Cross over from tablet to liquid OR changing the brand

[littlebird]

Thank you for this thread! The crossover from SR to IR with Wellbutrin has been throwing me for many loops a day. I think it helps that I’m able to use the same generic SR, and make it into IR by cutting it up per Alto’s Wellbutrin tapering thread advice.

 

The day the generic IR form arrived, I tried it just to see if it would feel the same, and it was a bumpier ride. Still figuring out if it’s best to taper with the SR I’ve got a whole bottle of, and hold off on switching manufacturers until I get used to IR delivery, but it feels right so far. Hard to have so much unknown and self-experimentation, but I’m holding on for the ride and keeping at it.

[Obstacle1]

Anyone know if it's possible to ensure you get the same brand each time? I've been crushing pills of Paroxetine from Milpharm for a while and picked up a prescription recently manufactured by Crescent. They appear to have some different ingredients and I'm starting to feel a bit 'off'.

 

If I wanted to do a crossover with crushed pills how do people do this - do you weigh out two parts and take them in separate gelatin capsules? This feels like a super long winded process!

[Fifree]

Hi fellow taperers

 

I will soon be switching from tablets to liquid and wanted to get extra advice. 
 

In Australia, as far as brands go, you get what you get from the pharmacy if you want to get the reduced price under the Pharmaceutical Benefits Scheme.  You can request “brand only” but then you have to pay full price which is significantly higher. 
 

I’ve been successfully tapering using Sandoz brand Escitalopram tablets. Now that I’m down to 10 mg I will be switching to the liquid before my next drop. But when I went to the pharmacy to get my liquid script they gave me name brand Lexapro. So when I switch, it’s going to be two changes at once - both brand and form. 
 

does anyone have any extra advice? @Faure @Gridley @Erimus?

 

thank you

[Gridley]

11 hours ago, Fifree said:

So when I switch, it’s going to be two changes at once - both brand and form. 

I would just take bit longer for each stage of the crossover.  I don't know if you already have this schedule:

 

3/4 old, 1/4 new for 3 to 7 days

1/2, 1/2 for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

 

[Mcat]

Dear cross-over gurus: I'm currently stabilising on 7.5mg Mirtazapine before switching to liquid for a 10% (or less) taper after a recent too-fast taper, bad WD, and reinstatement. I've read the thread and get that it's optimal to do a slowly graduated switch between pill and liquid forms. I won't be able to do that as I can't handle the weight calculations (v. bad maths) and will be getting liquid made by a compounding chemist, so I'm thinking I'll just do the switch and hope for the best, but now that I've read this thread I'm feeling nervous about it. Have some people just made the switch to liquid straight up without major issues? If I go ahead with this plan, I should just take the same dose in liquid form until stable, yes? And is liquid likely to be stronger or less strong or no way to know? It's all so complicated; whenever I think I have a plan and start to feel a bit bolder about it, I read a bit more fine print that makes me doubt it. 

[Mezzer]

9 hours ago, Mcat said:

Dear cross-over gurus: I'm currently stabilising on 7.5mg Mirtazapine before switching to liquid for a 10% (or less) taper after a recent too-fast taper, bad WD, and reinstatement. I've read the thread and get that it's optimal to do a slowly graduated switch between pill and liquid forms. I won't be able to do that as I can't handle the weight calculations (v. bad maths) and will be getting liquid made by a compounding chemist, so I'm thinking I'll just do the switch and hope for the best, but now that I've read this thread I'm feeling nervous about it. Have some people just made the switch to liquid straight up without major issues? If I go ahead with this plan, I should just take the same dose in liquid form until stable, yes? And is liquid likely to be stronger or less strong or no way to know? It's all so complicated; whenever I think I have a plan and start to feel a bit bolder about it, I read a bit more fine print that makes me doubt it. 

Hi mcat,

I just did a switch in December. From tablet to liquid. I had to make the switch as the pharmacy kept switching mfgers of the tablets so it was getting to complicated to make a gradual change so I just made the switch. I did don’t notice anything odd beyond the normal symptoms I was dealing with. Hope this helped 

[Mcat]

Thanks, Mezzer, that's reassuring!

[LostInCanada]

@yoshi4844the first page, a few posts down... it's by Gridley 

[PattyCatty]

Dear @Gridley and @brassmonkey

 

I'm on a 10mg film coated Citalopram tablet and looking to switch to liquid so that I can start a taper.

 

I'm trying to work out how to minimise disruption in switch over.

 

In order to make the graded switch to liquid you recommend cutting and measuring the weight of the tablet and putting in a gel capsule? Is the gel capsule to replace the film coating of the tablet (to mimic slow release / allow content to survive stomach?)

