped up with fighting CLL (leukemia) from 2008 until treatment started in 2014, thus could not come back to Dr Scotts very generous free ODR site. I am still Rx'd 0.6mg buprenex 5x/day for pain, but I need to switch due to tolerance and in order to try Relistor for OIC. Relistor was recently approved in oral form (was sub cue injection when approved in 2008). So, again I was trying to see if there is a way to switch back to MS Contin for my pain, and so that I can try the Relistor. Resistor Methylnaltrexone has been around for a long time and used by Drs at Univ of Chicago where it was invented for OIC, but never FDA trialled -- just used internally in the hospital.

    You asked about my past efforts where I gave folks on this board instructions on how to detox off pure opiates using buprenex IM. I do not know how to detox folks off buprenorphine, just off pure opiates using buprenex then tapering off the buprenex before they get addicted to the buprenex. It works with pure opiates since the hard detox only lasts for 12-24 maximum, then you do the slow tampered use off buprenex.I learned the detox from folks on this site, and used it myself in order to switch from MS Contin to buprenex, but I did not tapper off the buprenex due to intractable pain ordeal.

    OK Spring, this is where I am, stuck on buprenex, and being treated for Leukemia, and feeling the effects of fusions to the spine that are not solid in addition to all the scar tissue and changed anatomy associated with fusions which are solid. The leukemia was no walk in the park, but no where close to the spinal ordeal and now the buprenex addiction. My spine is very busted up from operations that went wrong in 1980's. At this point, I am not sure that I have the drive to even try to switch to MS Contin. This entire ordeal started in 1982, and here I am. Mercy, and thanks for your response, and sorry I have not been back to the ODR site in a while. Also, thank you for helping folks on this site. I got off the site about the time subtext/suboxone were approved, thus assume folks would and did move to using the sublingual tablets which have been a nightmare due to not being used as buprenex can be used to detox folks off opiates without the horrors of UROD, and the cold turkey methods. Regards to you Spring.
    Last edited: Aug 25, 2016

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