Archive for September, 2016

Buspirone Vs Xanax

Sep 28 2016 Published by under Medication Comparison

What is Buspirone? What is Buspirone used for?

Buspirone is a Generic name for prescription medicine that works by affecting brain chemicals that may be unbalanced in patients with anxiety disorders. Buspirone is used for the treatment of anxiety symptoms such as fear, irritability, tension, irregular heartbeat, dizziness, and other physical symptoms. Buspirone is available in the form of a tablet of 5 mg, 7.5 mg, 10 mg, 15 mg and 30 mg that should be taken by mouth. This drug should not be used for treating occasional stress associated with everyday life. Rather, doctors decide to prescribe Buspirone for anxiety disorders and short-term relief of anxiety symptoms.

What is Xanax? What is Xanax used for?

Xanax is a Brand name for a drug that contains alprazolam as an active ingredient which is a short-acting benzodiazepine drug. This drug works by affecting chemicals in the brain that may be unbalanced in patients with anxiety disorder. Xanax is indications are: generalized anxiety disorder, panic disorders with or without agoraphobia, and anxiety linked with depression. It is available on the market in the form of immediate release tablet in doses of: 0.25, 1, 2 and 5 mg and in form of extended release tablet, named as Xanax XR in doses of 3 and 5 mg.

How Buspirone and Xanax work in the body?

Buspirone is anti-anxiety drug called anxiolytic however it seems that this drug works somewhat differently than other drugs from the same class. Though, it is not known how exactly buspirone reduces anxiety, they believe that it competes with neirostransmitters serotonin and dopamine, that are involved in causing anxiety symptoms. Pharmacologically Buspirone binds to serotonin’s 5-HT-1a receptors on presynaptic neurons located in the dorsal raphe system of the brain and on postsynaptic neurons in the hippocampus, where it blocks firing frequency of serotonin neurons in the dorsal raphe. Buspirone can also bind to dopamine type 2 receptors. Buspirone also increases firing in the area of brain called Locus ceruleus where norepinephrine neurotransmitter is found in high concentration. The final result of buspirone actions is suppression of serotonergic activity while noradrenergic and dopaminergic are enhanced.

Alprazolam which is the active substance of Xanax works by binding to benzodiazepine BNZ-a receptors, which are responsible for sleep induce and benzodiazepine receptors BNZ2 – benzodiazepine receptors which are responsible for anticonvulsant activity, motor coordination and memory. BNZ1 and BNZ2 receptors are coupled GABAA receptors and increases the inhibitory effects of GABA neurotransmitter by increasing the affinity of GABA for its binding sites. After binding to its receptor, GABA opens the chloride channel, which results in a cell membrane hyperpolarization and prevention of further cell excitation.

What are difference between Buspirone and Xanax? Are Buspirone and Xanax the same thing? 

No they are not the same. Those are different active substances. They are both classified as anxiolytic drugs however they have totally different mechanisms of action through which they express their anxiolytic effects. Xanax increases the action of GABA neurotransmitter while Buspirone reduces serotonin’s actions and enchances dopamine’s and norepinephrine’s neurotransmitter actions. Buspirone is not chemically or pharmacologically in relation to benzodiazepines, barbiturates, or other sedative and anxiolytic drugs. Also, benzodiazepines such as alprazolam (Xanax) causes addiction while buspirone not. Xanax also causes serious withdrawal symptoms while Buspirone’s withdrawal is mild.  Xanax is short acting and short lasting anxiolytic drug while Buspirone is also short lasting but it is long-lasting drug. Studies have been shown that long-term benzodiazepines use is linked with dementia while Buspirone is not. Neither is known to cause a weight gain, and side effects are minimal for both.  These medications do not work well with alcohol, as alcohol may potentiate effect increase the risk of dangerous side effects. However, Xanax is known as a wonder drug for anxiety, while Buspirone is known to work well for select individuals, but in some cases it much do of anything in others even at a higher doses. Compared to Xanax, Buspirone is much safer and it might be the best option for treating anxiety. There are no major unwanted long term effects after Buspirone use. Its effects may be reduced over time, but most people tolerate it for an extended period of time. Buspirone is also favorable compared to many anxiolytics because it doesn’t cause sedation in degree that other classes do. Although, body energy levels may fluctuate until body gets used to Buspirone, sedation is however not usually a major side effect of this drug. It is known that Buspirone has mildest side effect’s compared to all anxyolitics. Additionally Buspirone may improve libido and isn’t associated with any major weight gain. It also doesn’t result in slower cognitive functioning like a Xanax.  Buspirone is used for the treatment of generalized-anxiety disorder since 1986.

is buspirone like xanax

Xanax side effects

Most common Xanax side effects are following:

·         Drowsiness (41%)

·         Headache (10-15%)

·         Depression (10-15%)

·         Constipation (10-15%)

·         Dry mouth (10-15%)

·         Diarrhea (10-15%)

·         Confusion (5-10%)

·         Tachycardia (5-10%)

·         Insomnia (5-10%)

·         Nausea/vomiting (5-10%)

·         Nasal congestion (5-10%)

·         Blurred vision (5-10%)

·         Hypotension (1-5%)

·         Syncope (1-5%)

·         Akathisia (1-5%)

·         Dizziness (1-5%)

·         Increased salivation (1-5%)

·         Nervousness (1-5%)

·         Tremor (1-5%)

·         Weight change (1-5%)

Postmarketing Reports:

·         Gastrointestinal side effects: hepatitis, liver enzyme elevations, hepatic failure

·         Immunologic side effects: Stevens-Johnson syndrome, peripheral edema, angioedema,

·         CNS side effects: Hypomania, mania

·         Endocrine side effects: gynecomastia, galactorrhea, hyperprolactinemia,

Buspirone side effects

Most common Xanax side effects are following:

·         Dizziness (12%)

·         Drowsiness (10%)

·         Nausea (8%)

·         Headache (6%)

·         Nervousness (5%)

·         Blurred vision (2%)

·         Confusion (2%)

·         Diarrhea (2%)

·         Excitement (2%)

·         Insomnia (2%)

·         Myalgia (1%)

·         Numbness (2%)

·         Paresthesia (1%)

·         Rash (1%)

·         Tremor (1%)

·         Weakness (2%)

·         Nasal congestion (1%)

·         Sore throat (1%)

·         Nonspecific chest pain (1%)

·         Tinnitus (1%)

·         Dream disturbances (1%)

Who should avoid Xanax and Buspirone?

  • Patients with depression
  • Patients with acute narrow-angle glaucoma and untreated open-angle glaucoma
  • People with a history of alcoholism, drug abuse, or personality disorder
  • Patients with renal or liver disease
  • Patients with severe lung disease
  • Patients with epilepsy
  • Obese patients
  • Patients allergic to Buspirone, Xanax or other benzodiazepines.
  • Pregnant women. Alprazolam is classified in the FDA pregnancy category D list of drugs. That means: Studies in humans has shown adverse effects to the fetus when the mother takes the drug. This drug should only be used during pregnancy in serious cases where it’s needed to treat a dangerous condition in the mother. Patients should talk with their doctor if they are pregnant or plan to become pregnant. Doctor should tell you about the specific harm that may be done to the fetus when this drug is used. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefits. Buspirone is classified in the FDA pregnancy category D list of drugs. Animal studies have not revealed any fetal damage or fertility impairment. There are no controlled data in human pregnancy.
  • Mothers who are breast-feeding. Alprazolam and Buspirone may pass into breast milk and may cause side effects in infant. Infant may become drowsy and lose weight. Mothers who are breast-feeding should talk with their doctor, and they may need to decide whether to stop taking this medication or stop breast-feeding.
  • Elderly (+65) and Children younger than 18 years should not use Xanax. However, studies showed that short-term use of Buspirone for no more than six weeks is safe in people 65 and older as in other adults and in children from 6 to 17 years.

 

Cold Water Extraction
Xanax addiction and withdrawal symptoms

What do xanax bars look like?

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Cold Water Extraction

Sep 26 2016 Published by under Common Health Questions

What is Cold Water Extraction?

Cold water extraction, or shortly CWE is a physicochemical procedure in which a substance is extracted from a mixture through cold water. It is a type of fractional crystallization. This procedure is based on solubility differences of different substances in a low temperature mixture.  CWE involves taking a combination of substances, dissolving them in warm water, and then rapidly cooling the mixture.

Insoluble compounds will precipitate out of the water, while the soluble ones stay dissolved. The solution can then be separated by decantation or filtration. It is commonly used to separate out opiate drugs that have been mixed with common non-opiate-based analgesics.

So, Opiates such as morphine, codeine, hydrocodone and oxycodone are much more soluble in cold water comparing to acetaminophen, aspirin and ibuprofen so they will be dissolved, while acetaminophen, aspirin and ibuprofen will be precipitated.

Why is Cold Water Extraction performing?

Many opioid drugs combination such as Vicodin (hydrocodone), Lortab (Hydrocodone/paracetamol), Lorcet, Tylenol forte, Percocet etc., may be harmful for the patient. A cold water extraction is a procedure that is most commonly used to remove acetaminophen (paracetamol) from such combinations.

CWE also works fine with aspirin and to a slighter extent with ibuprofen, which may be all very toxic if they are taken in high doses together with opioid drugs and overdosed. Serious side effects may result in permanent liver damage.

Acetaminophen’s hepatotoxicity is one of the major causes of poisoning worldwide, and in the UK and US, it is one of the most common cause of acute liver failure. By performing cold water extraction acetaminophen and aspirin can be easily removed from prescription pills.

Manufacturers and health professionals generally recommended that adults with no issues may take no more than 4 grams of acetaminophen during a day, and not more than 1g APAP at once, however in some cases, and in predisposed patients, even the lower doses may cause liver damage. Cold water extraction is most commonly used with Hydrocodone/acetaminophen, Oxycodone/acetaminophen and Codeine/acetaminophen medications.

There is one exception of this rule. Many opioid/analgesic combinations also contain caffeine. Such products can be also used with the knowledge that the most of the caffeine dose will ended in the finished product. Most patients should not matter, however some patients with issues after taking caffeine have to be warned!

Cold Water Extraction preparation

The main idea is that acetaminophen and aspirin are hardly soluble in water. However, most opioids are very soluble in water. Acetaminophen and Aspirin are soluble in methanol, ethanol, ethylene dichloride, dimethyl-formamide, acetone and ethyl acetate; slightly soluble in ether; very soluble in cold water, considerably more soluble in hot water.

The best temperature of water to extract acetaminophen or aspirin is about 10C/50F. Solubility is given in table below:

Type Solubility (31C/88F water) Solubility (21C/70F water)
Acetaminophen 1g/ 70ml 1g/ 159ml
Aspirin 1g/ 100ml 1g/300ml
Codeine 1g/2.3ml 1g/0.7ml

Extraction works because the opioids will be dissolved into the cold water and leaves the APAP, aspirin, or ibuprofen behind. Also, the aspirin will be able to be caught in your filter.

