Posted by gardenergirl on September 6, 2004, at 9:42:37
In reply to Re: Wow, my pdoc was just talking abou this... » gardenergirl, posted by Larry Hoover on September 6, 2004, at 8:35:20
> > > >
> > Incidentally, I would suspect I am a poor metabolizer and my family heritage is Finnish. Wonder if there is a regional/genetic connection?Wow, I can tell this was during major insomnia...where the heck was I going with the Finnish thing?
> >
> > And this explains to some extent how once I got nearly hypomanic from an antibiotic...Biaxin XR. All the pharmacist could say when I called was "maybe your liver is not metabolizing it well." As if I had some liver pathology. Hmmmm.
> >
> > Thanks for posting this.
> >
> > gg
>
> Biaxin is not only a substrate of enzyme 3A4, it is also an inhibitor. Makes predictions of what is going to happen rather difficult. Also, if you are ingesting any of the following, there is a strong likelihood of an interaction caused by these inhibitors: Ketoconazole (Nizoral), Itraconazole (Sporanox), Erythromycin, Grapefruit Juice, Seville Oranges, Nefazodone (Serzone), Fluvoxamine (Luvox), Fluoxetine (Prozac), Diltiazem (Cardizem), Verapamil (Calan), Clarithromycin (Biaxin), Omeprazole (Prilosec), Propoxyphene (Darvon), Ritonavir (Norvir), Indinavir (Crixivan), Nelfinavir (Viracept), Saquinavir (Fortovase)Nope, none of those...just lucky I guess. The doc and his med student insisted it couldn't be the biaxin, but I made them look at the insert, and it listed mania, psychosis, and transient CNS symptoms as possible although more unusual side effects.
>
> From:http://www.geocities.com/hupiteekki/paihde01.htm
>
> One of the most common enzyme deficiencies is in enzyme 2D6. If you've ever used codeine, you can predict your 2D6 activity rather accurately, based on your reaction. If 2D6 activity is low, you will get constipation and dry mouth, but poor pain control. If normal 2D6 activity, you'll get a nice balance between side effects and pain relief. If you have high 2D6 activity (so-called extensive metabolizers), you'll get a major high. 2D6 converts codeine to morphine. It's a prodrug for morphine. Poor metabolizers get little or no morphine. Normal metabolizers get something like extended-release morphine. Extensive metabolizers get something like an IV injection of morphine. The variability in 2D6 activity is at least 118-fold, or 11,800% difference in the rate of morphine yield.
>
> LarHmmm, if I remember correctly, I had cough syrup with codeine and got kind of jittery. It certainly didn't help me sleep like the doc. said it would. I did take vicoprofen (not sure if this would have same reaction) after some dental work. Some people told me this was a "feel good" drug, but I didn't feel anything. It did control my pain, though. And I didn't have any side effects on one tab dose.
>Interesting...
gg
poster:gardenergirl
thread:385176
URL: http://www.dr-bob.org/babble/20040904/msgs/387020.html