 

If liquid has a shorter half life as suggested by @ChessieCat would you have thoughts on how this would be managed to prevent intraday effects during switchover and then thereafter?

 

Thank you.

[PattyCatty]

A fellow traveller mentioned that they just dissolve their tablet in water and use this solution to taper. I had not considered doing this, but I have the same questions in the absence of film coating re: faster release and shorter half life... Any thoughts?

 

(I ask because, I tried to simultaneously switch and reduce dose of Citalopram in November and I noticed (1) I should not reduce and switch at the same time (2) even when I matched the liquid dose to the full tablet dose, the effects of the liquid wore off very quickly and taking a bit more liquid later in the day helped. After two days of realising I wasn't taking the right steps and Christmas was around the corner I switched back to the full tablet dose, waited to stabilise and try again.)

[Gridley]

@PattyCatty

 

Sorry, I'm no longer moderating.

[hayduke]

On 3/19/2023 at 11:50 AM, Fifree said:

Hi fellow taperers

 

I will soon be switching from tablets to liquid and wanted to get extra advice. 
 

In Australia, as far as brands go, you get what you get from the pharmacy if you want to get the reduced price under the Pharmaceutical Benefits Scheme.  You can request “brand only” but then you have to pay full price which is significantly higher. 
 

I’ve been successfully tapering using Sandoz brand Escitalopram tablets. Now that I’m down to 10 mg I will be switching to the liquid before my next drop. But when I went to the pharmacy to get my liquid script they gave me name brand Lexapro. So when I switch, it’s going to be two changes at once - both brand and form. 
 

does anyone have any extra advice? @Faure @Gridley @Erimus?

 

thank you

You should be able to request a specific type of generic if you use a good chemist.  The chemists I consistently used through my last taper would accommodate that, and get them in for me ahead of time.  Saved chopping and changing.

[hayduke]

18 hours ago, PattyCatty said:

A fellow traveller mentioned that they just dissolve their tablet in water and use this solution to taper. I had not considered doing this, but I have the same questions in the absence of film coating re: faster release and shorter half life... Any thoughts?

 

(I ask because, I tried to simultaneously switch and reduce dose of Citalopram in November and I noticed (1) I should not reduce and switch at the same time (2) even when I matched the liquid dose to the full tablet dose, the effects of the liquid wore off very quickly and taking a bit more liquid later in the day helped. After two days of realising I wasn't taking the right steps and Christmas was around the corner I switched back to the full tablet dose, waited to stabilise and try again.)

 

Rhi developed the suspension method using citalopram.  I don't know about its half life, but it seems a well trodden path to make a suspension from.

 

Also see 

 

 

Edited February 7 by hayduke
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[Daniel1269]

Hi @hayduke,

 

Im enquiring about liquid solution sertraline today (currently taking 50mg tablets) at my GP appt

 

If I am successful, I believe I will just “get what I’m given” as I don’t have any control of what brand I receive (Boots is my pharmacist) (NHS)

 

For example the brand sometimes differs for the 50mg tablets I receive (Milpharm, Crescent etc. etc.)

 

Should I request the same brand from the chemist and/or doctor in my appt each time in case that may help?

 

Obviously there is the option of a private compounding pharmacy in Leeds too which will be the same brand throughout I’m assuming if I choose that route?

 

Also is there any other reasoning for a slow cross over from tablets to liquid other than the potential differing ingredients in the liquid which could affect how the drug works and is metabolised?

 

Many Thanks!

[hayduke]

19 hours ago, Daniel1269 said:

Hi @hayduke,

 

Im enquiring about liquid solution sertraline today (currently taking 50mg tablets) at my GP appt

 

If I am successful, I believe I will just “get what I’m given” as I don’t have any control of what brand I receive (Boots is my pharmacist) (NHS)

 

For example the brand sometimes differs for the 50mg tablets I receive (Milpharm, Crescent etc. etc.)

 

Should I request the same brand from the chemist and/or doctor in my appt each time in case that may help?

 

Obviously there is the option of a private compounding pharmacy in Leeds too which will be the same brand throughout I’m assuming if I choose that route?

 

Also is there any other reasoning for a slow cross over from tablets to liquid other than the potential differing ingredients in the liquid which could affect how the drug works and is metabolised?

 

Many Thanks!

 

This is just something I have found friendly local chemists will help you sort out.

I never had any trouble crossing over to liquids, never felt worse than any cut, but a lot of people report it.  In those instances crossing over more gently may help.

[johnjohn82]

I talked to a local compounding pharmacy and they could use the pill I take ( lamictal 25mg dissolvable) and create capsules with de dose I take twice daily.

 

Is that a method that anyone on the forum has used? I see a lot of members order the liquid from the pharmacy but couldn’t find find many who ordered capsules.