If capsules are, you will not need to crush them, they only need to be opened and their content poured into water. Capsules are also much easier to dissolve. If you don’t have capsules, tablets/pills should be crushed before performing the CWE.

How to do a cold water extraction?

Cold water extraction step by step

CWE is relatively quick to do apart from cooling the water. You should just crush the tablets, or open capsules and pour their content, dissolve them in water, and strain the mixture through a filter. Below are steps that you should follow:

  1. Crush your tablets into a fine powder. Try to minimize powder loss. If you have capsules, simply open them and pour the content.

Tip: Put tablets in a Ziplock bag. Use some object to crush all tablets into a fine powder without perforating the bag.

  1. Fine powder should be dissolved into warm water. You should get hot water from your tap and it should not be too hot, because boiling water may destroy the opioid molecule. Put the water in a bowl or container that should be with a wide surface area, allowing the mixture to cool more quickly. Add the powder to about ½ or ¾ cup of water.

Tip: It is always better to have too much water than not to have enough.

  1. Let the mixture cool to room temperature on for about 10-20 minutes. Stir it every few minutes until it is completely dissolved. Mixture should not be cooled to too quickly, because codeine may be destroyed within. Leave it sit on the counter for a period of time, until it is at or near room temperature.
  2. Put the bowl or container with a mixture into the freezer to be cold enough. This is where magic happens. You do not need to put the lid on the container. You should leave it until it is extremely cold to the touch. However, do not let it freeze! This might take up to 20 or 25 minutes.
  3. The next step is filtration. You can use for that filter paper, cheesecloth, coffee filter, or even aeropress. A handkerchief might also work well if you do not have mentioned stuff. Put the filter at the top of a cup and secure it with a tape. Pour slowly the mixture into the filtered cup. Do not pour in too much water and do not touch the filter, as you make break it and have to do filtering again.
  4. When appears that filter is done with dripping into the cup and there is nothing left to be filtered, you will then get a dense, marshmallow-like substance. You can the squeeze the contents of the old filters via new filter to save any remaining moisture. You also add more water to the marshmallow mixture and re-filter it; nevertheless it isn’t necessary to do.
  5. Drink your filtered mixture and throw away the acetaminophen/ibuprofen/aspirin. The most of these should have been successfully removed. The solution might be really bitter, so you can mix it with something sweet for better taste.
cold water extraction tylenol 3

Left: Acetaminophen’s precipitate;  Right: Opioid solution

How long does Hydrocodone stay in your system – Urine, Blood, Hair, Saliva, Drug Test?

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How long does Hydrocodone stay in your system, Urine, Blood, Hair, Saliva, Drug Test

Sep 23 2016 Published by under Common Health Questions

What is Hydrocodone? What is Hydrocodone used for?

Hydrocodone is a Generic name for an opioid pain reliever medicine. Chemically hydrocodone is also known as dihydrocodeinone. It is semi-synthetic opioid medicine that is synthesized from codeine.

Hysingla ER and Zohydro ER are hydrocodone’s extended-release forms that are used for around-the-clock treatment for moderate to severe pain treatment. Extended-release form of hydrocodone is not for use on an as-needed basis for pain. Hydrocodone is also commonly used in liquid form as an antitussive/cough suppressant.

how long does hydrocodone stay in your urine

How does Hydrocodone works?

Hydrocodone works as an opioid agonist of opioid receptors in the brain. This drug blocks pain perception in the cerebral cortex of the brain. Hydrocodone reduces synaptic chemical transmission in the brain, which then inhibits pain sensation into the higher centers of the brain. Agonist actions at the μ and k receptors cause analgesia, decreased body temperature and miosis.

Agonist activity at the μ receptor may also cause the opiate withdrawal suppression, while antagonist activity can result in precipitation of withdrawal. Hydrocodone acts at several areas within the brain by involving several neurotransmitter systems to produce pain relieving, but the precise mechanism has not been fully yet understood.

Hydrocodone can also produce inhibition at the chemoreceptors through μ-opioid receptors and in the medulla through μ and δ receptors which can lead to dose-related respiratory depression.

Hydrocodone side effects

Common hydrocodone’s side effects that usually do not require medical attention include:

  • dizziness
  • drowsiness
  • itching
  • nausea
  • vomiting

Side effects that patients have to report to their doctor or health care professional as soon as possible as it can be very serious include:

  • breathing difficulties, wheezing
  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
  • confusion
  • light headedness or fainting spells

How long does Hydrocodone stay in your system?

Studies have been shown that the elimination half-life time of hydrocodone is an average 3.8 hours. This means that, it will take under 4 hours for your body to excrete 50% of the administrated hydrocodone dose. This means that the body will fully excrete hydrocodone from its system for 20.9 hours. However, other findings suggest that there could be more difference in drugs half-life time ranging it from 3.3 hours to 4.1 hours.

This indicates that some patients may be able to eliminate the drug much quicker for 18.15 hours, while others may have prolonged systemic clearance time with 22.55 hours). In most patients hydrocodone should be cleared from the body within 1 day, however, it may not clear hydrocodone’s active metabolite named norhydrocodone for up to 2 days.

There are many factors that may have influence on how long will hydrocodone and its active metabolites stay in your system. Those factors can be internal or individual such as: age, genetics, body mass, liver and kidney function etc. Also external factors such as: frequency of hydrocodone use and other medicines taken at the same time can also have the influence.

How long does Hydrocodone stay in your urine?

In normal situations, Hydrocodone itself should be detectable in urine after 24 hours of last dose administration, but its active metabolite norhydrocodone can stay in urine up to 2-3 days.

How long does Hydrocodone stay in your blood?

In normal situations, Hydrocodone should be detectable in blood for one day after last dose administration.

How long does Hydrocodone stay in your hair?

Hydrocodone can be detectable in hair up to 90 days.

How long does Hydrocodone stay in your saliva?

In saliva, hydrocodone can be detectable for up to 1 day after administration, while norhydrocodone could remain detectable for up to 2 days.

How long does Hydrocodone stay in your system if you snort it?

If hydrocodone is snorted, it will pass in your system more quickly than after ingestion. There is no time to lose on absorption of the drug. The effects are almost immediate. Depending on how much of hydrocodone is taken, it will approximately stay in the body for 12-24 hours after administration.

How the age affects Hydrocodone elimination?

The elderly (aged 65+) compared to younger individuals often metabolize and eliminate drugs by much slower rates. Their organs such as liver or kidneys may have lower function and/or their internal blood flow is reduced to the liver. Further, elderly are often on many other medications and some of them could delay hydrocodone metabolism or excretion.

How body height / weight / fat affect Hydrocodone elimination?

Patient’s height, weight, and fat amount when can have impact on how quickly body eliminate the drug from the system. In theory, taller and heavier patients should clear a 5 mg of hydrocodone quicker compared to shorter and lightweight individuals. This is because of the fact that the smaller the dose of the drug is taken proportionate to your height/weight the quicker the elimination, vice-versa also applies.

How genetics affects Hydrocodone elimination?

Different genes are known to have the influence on drug metabolism, including hydrocodone. Genes that regulate CYP450 liver enzymes such as CYP2D6 may have strong influence whether some patient metabolizes hydrocodone in a quicker or slower rate than average.

Based on genetics, certain patients are classified as “rapid metabolizers,” while others are “poor metabolizers.” This may result in different drug effects, but also variability in clearance rates.

How food affects Hydrocodone elimination?

Food like carbohydrates may slow hydrocodone absorption if they are taken together. However, taking hydrocodone on empty stomach may increase absorption this drug.  Absorption time differences could influence rate of drug clearance from the body. Those who ingest a high-carbohydrate meal along with hydrocodone, clearance may be delayed.

How liver or kidney function affects Hydrocodone elimination?

Since hydrocodone is metabolized in the liver, liver issues and impaired liver function may extend half-life time and prolong hydrocodone elimination. For example, someone with cirrhosis or hepatitis may take hours longer to metabolize and eliminate hydrocodone from their system compared to healthy individuals. In addition, kidney impairment may also delay drug clearance.

How urinary pH affects Hydrocodone elimination?

Patients with more acidic urine may clear hydrocodone and it metabolites more efficiently than those with highly alkaline urine. Alkalinity of urine is known to promote drug reabsorption prior to their elimination, and thus slowing the clearance.

How frequency of Hydrocodone use affects its elimination?

Single dose users (patients that use hydrocodone only once) are more likely to clear the drug faster from the body than those who regularly used the drug for a long period of time.  This is likely to be caused because of the fact that when hydrocodone is used frequently for several days, hydrocodone and its metabolites will accumulate in the body until the “peak” is reached.  Once the “peak” is reached the clearance time will be prolonged.

Single-dose, infrequent, users will less likely accumulate hydrocodone compared to frequent users.  Such patients should be able to excrete the drug efficiently from the body in under 2 days.  However, long-term users who are on chronic hydrocodone therapy could take longer than 2 days to fully eliminate hydrocodone.

How other drugs affect Hydrocodone elimination?

Since hydrocodone is metabolized by cytochrome 450 isoenzyme CYP2D6, all drugs that affect CYP2D6 may reduce or prolong hydrocodone’s half-life time.  Drugs classified as CYP2D6 inhibitors are known to impair body’s ability to eliminate hydrocodone from the body. CYP2D6 inhibitors are: SSRI drugs (such as paroxetine, citalopram, fluoxetine etc.), Codeine, Methadone, Amiodarone, Serindole, Yohimbine and more.

Certain inhibitors of CYP2D6 may slow metabolism to a greater level than others and that dosing often plays a role. There are also drugs known as CYP2D6 “inducers” such as Dexamethasone and Rifampin which may enhance metabolism of hydrocodone.  These drugs enhances metabolism of hydrocodone, thus resulting in quicker clearance from the system.

Can I take toradol and hydrocodone together?
What happens if you take too much Zzzquil?

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ZzzQuil high

Sep 22 2016 Published by under Common Health Questions

What is ZzzQuil?

ZzzQuil is a Brand name for an OTC antihistamine medication that contains diphenhydramine as an active ingredient. This drug reduced the natural levels of body histamine and thus relieves the symptoms such as: runny nose, sneezing, watery eyes, hives, itching, skin rash, and other cold or allergy symptoms.

Diphenhydramine may be also used for the acute treatment of motion sickness, as a sleep inducer, and in rare cases to treat certain Parkinson’s disease symptoms such as tremor and muscle stiffness. It is available in the form of liquid capsules and liquid as a non-habiting forming diphenhydramine of 25 mg for short-term use.

In General, the main ZzzQuil indication is the relief of occasional sleeplessness.  This medicine product reduces the time to falling asleep in patients who have difficulty falling asleep. Usual adult dose for insomnia is 25 to 50 mg orally at bedtime.

zzzquil hallucinations

How does ZzzQuil works?

ZzzQuil’s active substance is antihistamine drug of ethanolamine class called diphenhydramine. It is a first generation antihistamine that passed through blood-brain barrier and causes sedation and has also significant antimuscarinic activity. Diphenhydramine works by competeting with free histamine in the body for binding at histamine HA-receptor binding sites.

This action antagonizes the effects of histamine on its receptors, leading to a decline of the negative symptoms that high levels of endogenous histamine may cause. Diphenhydramine antagonizes histamine effects on HA-receptors in the GI tract, large blood vessels, uterus and bronchial muscle.

Ethanolamine derivatives, in general, have greater anticholinergic effects comparing to other antihistamines and probably accounts for the diphenhydramine’s antidyskinetic effects. Central antimuscarinic effects may be responsible for its antiemetic effects, although the exact mechanism is still unknown.

ZzzQuil side effects

ZzzQuil may cause following side effects:

  • Sedation
  • Anticholinergic effects
  • Confusion
  • May decrease cognitive function in geriatric patients
  • Dry nasal mucosa
  • Xerostomia
  • Thick bronchial sputum
  • Pharyngeal dryness
  • Agranulocytosis
  • Thrombocytopenia
  • Hemolytic anemia
  • Convulsions
  • Hypotension
  • Nervousness
  • Tachycardia
  • Blurred vision
  • Restlessness
  • Palpitations
  • Vertigo
  • Constipation
  • Menstrual irregularities
  • Anorexia
  • Euphoria
  • Urinary retention
  • Diplopia
  • Neuritis
  • Tinnitus

Patients should get emergency medical help immediately if they experience any of following signs and symptoms of an allergic reaction: hives; difficult breathing; swelling of face, lips, tongue, or throat.

Patients should stop using diphenhydramine immediately and call their doctor at once if ythey exhibit following serious symptoms:

  • pounding heartbeats or fluttering in your chest;
  • confusion, feeling like you might pass out;
  • painful or difficult urination;
  • little or no urinating

How fast does ZzzQuil work?

An oral dose of ZzzQuil usually start working after 20-30 minutes, reaches maximum blood concentrations after 2 to 3 hours and the effects usually last for 4 to 6 hours. Many health professionals will suggest taking an oral dose of Bendryal about 30 minutes before bedtime, if the drug is being used as a sleep aid.

How long does ZzzQuil stay in your system?

A single dose of Diphenhydramine is active in the body for between four and six hours on average. The half-life time of diphenhydramine is about 8 hours in children to 17 hours in the elderly. In normal situations, this drug is metabolized in the liver and excreted through urine within approximately 24 hours.

Can I give ZzzQuil to a dog?

Diphenhydramine is one of the few over-the-counter drugs that veterinarians routinely have owners administer at home.  It is generally well tolerated and has a wide safety margin. Some of its most common veterinary indications are the treatment of allergic reactions to insect bites or stings, environmental allergies and pre-treatment of vaccine reactions.

It can be also used for the prevention of motion sickness in dogs and as a mild sedative. The standard dosage for oral ZzzQuil is 1 mg per pound of dogs body weight, given 2-3 times a day. Most drug store diphenhydramine tablets are 25 mg, which is the size used for a 25 pound dog.

Warnings and precautions during ZzzQuil use

ZzzQuil should never be used in following situations:

  • For children under 12 years of age
  • With other drugs that also causes drowsiness such as antihistamines and nighttime cold/flu products
  • With any other product that also contain diphenhydramine, even one that is used on skin
  • Do not use in combination with NyQuil

Before using ZzzQuil, patients should ask their doctor:

  • If they have breathing problems such as asthma, chronic bronchitis or emphysema
  • Difficulty in urination due to enlargement of the prostate gland
  • Glaucoma
  • Heart disease
  • If you are taking tranquilizers or sedatives or any other sleep aid

Patients should know that when using this product:

  • They should avoid alcoholic beverages and other drugs that cause drowsiness
  • Be careful when driving a motor vehicle or operating with machinery because drowsiness will occur
  • Stop use and ask a doctor if sleeplessness persists continuously for more than 2 weeks. Insomnia may be a symptom of serious underlying medical illness
  • If pregnant or breast-feeding, patients should ask a doctor before use. Keep out of reach of children.
  • Overdose warning: Taking more than directed can cause serious health problems. In case of overdose, patients should get medical help immedietely or contact a Poison Control Center right away.

Can you get high off zzzquil

Many people suffer from sleeping disorders. When such individuals are going to bed, at night, they will know immediately that they will have trouble with sleeping. This is something that encourages them to find out a remedy in order to calm their nerves very quickly. This is why many patients reach for sleeping aids such as ZzzQuil products.

This OTC medication is non-habit forming and is capable of proving a restful night’s sleep. Unfortunately, some individuals will attempt to abuse this medicine as a way for experiencing a euphoric feeling. During administration of this drug, it is possible for the consumer to experience some pleasant feelings; however these are just adverse effects of the ZzzQuil. These include dizziness and drowsiness.

These are not pscychological effects of the drug. The experience is caused because diphenhydramine blocks acetylcholine in the brain, which is the neurotransmitter responsible for the motor coordination and muscles movement. Because of this, in some cases patients may experience that they are not able to walk easy and hard to verbalize anything, or to lose the will to do anything besides lying on the ground in a psychotic state of mind.

This may also happen in patients who were using this drug, as a sleep aid. ZzzQuil is considered to be non-habit forming, there is no physical dependence but it is still possible to become psychologically addicted to it.

ZzzQuil psychosis effects

It has been reported that large doses of diphenhydramine may cause psychosis and delirium effects in a higher rate than other hallucinogens such as LSD, ketamine or DMT. There are a large number of experience that are reported online which describe states of amnesia, psychotic delirium and other serious consequences after abusing thise drug. In many cases, it has resulted in hospitalization and death.

Toxicity and harm potential of ZzzQuil

It is very important to know that even a single dose of ZzzQuil can be in some cases very unpredictable and may have potential to result in severe consequences, hospitalization, coma or death.

The toxicity and long-term effects of regular ZzzQuil administration has not been studied relevant and scientific fashion very-well, because chronic ZzzQuil administration is very rare occasion and the majority of people who uses this drug for a long-term do not wish to repeat the experience.

If this drug is taken on a regular basis, there are reports suggesting that diphenhydramine may have some serious side effects on one’s kidneys with the potential to have side effects in bladder issues similar to that of ketamine cystitis.

ZzzQuil overdose

The ZzzQuil’s specific effects and symptoms of overdose in each patient may be different and vary which depends on many factors such as: drug formulation, the total dose of drug that is taken, and whether it is taken in combination with other drugs.  Overdose effects may include:

  • Blurred vision
  • Drowsiness
  • Dilated pupils
  • Dryness of mouth, nose and throat
  • Fever
  • Extreme sleepiness
  • Flushing
  • Insomnia
  • Hallucinations
  • Irregular heart rhythm
  • Nausea and vomiting
  • Low blood pressure
  • Ringing in the ears
  • Rapid breathing
  • Rapid heart rate
  • Shaking
  • Weakness
  • Slow digestion
  • Possible psychological effects, such as:
    • Hallucinations
    • Confusion
    • Agitation
    • Seizure
    • Delirium
    • Coma
    • Death, rare

Sometimes, the signs and symptoms of a drug overdose may be difficult to notice. Patients should contact their doctor or call local Poison Control Center in case an overdose is suspected. ZzzQuil overdose in adults and children is a medical emergency that requires immediate attention.  Seek immediate medical attention if these side effects are observed.

ZzzQuil Overdose Treatment

ZzzQuil overdose is treated depending on the severity of symptoms and condition in general. If the overdose occurred recently, doctor may give certain medicines – antidote’s or irrigates the stomach by inserting tube into it. Some of the common supportive measures may include:

  • Medicines may be given in order to manage treat symptoms such as changes in blood pressure, treat irregular heart rate and rhythm, control seizures.
  • Inserting an intravenous line for supplemental fluids
  • In case of respiratory depression, oxygen therapy or insertion of a breathing tube may be necessary.
  • Monitoring of cardiovascular function and breathing patterns.
  • Other treatments depending on the complications.

Can I take ZzzQuil with alcohol?

Mixing ZzzQuil together with alcohol may cause potential side effects and adverse reaction. However, the exact mechanism of this interaction is not fully understood but in theory alcohol may enhance ZzzQuil Central Nervous System depressive effects. Both substances can cause drowsiness and sedation as their most common side effects. These drugs may also impair concentration, focus, memory and thinking.

Alcohol can potentiate the effects of ZzzQuil, and vice versa. Toleration to these sedative effects depends from person to person. Some patients can tolerate drinking a glass or two of alcohol very well while they are on ZzzQuil therapy while others may develop mentioned side effects immediately after drinking. That is why patients should avoid taking alcohol while they are on this drug treatment.

Patients who operate heavy equipment and machinery or drive are must avoid drinking alcohol because of the possible drowsiness. If they choose to drink alcohol, they should not drive, operate machinery or engage in other activities that require concentration and focus.

What happens if I miss ZzzQuil dose?

Since diphenhydramine is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose ZzzQuil?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Where should I keep my ZzzQuil?

  • It has to be kept out of the reach of children.
  • Store at room temperature between 20 and 25 degrees C. Do not freeze. Protect the product from light. Throw away any unused medicine after the expiration date. Some products may contain alcohol or have other flammable components. Do not use while smoking or near heat or flame.

ZzzQuil during pregnancy

Diphenhydramine has been classified in pregnancy category B by the FDA pregnancy category list of drugs. Animal studies have failed to reveal this drug teratogenicity. No relationship was found to large categories of malformations.

However, possible relations with individual malformation were found. One study reported that there is a statistically important relationship between diphenhydramine administration in the first trimester during pregnancy and cleft palate. There is also one case of withdrawal in an infant whose mother ingested 150 mg per day of diphenhydramine has been reported.

This infant has been developed tremor on the fifth day of life which was treated with phenobarbital. Diphenhydramine is only recommended for use during pregnancy only when benefit outweighs risk. Diphenhydramine has been shown to have oxytocic side effects in animal and human uteri.

One case report of a pregnant woman who administrated a large diphenhydramine dose in an attempted suicide developed strong, regular uterine contractions that were halted by the administration of intravenous magnesium.

ZzzQuil during breastfeeding

Small doses of diphenhydramine that are used occasionally are not expected to cause any side effects in infants during breastfeeding. However, larger doses and long term use of this drug may cause side effects in the infant or may even decrease the milk supply, particularly if it used together with a sympathomimetic drugs such as pseudoephedrine or before lactation.

Single bedtime doses after the last breast-feeding of the day may be suitable for many women and will minimize any side effects of the drug. However, the nonsedating antihistamines are preferred alternatives.

ZzzQuil drug interactions

ZzzQuil + anticholinergic drugs: Taking ZzzQuil together with anticholinergic drugs may increase the risk of side effects such as difficulty passing urine or scanty urine output; constipation, and dryness of mouth, nose and eyes. Patients should tell their healthcare provider if they are taking any of these drugs:

  • atropine
  • benztropine (Cogentin)
  • clozapine (Clozaril)
  • pramlintide (Symlin).
  • belladonna (Donnatal, B&O Supprettes, Bellamine S)
  • darifenacin (Enablex)
  • clidinium (Librax)
  • glycopyrrolate (Robinul)
  • haloperidol (Haldol)
  • dicyclomine (Bentyl)
  • hyoscyamine (Levsin)
  • ipratropium (Atrovent)
  • oxybutynin (Ditropan, Oxytrol)
  • tiotropium (Spiriva)
  • solifenacin (VESIcare)
  • scopolamine (Transderm Scop)
  • homatropine (Hycodan)
  • tolterodine (Detrol)

ZzzQuil + Acetylcholinesterase Inhibitor drugs: Combining ZzzQuil with and anticholinesterase drug may reduce the effects of both drugs due to their opposing effects. Close medical monitoring and possible dose adjustments are necessary in order to avoid drug interactions. Patients should tell their healthcare provider if they are taking any of these drugs:

  • galantamine (Razadyne)
  • donepezil (Aricept)
  • tacrine (Cognex)
  • rivastigmine (Exelon)

ZzzQuil + drugs that also cause drowsiness: These drugs may prolong and intensify side effects of ZzzQuil such as drowsiness, dizziness and confusion. Patients should tell their healthcare provider if they are taking any of these drugs:

  • Anxiety medications like benzodiazepines, including, clonazepam (Klonopin), alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium)
  • Anti-seizure drugs (carbamazepine)
  • Muscle relaxants
  • Sleep medications (Ambien)
  • Antipsychotic medications (chlorpromazine, amitriptyline, risperidone,  trazodone)
  • Tricyclic antidepressants (amitriptyline).
  • Narcotic pain relievers (codeine)

ZzzQuil + Other Antihistamines: Use of ZzzQuil together with other antihistamine drugs may increase the risk of side effects. Patients have to avoid taking other antihistamines while they are on ZzzQuil treatment.

ZzzQuil + Monoamine Oxidase Inhibitors (MAOI): Combining Monoamine Oxidase Inhibitors with ZzzQuil can increase and prolong certain side effects, such as constipation, drowsiness, difficulty passing urine; and dryness of mouth, eyes and nose. Patients should tell their healthcare provider if they are taking any of these drugs:

  • isocarboxazid (Marplan)
  • methylene blue
  • linezolid (Zyvox)
  • moclobemide (Manerix)
  • procarbazine (Matulane)
  • rasagiline (Azilect)
  • phenelzine (Nardil)
  • tranylcypromine (Parnate)
  • selegiline (Eldepryl, Emsam, Zelapar)

ZzzQuil + propoxyphene: Using propoxyphene together with ZzzQuil may enhance side effects such as drowsiness, dizziness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should take propoxyphene exactly as prescribed by your doctor.

ZzzQuil + tamoxifen. If it is used on regularly basis or continuously for extended periods of time, ZzzQuil may reduce the effectiveness of tamoxifen in the treatment of breast cancer. The proposed mechanism is probably the inhibition of tamoxifen bioactivation through liver enzyme CYP450 2D6 to metabolite known as endoxifen which is the active metabolite that may be responsible for tamoxifen’s antiestrogenic activity.

This is consistent with studies that showed poorer clinical results such as increased breast cancer recurrence; lower rates of event-free survival, shorter relapse-free periods and decreased incidence/severity of hot flashes in patients treated with tamoxifen who have genetic polymorphisms of CYP450 2D6.

Patients on tamoxifen therapy should talk with their doctor if they have any questions or concerns. Doctor may be able to prescribe alternative drugs that do not interact.

Who should avoid ZzzQuil?

  • Patients with depression. A variety of abnormal behavior and thoughts changes have been reported and occurred after hypnotics use. Some of these changes include decreased inhibition, agitation, aggressiveness and hallucinations. Anthistamines including diphenhydramine may worsen mental depression and cause suicidal behavior and ideation in critical patients. Patients should be monitored for any changes in mood or behavior. Therapy with this drug should be administered cautiously in patients with a history of depression or other psychiatric disorders. It may be prudent to refrain from dispensing large quantities of medication to these patients.
  • Patients with gastrointestinal obstruction, glaucoma and urinary retention. Antihistamines such as diphenhydramine often have anticholinergic effects, to which elderly patients are particularly sensitive. Therapy with ZzzQuil should be administered carefully, in patients with preexisting health issues that may be exacerbated by anticholinergic activity, such as gastrointestinal obstructive disorders, urinary retention or obstruction; angle-closure glaucoma or untreated intraocular hypertension.
  • Patients with asthma or chronic obstructive pulmonary disease – COPD. It has been proposed that the anticholinergic effect of diphenhydramine may decrease the volume and cause thickening of bronchial secretions, which may result in respiratory tract obstruction. Some health professionals will recommend that therapy with antihistamines have to be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.
  • Patients with Cardiovascular Disease, Hypotension or Hyperthyroidism. Antihistamines such as diphenhydramine may in some not some common cases cause cardiovascular side effects which are related to their anticholinergic and local anesthetic (quinidine-like) effects. Palpitation, ECG changes, arrhythmias, fast heart rate, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdose situations, health professionals recommend that therapy with antihistamines should be administered cautiously in patients with such issues.
  • Patients with renal or liver disease. Many first generation antihistamines such as diphenhydramine appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with some renal and/or liver issue may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients and monitor by health care provider. Lower initial dosages may be needed
  • Patients with glaucoma and trouble urinating. Some hypnotic drugs such as diphenhydramine have anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

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Xanax addiction and withdrawal symptoms

Sep 21 2016 Published by under Drug Abuse

What does Xanax do?

Xanax is a Brand name for that contains a short-acting benzodiazepine drug named alprazolam as an active ingredient. This drug works by affecting chemicals in the brain that are unbalanced in patients who have anxiety disorder.

Xanax is prescribed for: panic disorders with or without agoraphobia, generalized anxiety disorder and anxiety linked with depression. It is available in the form of immediate release tablet in following doses: 0.25, 1, 2 and 5 mg and in form of extended release tablet as Xanax XR in doses of 3 and 5 mg.

Other Brand names for products containing alprazolam as an active ingredient that can be found on the market are: Alprox, Niraval, Solanax, Restyl and Esparon.

Xanax addiction and withdrawal

How does Xanax work in the body?

Alprazolam acts by nonspecifically binding to BNZ1 – benzodiazepine receptors, which are responsible for sleep induce and benzodiazepine receptors BNZ2 – benzodiazepine receptors which are responsible for anticonvulsant activity, memory and motor coordination.

BNZ1 and BNZ2 receptors are coupled GABA(to gamma-aminobutyric acid-A)  receptors, that increases the inhibitory effects of GABA neurotransmitter by increasing the affinity of GABA for its binding sites. After binding to its receptor, GABA opens the chloride channel, which results in a cell membrane hyperpolarization and prevention of further cell excitation.

Xanax and addiction

Is xanax addictive drug? Yes. Xanax has a high potential of causing addiction and abuse, although it is a very commonly prescribed drug. Xanax may cause both physical dependence and mental addiction. Physical dependence can be caused when controlled substance is used for a long-term period.

Body becomes used to this substance which may incorporate into body normal metabolism so the body needs this substance in order to function properly. So, in situations when this drug is no longer in the body, patients may experience different symptoms that can drive them to take more of this drug.

On the other way, mental addictions, especially when it is about anxiolytic drug is very difficult to break. Patients who are mentally addicted to alprazolam are unable to control their panic attacks and other anxiety attacks on their own, and they need to continue with this drug for a long-term use in order to feel them better and safe.

While health professionals are ensuring that patients must have to understand how to properly use their drugs, it is in most cases individual thing for a patient itself to make a proper decision to take their drugs correctly.

The best way to prevent benzodiazepines addiction is to take the drug exactly as it has been directed and prescribe by the doctor and never at higher doses or more frequently. Patients who feel that they are beginning to become addicted to Xanax should speak with their doctors and possibly find another treatment for their issues with less potential for side effects.

Does Xanax cause withdrawal symptoms?

If Xanax is used for a long-term period in high doses it is likely that withdrawal will be caused. Withdrawal symptoms will occur in situations when patients who are physically dependent on Xanax therapy suddenly stop using it. In comparison with other benzodiazepine drugs, Xanax may have very serious withdrawal symptoms.

Alprazolam, the active ingredient of Xanax, is eliminated from the body faster than longer-acting benzodiazepines. This is why Xanax cause sudden and severe symptoms of withdrawal. Even the extended-release form of Xanax – Xanax XR may cause stronger withdrawal symptoms than some immediate release benzodiazepines.

Alprazolam is also very potent drug and it can be more than 10 times potent than drugs of the same class, such as diazepam or clonazepam. This drug hijacks brain reward centers more intensely.

What are Xanax withdrawal symptoms?

Because of high potential of causing addiction and withdrawal symptoms Xanax is only prescribed for short-term use. Some patients may experience withdrawal symptoms after taking Xanax after only few weeks. The most common symptoms of Xanax withdrawal are:

  • Blurred vision
  • Vomiting
  • Headache
  • Sweating
  • Aggression
  • Insomnia
  • Seizures
  • Depression
  • Anxiety
  • Paranoia
  • Sensitivity to noise and light
  • Uncontrollable shaking
  • Numb fingers
  • Muscle cramps and pain
  • Loss of appetite
  • Heart palpitations

Does Xanax cause rebound symptoms after withdrawal?

Patients who were prescribed Xanax for their panic disorder, generalized anxiety disorder or insomnia may experience rebound symptoms if they suddenly stop using a drug. Rebound effects are actually much intensified symptoms of a pre-existing psychological condition and may include anxiety, panic attacks and insomnia. Rebound symptoms often disappear for about a week; however underlying disorder usually requires specialized treatment again.

How long Xanax withdrawal symptoms last?

In general Xanax withdrawal symptoms do not last too long. As a short-acting benzodiazepine, it is faster eliminated from the body than other benzodiazepines. Withdrawal starts as soon as the body and brain stay without drug.

As soon as the drug is abrupt and stops being active usually 6-12 hours of the last dose are needed and withdrawal symptoms of Xanax can start. So, withdrawal symptoms may start after a few hours of Xanax abruption and usually last for little more than a week.

In some rare cases, Xanax withdrawal symptoms may appear up to two years after giving the drug up. This phenomenon is known as PAWS – post-acute withdrawal syndrome (PAWS) or protracted withdrawal.

What factors may affect Xanax Withdrawal?

Withdrawal is and individual thing for each person. Different factor may affect addiction and withdrawal. If the body and brain are more dependent to Xanax, more intense and longer withdrawal symptoms are likely to be caused.

Taken doses, method of ingestion, age at first use, combination with other drugs or alcohol, body and mind health, genetic predisposition, frequency and length of time during Xanax therapy or abuse can all affect how quickly dependence is formed and how strong it may be. Predisposed factors may also be: high levels of stress, history of a family or prior addiction, underlying medical complications, and environmental factors.

Xanax detoxification

How long does it take to detox off Xanax? Xanax detox can be a long-term process. Tapering off Xanax includes slowly cutting back on the dosage of the drug over a period of time. Doctor may also recommend moving to a less potent benzodiazepine with a short half-life, like Klonopin or Valium, to taper off use. Detox from Xanax has to be done under the medical professional monitoring.

Medical detox programs are best option for keeping patients comfortable and minimize the effects of withdrawal. This is aslo the safest detox method as doctors are always close to prevent events when withdrawal symptoms become life-threatening.

These programs can help patients on Xanax to exceed their physical dependence while also helping the psychological side of addiction. Getting treatment for Xanax addiction will give you your best chance at a successful recovery.

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How long does Ecstasy stay in your system

Sep 19 2016 Published by under Common Health Questions

What is Ecstasy?

Ecstasy or MDMA or chemically 3,4-Methylenedioxymethamphetamine, the drug which is also known on street as: XTC, Adam, hug drug, exer, beans or love drug, is a synthetic, psychoactive drug which is chemically similar to the stimulant drug methamphetamine and the hallucinogen mescaline.

This illegal substance has both stimulant and psychedelic properties.  Ecstasy produces energizing effects as well as distortions in perception and time and improves enjoyment, empathy, euphoria, and heightened sensations of tactile experiences.

It is most commonly used orally in a form of tablet, but it can also be snorted or smoked. This recreational drug has no medical uses. Clinical studies are testing MDMA therapeutic potential for post-traumatic stress disorder and anxiety associated with terminal phase of cancer. Ecstasy is one of the 4 most widely used illegal drugs in the U.S.A.

Different names for ecstasy pills

  • Drop, Double Drop
  • Molly (street name for “molecular”)
  • Thizzing
  • Flip or Flipping
  • Roll, Rolling
  • Cuddle Puddle, E-Puddle
  • E-tard
  • Raver, Raving

how long does ecstacy stay in your system for a urine test

How does Ecstasy works?

MDMA improve releasing of neurotransmitters in the brain such as: serotonin, norepinephrine, and dopamine. It enters neurons through monoamine transporters. Inside cell, MDMA blocks the vesicular monoamine transporter, which results in increased intracellular concentrations of serotonin, norepinephrine, and dopamine and induces their release through chemical reactions known as phosphorylation.

MDMA may also act as a weak agonist of 5-HT1 and 5-HT2 receptors. This drug unusual and high entactogenic effects have been theorized to be the result of oxytocin hormone indirect secretion through activation of the serotonin system. It is known that oxytocin is released during events like hugging, orgasm and childbirth, and is believed to facilitate establishment of trust and bonding.

Ecstasy side effects

  • The immediate adverse effects of Ecstasy may include: dehydration, bruxism (grinding and clenching of the teeth), hyperthermia, increased perspiration and sweating, increased wakefulness or insomnia, increased heart rate and blood pressure, nausea and vomiting, diarrhea, loss of appetite, erectile dysfunction and mydriasis.
  • Loss of memory and cognition issues: Chronic Ecstasy users may perform more poorly on certain types of memory and cognitive tasks. However, in most cases it is due to the use of other drugs in combination with Ecstasy. One study conducted in 2011 reported limited cognitive decline in Ecstasy users.
  • Physical adverse effects: In high doses, this drug will interfere with the body’s ability to regulate temperature. Rarely this can lead to an increase in body temperature which may result in kidney, liver and cardiovascular system failure, coma and sudden death.
  • Psychological Effects: These side effects can include depression, confusion, drug craving, sleep problems and severe anxiety. These problems may sometimes last for days or weeks after taking Ecstasy.
  • Neurotoxicity: Animal studies connected Ecstasy long-term exposure to neuron’s damage that may cause changes in mood, thinking, and judgment. A study on nonhuman primates showed Ecstasy exposure for only 4 days caused serotonin nerve terminals damage that was evident 6 to 7 years later. While similar neurotoxicity has not been found in humans, the wealth of animal research indicating this drug unsafe properties.

how long does ecstasy stay in your system saliva test

How long does Ecstasy stay in your system?

When taken by mouth, effects start after 30–45 minutes and usually last about 3–5 hours. Ecstasy reaches peak concentrations in the blood between 1.5 to 3 hours after administration. It is then slowly metabolized and eliminated, with 3, 4-Methylenedioxymethamphetamine and its metabolites decreasing to half of their peak concentration over the next several hours.

The elimination half-life time of ecstasy is by some data approximately 7 hours, while other data suggest half-life of 8 to 9 hours. If half-life time is 7 hours it can be calculated that in normal situations will take a total of 1.6 days for ecstasy to be eliminated in whole from the body.  Otherwise, if a half-life time is 8 to 9 hours it may take 2 days for the drug to be completely eliminated.

Though, in most persons Ecstasy will be cleared within 2 days, nearly everyone can expect the drug to have been eliminated within 3 days. However, if alkalinity of urine exists, it can prolong MDMA excretion, increasing its half-life time for about 16 and 31 hours.  Furthermore, MDMA’s metabolite named HMMA (4-hydroxy-3-methoxy-methamphetamine) is thought to remain in the body for nearly 33 hours longer than MDMA.

Factors that may affect on how long Ecstasy (MDMA) stays in the body

There are many factors that may have effects on MDMA metabolism and excretion, and thus the time drug stay in the system. While some persons may be able to pass MDMA drug test within 2 days after administration, yet other may fail.  Those factors include:

  • Age. Younger individuals usually have faster metabolism, they are physically more active, and usually have better health than elderly. Elderly individuals of ages 60+ usually have reduced blood flow to their kidneys and liver, have decreased function of liver and kidneys, and commonly they are taking more drugs for their diseases that may interact with MDMA. As a result, it takes longer time for older individuals to metabolize and eliminate drugs like MDMA from their body.
  • Genetic factors. Genes may affect the speed of drug metabolism. Since MDMA is metabolized mainly in the liver by CYP2D6 enzyme, genetic variants of this enzyme may affect the rate of MDMA degradation.  MDMA is converted into the metabolite DHMA by metabolic reaction with CYP2D6 through the chemical reaction of demethylenation, but those who are poor metabolizers are unable for this transformation.  So certain people may take longer time than usual to metabolize MDMA, while others may faster metabolize and clear this drug from their body.
  • Liver and kidney function. Individuals with some liver or kidney disease and poor functioning of these organs may not eliminate MDMA adequately. This result in a prolonged and less efficient metabolism and excretion and extended time in which this drug stays in the body.
  • Body mass index (BMI). BMI is calculated by height and weight as parameters. Generally, the higher the dose of MDMA is taken in proportion to lower BMI the slower will be elimination of the drug.  Taller and weightier individuals should have easier time of processing MDMA standard doses compared to smaller and low weight individuals.
  • Other medicines or supplements. Many drugs may interfere with the MDMA metabolism. Drugs such as: fluoxetine, paroxetine, cocaine, and other may interact with metabolism of MDMA.  CYP2D6 inhibitors may significantly impair MDMA metabolism. As a result, the drug stays in the body for longer time. However, certain drugs or supplements may induce CYP2D6 enzymes and thus accelerating MDMA metabolism.

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Oxycodone Vs Percocet

Sep 17 2016 Published by under Medication Comparison

What is Oxycodone?

Oxycodone is a Generic name for an opioid pain reliever drug that is used to treat moderate to severe pain. This drug belongs to the group of controlled substances, which means that it can be taken only by doctors close supervision.

It is available in the form of immediate release tablets and capsule, extender-release capsules in doses of 5, 10 15, 20, 40 and 80 mg and in the form of solution. Extended-release capsules are used only for around-the-clock treatment of pain. This form should not be used on an as-needed basis for acute pain.

is oxycodone the same as percocet on a drug test

What is Percocet?

Percocet is a Brand name for an opioid pain medicine that contains combination of oxycodone and acetaminophen as active ingredients. Oxycodone is opioid/narcotic drug that is used for the treatment of moderate to severe pain.

In this mixture, Acetaminophen is used as a less potent pain reliever that increases the effects and decreases unsafe high doses of oxycodone. Percocet is available in tablet form in following doses: 2.5 mg/325 mg, 5 mg/325 mg, 7.5 mg/325 mg, 10 mg/325 mg.

is oxycodone immediate release the same as percocet

Are Oxycodone and Percocet the same thing?

No, they are not the same. Oxycodone is generic drug and active ingredient, while Percocet is a Brand name drug that is made also from oxycodone, but it also contains acetaminophen which is added in order to increase oxycodone effect and reduce its unsafe high doses. So, Percocet is little stronger than Oxycodone, it works longer and may work better.

Also the doses of narcotic drug are reduced in Percocet, so there is a bit less chance to cause serious side effects, withdrawal symptoms, addiction and overdose. However, in patients who have some liver disease Percocet is never recommended. Both active ingredients are metabolized in the liver, so it may be too hard for the liver to metabolize both drugs, and also acetaminophen is known as hepatotoxic drug if it is taken in high amounts.

How Oxycodone and Percocet work in the body?

Oxycodone works as a weak agonist at mu, kappa, and delta opioid receptors in the CNS. Oxycodone primarily binds to opioid mu-type receptors that are coupled with G-protein receptors and function as positive or negative modulators of synaptic transmission through G-proteins that in last step activate effector proteins. Binding of oxycodone to its receptors stimulates the exchange of GTP for GDP on the G-protein complex.

By inhibiting adenylate cyclase oxycodone decreases intracellular levels of cAMP. Consequently, it inhibits the effects of pain transmission neurotransmitters such as substance P, GABA, dopamine, acetylcholine, and noradrenaline. Oxycodone may also inhibit hormone release of vasopressin, insulin, somatostatin and glucagon.

Oxycodone closes N-type voltage-operated calcium channels by activating kappa-receptor and open calcium-dependent inwardly rectifying potassium channels by activating mu and delta receptors. This result is hyperpolarization of neural membrane and reduced neuronal excitability.

Acetaminophen is a selective COX-2 inhibitor that inhibits synthesis of prostaglandin. It can also inhibit COX-2 in Central nervous System. This drug also acts on the hypothalamic heat regulating centers to produce antipyresis. Acetaminophen’s reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI) can cause a very serious and potentially fatal, hepatic necrosis via processes of lipid peroxidation if it is overdosed (taken of more than 4g daily).

Clinical efficacy and safety of oxycodone/acetaminophen combination

Relevant studies have found that combination of NSAID’s such as acetaminophen and aspirin with opioid drugs such as hydrocodone, oxycodone and codeine obtain better analgesic effects compared to double higher doses of opioids drugs alone. The best results were given on animal models.

However, not all of the NSAID’s potentiate oxycodone’s antinociceptive activity. For example, same effects have not been noticed for ibuprofen and oxycodone combination. No studies were found non-additive analgesic interaction between oxycodone and acetaminophen. Also, studies had been reviled that low doses of oxycodone and acetaminophen 2.5/325 mg and 5mg/325 mg are much safer than double doses of oxycodone alone.

Oxycodone and Percocet side effects

Most common side effect that these medicine may cause include:

  • Nausea and vomiting
  • Headache
  • Constipation
  • Dizziness
  • Drowsiness
  • Lightheadedness
  • Weakness or lack of energy
  • Dry mouth
  • Severe itching
  • Trouble falling or staying asleep
  • Sweating

If these side effects are mild, they will probably go away within a few days or a couple of weeks. If they’re more severe or don’t go away, patients should talk with their doctor or pharmacis immediately.

Serious side effects that may happen in not so common cases include:

  • Serious breathing problems that may lead to respiratory depression such as: slowed breathing, very shallow breathing, fainting, dizziness and confusion
  • Seizures
  • Low blood pressure

Symptoms of Physical dependence (addiction) and withdrawal may include:

  • Irritability or anxiousness
  • Restlessness
  • Increased blood pressure
  • Trouble sleeping
  • Fast heart rate
  • Fast breathing rate
  • Teary eyes
  • Dilated pupils (enlargement of the dark center of your eyes)
  • Yawning
  • Runny nose
  • Nausea, vomiting, and a loss of appetite
  • Sweating
  • Diarrhea and stomach cramps
  • Chills
  • Muscle aches and backache

Oxycodone abuse or addiction symptoms may include:

  • Taking the drug regularly even if you don’t need it
  • Taking more of the drug than your doctor prescribes
  • Continuing to use the drug despite negative reactions from friends, family, your job, or the law
  • Taking the drug secretly or lying about how much you’re taking
  • Ignoring regular duties of your life

Who should avoid Percocet and Oxycodone?

  • Patients with lung disease or breathing problems: Oxycodone can slow down respiration or cause you to have shallow breathing. Patients with asthma or chronic obstructive pulmonary disease must avoid these drugs. Certain patients should never take oxycodone such as patients with acute asthma attacks and those who already have slow or shallow breathing, or who have too much carbon dioxide in their blood due to poor breathing.
  • Patients with liver disease: As a result of liver issues, more of a drug will stay in your body for a longer time. This raises your risk of side effects. It can be very serious if Percocet is taken, because acetaminophen is very dangerous for the liver due to its hepatotoxic metabolites. Such patients should never take Percocet.
  • Patients with gastrointestinal problems: Oxycodone may worsen existing stomach or bowel issues. This is because this drug makes it harder for food to move through your digestive tract. Patients with GI obstruction should never take extended-release oxycodone. The immediate-release forms may be used cautiously.
  • Patients with kidneys problems. Patients with kidney issues have to avoid these drugs, because low kidney function may increase the levels of oxycodone in your body and cause more side effects. These drugs may also decrease your kidney function, making your kidney disease worse.
  • Patients with epilepsy. Oxycodone may cause or worsen seizures in some not so common cases.
  • Patients with adrenal gland issues. Patients with Addison’s disease should talk with their doctor about whether these drugs are safe for them. Oxycodone and Percocet may make their condition worse.
  • People with hypothyroidism and low thyroid function. Oxycodone could make your condition better or worse.
  • People with pancreas and gallbladder problems. Oxycodone and Percocet raises the risk of pancreatitis. Patients with acute or chronic pancreatitis should avoid these drugs. If you have a history of pancreatitis or gallbladder problems, you’re at higher risk of acute pancreatitis.
  • Pregnant women. These drugs should be avoided during pregnancy; they should be never taken without doctor advice.
  • Mothers who are breast-feeding. Oxycodone may pass into breast milk and may cause side effects in a child who is breast-fed. These drugs should be avoided during breastfeeding.

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How long does Suboxone stay in your system

Sep 16 2016 Published by under Common Health Questions

What is Suboxone? What is Suboxone used for?

Suboxone is a Brand name for a medication that contains combination of buprenorphine and naloxone as active ingredients. Suboxone is used for the treatment of narcotic (opiate) addiction. It is not as a pain reliever medicine.

Buprenorphine is a partial opioid agonist, which relieves symptoms of opiate withdrawal, while naloxone belongs to the class of drugs called opioid antagonists, which reverse the effects of narcotics.

Suboxone is used as part of a treatment program that usually includes lifestyle changes, counseling and other interventions. It is available in sublingual tablet form in buprenorphine dose of 8 mg and naloxone dose of 2 mg.

how long does suboxone stay in your system after you stop taking it

How does Suboxone work?

Buprenorphine exhibit analgesic effects due to its partial agonist activity on mu-opioid receptors in the brain. Buprenorphine is also antagonist of kappa-opioid receptor. The partial agonist activity means that the antagonist of opioid receptors (such as naloxone) only partially reverses the buprenorphine’s effects.

Binding to the mu and kappa receptors result in hyperpolarization of neural membrane and reduces excitability of neurons. Buprenorphine slowly dissociates from its receptor and has longer effects compared to morphine. It has a very low level of causing physical dependence. Buprenorphine’s receptor half-life is about 40 minutes which is much longer than morphine which half-life is counted in milliseconds.

Naloxone is an opioid antagonist drug that prevents or reverses the effects of opioids drugs such as respiratory depression, hypotension, pupillary constriction and sedation. Also, it can reverse dysphoric and psychotomimetic effects of agonist-antagonists drugs such as pentazocine. It is essentially pure narcotic antagonist that does not have “agonistic” or morphine-like characteristics.

While the mechanism of naloxone action is not yet fully understood, the some evidences suggest that naloxone antagonizes opioid effects by competing for the same receptor sites, especially the opioid mu receptor. Recent findings show that naloxone binds to all three opioid receptors (mu, kappa and gamma) but the strongest binding is to the mu receptor.

Suboxone side effects

Patients should tell their doctor if any of the following side effects become severe or do not go away:

  • Headache
  • Constipation
  • Stomach pain
  • Vomiting
  • Difficulty falling asleep or staying asleep
  • Sweating

Patients should contact their doctor immediately if they experience any of the following serious side effects:

  • Difficulty breathing or slowed breathing
  • Itching, skin rash, or hives
  • Upset stomach
  • Difficulty swallowing
  • Extreme fatigue
  • Unusual bleeding or bruising
  • Low energy
  • Loss of appetite
  • Pain in the upper right part of the stomach
  • Flu-like symptoms
  • Yellowing of the skin or eyes

How long does Suboxone stay in your urine system for a drug test

Buprenorphine is metabolized in the liver and eliminated by urine and feces. Naloxone undergoes metabolism in the liver as well. Metabolic reactions in the liver create Suboxone’s metabolites that can stay in the body for even longer than the drug itself. Modern drug tests can detect such metabolites as well even after 8 days.

After Suboxone sublingual administration, buprenorphine has an elimination half-life time ranging from 24 to 42 hours and naloxone has an elimination half-life time ranging from 2 to 12 hours.

Buprenorphine becomes detectable in the urine just 40 minutes after consumption, and if it is used for a long-term, drug may show up in lab tests for up to 2 weeks later. The drug and its metabolites can also build up in follicles of the hair and can be detected for 1-3 months; however this is so reliable drug testing form.

How to use Suboxone sublingual tablets?

Tablet should be placed under the tongue and dissolved. Several minutes will be needed for full dissolving. Patients should follow the directions on the prescription label. Medicine should be leaved in the sealed foil pack until patients is ready to use it.

If dose requires to take at once more than 2 tablets, either place all the tablets at once under the tongue, or if you cannot fit more than 2 tablets comfortably, place 2 tablets at a time under the tongue. Either way, you should hold the tablets under the tongue until they completely dissolve. Do not swallow or chew this medicine. This medicine has to be taken at regular intervals. Patients should not take this medicine more often than directed.

What happens if I miss a Suboxone dose?

Take the missed dose of Suboxone as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose Suboxone?

Patients have to seek emergency medical attention immediately or call the Poison Help line at 1-800-222-1222 if they overdose Suboxone. A Suboxone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms include severe drowsiness, blurred vision, slurred speech, thinking problems, loss of coordination, and weak or shallow breathing and weakness or limp feeling.

Suboxone and alcohol interaction

Patients should never take Suboxone together with alcohol. If buprenorphine is used together with central nervous system depressants such as alcohol, there will be increased risk of buprenorphine overdose and causing serious side effects such as severe respiratory depression, coma, and death.

The most common reported cases have primarily occurred in the setting of buprenorphine maintenance therapy for the patients with opiate addiction, and many involved abuse or misuse of buprenorphine including intravenous self-injection.

The exact mechanism of interaction between alcohol and buprenorphine is still unknown, but some preclinical studies suggest that CNS depressives can alter ceiling effect on buprenorphine-induced respiratory depression and render the buprenorphine’s respiratory effects similar to those of full opioid agonists such as morphine.

Suboxone and pregnancy

Animal studies data have failed to find the evidence of Suboxone teratogenicity; however, it is known that use of buprenorphine has been related with fetotoxicity and difficult parturition, including implantation losses and decreased postnatal survival in animals. However, there are no controlled data in human pregnancy.

FDA pregnancy category is C which means that: Animal reproduction studies have been shown side effects on the fetus and there are no acceptable and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

What are Xanax bars?
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Xanax bars

Sep 15 2016 Published by under Medicines

What is Xanax?

Xanax is a Brand name for a benzodiazepine drug that contains alprazolam as an active ingredient. It has effects on chemicals in the brain that may be unbalanced in people with anxiety.

white xanax bars

What is Xanax used for?

Xanax indications are:

  • Anxiety disorders such as: generalized anxiety disorder, motor tension, autonomic hyperactivity, vigilance and scanning
  • Anxiety associated with depression
  • Panic disorders with or without agoraphobia
  • Other uses such as severe premenstrual syndrome

Xanax available dosage forms

Xanax is available in following forms and doses: immediate release tablets in doses of 0.25 mg, 0.5 mg, 1 mg and 2 mg and as extended release tablets (Xanax XR) in doses of 0.5 mg, 1 mg, 2 mg and 3 mg.

Difference between different tablet colors of Xanax

Differences between different colors of Xanax tablets are in alprazolam dose and in type of the tablet (immediate or extended release).

  • Xanax 0.25 mg immediate-release tablets are white. 
  • Xanax 0.5 mg immediate-release tablets are orange.
  • Xanax XR extended-release tablets of 1 mg are yellow,
  •  Xanax XR extended-release tablets of 2 mg are blue, 
  • Xanax XR extended-release tablets of 3 mg are green,
  • and Xanax XR extended-release tablets of 0.5 mg are also white but designed in 5-side shape.

What are Xanax bars? 

Xanax bar is actually Xanax tablet of 2 mg that is shaped like a bar or stick so it can be easily divided into 1/4s of 0.5 mg. This formulation allows exact and the best distribution of 0.5 mg of alprazolam in every quarter of a bar.

xanax 1

How Xanax works?

Alprazolam is a benzodiazepine drug that works by nonspecifically binding to the benzodiazepine receptors BNZ1, which are responsible for sleep sleep, and BNZ2, which are responsible for muscle relaxation, motor coordination, anticonvulsant activity and memory.

Alprazolam can be also coupled to GABAa – gamma-aminobutyric acid-A receptors, so this interaction enhances the effects of GABA in the brain, which is strong inhibitory neurotransmitter, by increasing GABA affinity for the GABA receptor. When GABA binds to its receptors, it opens chloride channels, resulting in a membrane hyperpolarization that prevents further cell excitation.

Different from clorazepate, chlordiazepoxide and prazepam, alprazolam has a much shorter half-life and its metabolites have a minimal activity. Similar to triazolam, alprazolam may have important drug interactions that involve the hepatic cytochrome P-450 3A4 isoenzyme.

Like all benzodiazepines, alprazolam may also cause a dose-related CNS depression varying from mild impairment of performing tasks to hypnosis. Another difference from other benzodiazepines is that alprazolam may also have some antidepressant activity; however there are no major clinical evidences for it.

Xanax side effects

The table below shows more common mild to moderate side effects that Xanax may cause:

Xanax more common mild to moderate side effects
  • drowsiness
  • dizziness or lightheadedness
  • blurred vision
  • headache
  • trouble concentrating
  • memory problems
  • sleep problems
  • upset stomach
  • muscle weakness or lack of coordination
  • nausea or vomiting
  • increased sweating
  • diarrhea
  • dry mouth
  • stuffy nose
  • increased or decreased appetite
  • weight loss or gain
  • loss of interest in sex

If these effects are mild, they will probably go away within a few days or a couple of weeks. If they’re more severe or don’t go away, patients should talk with their doctor or pharmacist.

The next table shows serious side effects that can happen after Xanax use. Patients should call their doctor immediately if they exhibit such side effects.

Xanax rare, but serious side effects

  • Mental problems such as depressed mood, suicide thoughts, confusion, hallucinations
  • Motor and movement such as: uncontrolled muscle movements, seizures and tremor
  • Cardiovascular problems such as: chest pain and abnormal heartbeat
  • Liver problems such as jaundice with yellowing of the skin or the whites of the eyes
  • Urinary problems such as urinating less than usual or not at all

Who should not take Xanax?

  • Patients with depression. In those with pre-existing depression, Xanax may make their condition much worse, because of its CNS depressive effects. If depression gets worse or patients have suicidal thoughts, doctor should be called immediately. Episodes of hypomania and mania have also been reported in depressed patients treated Xanax.
  • Patients with acute narrow-angle glaucoma and untreated open-angle glaucoma. Xanax can make this condition worse. Do not take Xanax if you have acute narrow-angle glaucoma. Xanax has anticholinergic effects; however it has been very rarely associated with increased intraocular pressure.
  • People with a history of alcoholism, drug abuse, or personality disorder. Xanax can lead to psychological physical and addiction. Patients with a history of these conditions may have a greater risk of addiction to this drug.
  • Patients with renal or liver disease. Xanax is metabolized by the liver, and metabolites are excreted in the urine. For patients with lower kidney or liver function it may be harder for metabolize and eliminate this drug from the body. This can increase the amount of the Xanax in blood, and may increase the risk of causing serious side effects.
  • Patients with severe lung disease. Like all benzodiazepines, Xanax may also cause respiratory depression and apnea, usually when it is given in high doses. However, some patients may be more sensitive to recommendable dosages such as elderly, debilitated or severely ill patients, patients on other CNS depressants, and those with limited ventilatory function, chronic pulmonary insufficiency or other respiratory disorders. Therapy with Xanax must be administered cautiously and monitor closely in these patients.
  • Patients with epilepsy. Xanax may increase the incidence or precipitate the onset of generalized tonic-clonic seizures attacks in patients with epilepsy. Also, abrupt cessation of Xanax may precipitate seizures attacks as withdrawal symptoms, in generally after prolonged use of CNS depressants. Status epilepticus may also occur if long term Xanax therapy is rapidly withdrawn.
  • Obese patients. The plasma half-lives of Xanax may be prolonged in obese patients, likely because increased distribution into fat. The amount of the drug can be increased in their body, which can lead to increased risk of side effects to happen. Xanax should be administered cautiously in obese patients, with careful monitoring of CNS status.
  • Patients allergic to Xanax or other benzodiazepines. Xanax may cause a severe allergic reaction in hypersensitive patients. Symptoms can include: trouble breathing and swelling of throat or tongue
  • Pregnant women. This drug is classified in the FDA pregnancy category D list of drugs. That means: Studies in humans has shown adverse effects to the fetus when the mother takes the drug. This drug should only be used during pregnancy in serious cases where it’s needed to treat a dangerous condition in the mother. Patients should talk with their doctor if they are pregnant or plan to become pregnant. Doctor should tell you about the specific harm that may be done to the fetus when this drug is used. This drug should be only used if the potential risk to the fetus is acceptable given the drug’s potential benefits.
  • Mothers who are breast-feeding. Alprazolam may pass into breast milk and may cause side effects in infant. Infant may become drowsy and lose weight. Mothers who are breast-feeding should talk with their doctor, and they may need to decide whether to stop taking this medication or stop breast-feeding.
  • Elderly who are over the age of 65 years may become more sensitive to the sedative side effects Xanax. They will be more likely drowsy. Doctors should monitor such patients closely. Also, they should take extra care to avoid falls that may be caused by drowsiness or dizziness.
  • Xanax should never be given to a child younger than 18 years of age.

What happens if I miss Xanax dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose Xanax?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of alprazolam can be fatal. Overdose symptoms may include extreme confusion, drowsiness, muscle weakness, feeling light-headed, fainting and loss of balance or coordination.

Xanax dosage information

Usual Adult Dose of Xanax for Anxiety:

Immediate-release tablets initial dose: 0.25 to 0.5 mg orally 3 times a day. Dose may be gradually increased every 3 to 4 days if needed and tolerated.

Immediate-release tablets maintenance dose: May increase up to maximum daily dose of 4 mg in divided doses

Usual Adult Dose for Panic Disorder:

Immediate-release tablets initial dose: 0.5 mg orally 3 times a day. Dose may be gradually increased every 3 to 4 days if needed and tolerated.

Immediate-release tablets maintenance dose: 1 to 10 mg per day in divided doses

Extended-release tablets initial dose: 0.5 to 1 mg once a day. The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days if needed and tolerated.

Extended-release tablets maintenance dose: 1 to 10 mg once a day

Usual Adult Dose of Xanax for Depression:

Immediate-release tablets initial dose: 0.5 mg orally 3 times a day. The daily dose may be gradually increased by no more than 1 mg every 3 to 4 days.

How long does it take Xanax to work?

After oral administration, Xanax is readily absorbed. Xanax work very quickly, after 20-30 minutes. Maximum concentrations in the plasma occur in 1 to 2 hours after following administration. Its full effects last an average of about 5 hours.

How long does Xanax stay in your system?

Xanax may remain in your bloodstream long after its effects are gone. That is because Xanax average half-life is about 11 hours. A drug’s half-life is the time it takes for half of the dose in the blood to be eliminated. For Xanax, it takes about 11 hours to eliminate half of the dose taken and several half-lives for the drug to be completely eliminated.

However, different factors may have impact on duration of drug action such as age, weight, kidney or liver disease, which can all cause a prolongation of its elimination. So for some patients, a small amount of Xanax may stay in the body even after two or more days after taking just one dose.

Furthermore, if Xanax is taken regularly, higher levels of the drug may maintain in the bloodstream, since it tends to accumulate. It may take several weeks for Xanax to be completely eliminated from your body. Xanax passes from into urine and can be detected in drug tests long after you have taken the last dose.

Xanax drug interactions

  • Xanax + Acid reducers (ranitidine, famotidine, pantoprazole, omeprazole, esomeprazole etc…). Drugs that lower acid production in the stomach may prevent Xanax from being absorbed into the blood properly, thus greatly reducing the concentration of the drug and its efficacy.
  • Xanax + Painkillers (codeine, morphine, hydrocodone and oxycodone). Narcotic pain relievers can add sedation and drowsiness side effects if they are taken together with Xanax. Patients who are taking these drugs with Xanax should always do according to their doctor’s advice. In most cases, the dosages of these drugs have to be reduced in order to prevent severe side effects.
  • Xanax + Diphenhydramine. Many of the OTC products that are used to treat allergy and cold symptoms contain diphenhydramine as active ingredient, a drug very known to cause extreme drowsiness. Patients should be sure to mention all of the medications they take to their pharmacists in order to monitor for potential issues.
  • Xanax + OTC Sleep Aids. Xanax and sleep aid herbal (valeriana or hop) or melatonin supplements and remedies such as Unisom, Sleep Ease, Simply Sleep and different Melatonin products may increase sedation and drowsiness if they are used together. Patients should keep in mind that these preparations are usually also available in generic form. If there are questions or concerns regarding these medications, patients can get more information from their pharmacists.
  • Xanax + Prescription Sleep Aids. Prescription sleep aids such as Lunata, Ambien, Trazodone, Sonata, Lunasta and Halzion are much more effective than OTC sleep aid drugs, so they are likely to interact with Xanax and cause side effects. Interaction can result in severe depression of the respiratory system, and may dangerously slow heart rate causing coma and even death.
  • Xanax + Propoxyphene. Propoxyphene is a narcotic drug that is used to treat mild to moderate pain when OTC pain relievers are not effective. It is available under next Brand names: Darvon, Darvocet, Balacet and Propacet. Using Xanax together with propoxyphene may increase side effects such as dizziness, confusion, drowsiness, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in judgment, thinking and motor coordination.
  • Xanax + Ketoconazole. Using ketoconazole and Xanax is not recommended. Using these drugs together can cause slowed breathing, sedation and drowsiness.

Does Xanax cause addiction?

Although Xanax is a very commonly prescribed drug which is used for the most conditions, there is a high potential for Xanax to cause addiction and abuse. Xanax may cause two different types of addiction: physical dependence and mental addiction.

When someone is using controlled substance for a long-term period, body become used to this substance, may incorporate in body normal metabolism so the body must have it in order to function properly. So, if this substance is no longer in the body, patients will experience different symptoms that most commonly drive them to take more of this substance.

On the other hand, mental addictions, especially when anti-anxiety drug is in question, are very difficult to break. Patients who have mental addiction to Xanax are unable to fend off panic attacks and other anxiety attacks on their own, and they need to continue with this drug for a long-term use in order to feel them safe.

While doctors and pharmacists are ensuring that patients understand how to properly take their drugs, it is however individual thing for a patient itself to make a conscious decision to take their drugs correctly.

The number one way to prevent addiction caused by benzodiazepines such as Xanax is to take the drug exactly as it has been directed and prescribe and never at a higher dosage or more frequently! Patients who feel as if they are beginning to become addicted to Xanax should speak with their doctors and possibly find another course of treatment with less potential for side effects.

Is Xanax abused?

Xanax abuse is also a big problem for many persons worldwide. This drug is produced in order to help individuals who suffer from anxiety.  But people often choose to buy the drug off the street in order to get high.

This is a very serious problem, not only for someone health, but also for society. Many groups and organizations are formed in order to put an end of Xanax and other prescription drugs abuse. Also, patients can also do their part by keeping the drugs out of the reach of others and by properly disposing it.

Those who abuse Xanax or other prescription drugs may need an expert intervention and treatment in an inpatient facility in order to break the habit. These treatment options are completely confidential and covered by most health insurance plans; they can be found by contacting substance abuse looking in the local Yellow Pages or hotlines.

Xanax withdrawal

Patients, who uses benzodiazepines such as Xanax for a long period of time and suddenly stops using it, may develop severe symptoms of withdrawal that may lead to a serious health problem known as benzodiazepines withdrawal.

When someone suddenly stops using Xanax after long time, he/she will certainly experience a rebound of the symptoms for which is this drug originally prescribed. Most common symptoms may include:

  • more frequent panic attacks
  • increased anxiety
  • headaches
  • insomnia
  • nausea
  • tremors
  • loss of appetite
  • irritability
  • fatigue

Also, in some not so common cases patients can experience high blood pressure and even seizures that in some cases may be fatal if they are not treated quickly. Seizures are among the most serious symptoms, but also delirium, delusions and hallucinations. Many of these symptoms will resolve with time, but some of them require medical help.

Avoiding Xanax is the best way to treat its withdrawal in the first place. This is the best option for most doctors who prescribe Xanax to their patients. Principal of therapy should be next: low doses which are taken only when absolutely is needed are much better than higher doses taken frequently.

Patients who need to take benzodiazepines on a regular basis may find that other drugs will work just as well and carry less risk, like Clonazepam and Valium. So, patients who are concerned about experiencing withdrawal should always speak with their doctors and pharmacists about the best way to take or stop taking the drug in order to avoid these symptoms.

Xanax and alcohol

Why patients should never take Xanax together with alcohol?

Alcohol and Xanax are both CNS depressants. Both drugs reduce brain activity and cause slow reaction and disorientation over time. Patients who regularly or only occasionally use Xanax may notice that they are very sensitive to the alcohol effects and are unable to tolerate it. When Xanax and alcohol are combined there is high chance of experiencing severe side effects. Mild to moderate side effects may include:

  • loss of coordination
  • drowsiness
  • dizziness
  • strange behaviors
  • memory issues
  • headache
  • nausea
  • vomiting
  • cold chills
  • hot flashes

If these side effects further progress or if the consumption of alcohol is significant, patients may experience serious side effects such as slowed heart rate and respiratory issues such as difficulty breathing. Such side effects may lead to coma or even death if it is not immediately treated.

Can I take Xanax with Grapefruit juice?

Grapefruit juice may block certain enzymes that can be responsible for drug metabolism or prevention of drug high amounts absorption into the bloodstream. When pharmaceutical companies develop dosages for their products, they will generally take these enzymes into account.

However, when grapefruit juice blocks these enzymes, high amounts of the drug may be able to enter into bloodstream this may increase the risk of side effects to happen and possible overdose. When patients take Xanax and grapefruit at the same time, they may experience higher effects of drowsiness and dizziness. This is because more of the drug is in bloodstream.

Studies have failed to discover how much of the drug does fruit allow into the system, but these studies were relatively unsuccessful because the absorption rate varies from patient to patient.

Also, apart from this, many patients have reported gastrointestinal upset and nausea when they drink grapefruit juice or eat the fruit either directly before or after ingesting some of benzodiazepine drug. In order to avoid these side effects, patients should never drink grapefruit juice and take Xanax within 24 hours of one another; this time allows the Xanax to be metabolized and eliminated from the body.

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Benadryl and Advil interaction

Sep 14 2016 Published by under Drug Interactions

What is Benadryl? What is Benadryl used for?

Benadryl is a Brand name for an OTC antihistamine drug that contains diphenhydramine as an active ingredient. It is first-generation, “sedating” antihistamine that crosses the blood-brain barrier and blocks H1 receptors in  the CNS and periphery nervous system.

Benadryl is used to treat allergy and cold symptoms such as: sneezing; itching, runny nose; hives; rashes; watery eyes; and other symptoms of allergies and the common cold.

Benadryl is also used to suppress coughs, for the treatment of motion sickness, as a sleep inductor, and in some cases to treat mild forms of Parkinson’s disease. Some Benadryl’s OTC preparations may also contain other active ingredients such as: Acetaminophen, added as a pain reliever and fever reducer, Pseudoephedrine or Phenylephrine added as a nasal decongestants.

What is Advil? What is Advil Used for?

Advil is a Brand name for an OTC medicine that contains ibuprofen as an active ingredient. It is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body.

Advil is used as a fever reducer and pain and inflammation reliever for conditions such as toothache, headache, back pain, menstrual cramps, arthritis, or minor injury. Some Benadryl’s OTC preparations may also contain other active ingredients such as: antihistamines Chlorphenamine or Diphenhydramine, decongestants Pseudoephedrine and Phenylephrine.

Can I take Benadryl and Advil together?

advil + benadryl

Since, there is no significant interaction between ibuprofen and diphenhydramine patients can take them together in recommendable doses for a short period of time. Ibuprofen is pain reliever and fever reducer while Benadryl is good for common cold and allergy symptoms. Together they will work fine.

However some of Advil products such as Advil Cold and Flu, 7-select Advil PM, Advil Cold, Cough & Flu Nighttime, Advil Cold, Cough & Flu Nighttime, Advil PM and Advil Pain & Head Cold Night already contain diphenhydramine in one dosage form with ibuprofen.

So if patients take on of such product in combination with Benadryl, patients may double the dose of antihistamine and increase the risk of side effects such sedation and drowsiness. Also some Benadryl product may contain acetaminophen as an active ingredient.

Taking such products together with Advil may be undesirable to patients with internal bleeding, gastrointestinal ulcers or some liver, kidney or heart disease. That’s why patients should always talk with their doctor and pharmacist first, before they take something on their own.

Also predisposed patients with some health issues, such as hypertension and fluid retention should talk with their doctor or pharmacist first before using this combination. It is known that ibuprofen may cause fluid retention. Antihistamines drugs such as diphenhydramine can also cause fluid retention due to their anticholinergic properties.

If you suffer from hypertension or worse yet you have heart failure, this drug combination can be very dangerous indeed. Age also plays an important factor as well and seniors should avoid this combination.

The table below shows side effects that can be caused by taking Advil and Benadryl. The incidence of these side effects can be much higher if these drugs are overdosed or if products with same active ingredient are taken together:

  • Nausea
  • Vomiting
  • Epigastric pain
  • Rash
  • Edema
  • Tinnitus
  • Sedation
  • Confusion
  • Anticholinergic effects
  • May decrease cognitive function in geriatric patients
  • Xerostomia
  • Pharyngeal and nasal mucosa dryness
  • Thick sputum

Can I take Advil or Benadryl with Alcohol?

Combination of Advil and alcohol can lead to a higher risk of development of gastrointestinal adverse effects, such as nausea, vomiting, abdominal pain, heartburn, and especially of gastrointestinal bleeding. Gastrointestinal bleeding symptoms can be: vomiting blood, diarrhea, and black color of stool. If such side effects happen, patients should immediately discontinue Advil and call their doctor.

Patients with risk factors for gastrointestinal bleeding, such as stomach or duodenal ulcer, gastritis or bleeding should never use Advil with alcohol. Patients with any sort of kidney or liver disease must avoid the combination of ibuprofen and alcohol as it can additionally exacerbate their condition.

In general alcohol should not be taken together with Benadryl. The exact mechanism of interaction is not clear, but it is known that alcohol may potentiate diphenhydramine’s depressive side effect in Central Nervous System and vice versa causing drowsiness and sedation as most common side effects. The tolerability of the sedative effects from person to person is individual.

Some may be able to tolerate one or two drink while there on Benadryl therapy while others may develop side effects immediately after drinking. Since potential side effects on patients are unpredictable, patients are advised to avoid any alcohol while taking Benadryl. Patients who drive or operate machinery and heavy equipment are highly advised to avoid drinking alcohol because of the possible drowsiness.

Special precautions and warnings during Benadryl and Advil administration:

  • Benadryl shouldn’t be used to make a child sleepy.
  • Benadryl should not be given to a child younger than 6 years without medical advice.
  • Before taking diphenhydramine or acetaminophen products, patients should tell their doctor or pharmacist if they are allergic to them or if they have any other allergies. These products may have some inactive ingredients, which can also cause allergic reactions or other side effects.
  • Alcohol may potentiate effects of antihistamines. Patients should limit alcoholic beverages while using Benadryl.
  • Before taking these medications patients should also tell their doctors or pharmacists if they have some health issues in the past such as: breathing problems (asthma or emphysema), high blood pressure, glaucoma, heart problems, kidney disease, liver disease, stomach or intestine problems, seizures, hyperthyroidism, or enlarged prostate.
  • Benadryl can make patients dizzy or drowsy. They should not drive, use machinery, or do any activity that requires alertness.
  • In elderly patients there is a high-risk after administration of Benadryl because they may increase: the risk of falls and incidence of anticholinergic effects (exacerbation of existing lower urinary tract conditions, benign prostatic hyperplasia, and tolerance).
  • In rare cases, Advil can cause a severe skin reaction. Patients should stop taking this medicine and call their doctor immediately if they have skin redness or a spreading rash that causes blistering and peeling.
  • Advil can increase the risk of serious effects on the stomach or intestines, including bleeding, ulcers or perforation. Advil may be more likely to cause stomach bleeding in adults who are older than 60 years. Patients should call their doctor immediately if they have symptoms of bleeding in your stomach or intestines. This includes worsening stomach pain, coughing up blood or vomit that looks like coffee grounds or black, bloody, or tarry stools.
  • Advil may increase the risk of life-threatening cardiovascular issues, including heart attack or stroke. Do not take Advil just before or after having heart bypass surgery. Patients should seek emergency medical help if they exhibit symptoms of cardiovascular issues, such as weakness, chest pain, shortness of breath or problems with vision or balance.

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