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Pharmaceutical liquids to make suspensions


Altostrata

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  • Moderator Emeritus

Thanks, Fresh - I reread the topic, seems I need a lot of re-do's these days :-)  Sarabera, mirtazapine is not very solube at all, which is why I ordered the Ora-Plus.  I will keep everything refrigerated.

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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  • 2 years later...

Has anyone from UK found an affordable supply of Ora-plus?

On Amazon.co.uk, it is more than $80, whereas it only costs $20 in the US.

 

Or is there anything equivalent?

31st May - 11th Aug '18: Olanzapine 2.5mg, Seroquel 50mg

12th Aug - 18th Aug '18: Olanzapine 2.4mg, Seroquel 50mg

18th Aug - present '18: Olanzapine 2.3mg, Seroquel 50mg

22 Sept '18: Olanzapine 2.2mg, Seroquel 50mg

01 Oct '18: Olanzapine 2.1mg, Seroquel 50mg

09 Oct '18: Olanzapine 2.0mg, Seroquel 50mg

28 Oct '18: Olanzapine 1.8mg, Seroquel 50mg

09 Nov'18: Olanzapine 1.6mg, Seroquel 50mg

1 Dec '18: Olanzapine 1.5mg, Seroquel 50mg

27 Dec '18: Olanzapine 1.4mg, Seroquel 50mg

02 Feb '19: Olanzapine 1.3mg, Seroquel 50mg

 

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  • Moderator Emeritus

You could enquire at a regular chemist to see if they are able to get it in for you.  Or you could try a compounding pharmacy.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

I got an email notification that Lakelander had asked a question here but I don't see his comment  He was asking peoples' thoughts about OraPlus keeping the drug suspended more uniformly than water.  

 

I use OraPlus with Mirtazapine SolTabs. Mirtazapine is insoluble, and  In water the mirt will still settle even with the SolTabs.  I use OraPlus 1:1 with water.  In other words, I make a 1 mg/ml solution by 1) dissolving two 15 mg tabs in 15 ml water first and 2) bringing the volume up to 30 ml with OraPlus.  Even at 1:1 the mirt stays suspended, though I always mix when pulling it from the fridge each night to take my dose, just in case.  Do not put the tabs directly in OraPlus or they will sit there like a white glob and be hard to break up!

 

OraPlus may have ingredients in it that some want to avoid but I haven't had any trouble that I'm aware of.  It preserves the drug, too.  At the dose I'm taking now, my solution lasts about 10 days and I haven't noticed any problem with the later doses losing potency.  I could do 1 tab in 15 ml total and go with that, as well.

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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  • Moderator Emeritus
42 minutes ago, SquirrellyGirl said:

I got an email notification that Lakelander had asked a question here but I don't see his comment  He was asking peoples' thoughts about OraPlus keeping the drug suspended more uniformly than water.  

 

This is the post, which I moved to his topic.

 

1 hour ago, Lakelander82 said:

I looked up the ora plus on amazon in the UK and it is quite expensive but I may consider switching over to it from water because it may suspend the drug more uniformly than water (I’m guessing it’s more viscous than water). What are people’s thoughts on this? 

 

I knew that Lakelander is tapering Zoloft/sertraline which is soluble in water.  This was my response:

 

1 hour ago, ChessieCat said:

If you are tapering Zoloft/sertraline, there is no need to use a suspension liquid because the tablet dissolves in water.  Other people have been successfully tapering by this method.

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 6 months later...
On 10/6/2012 at 1:55 PM, Altostrata said:

Information and instructions from the manufacturer (PDF) http://medicalfs.com.au/portal/images/stories/Orarange/Ora-Plus-Sell-Sheet.pdf

 

The above link is no longer working.

 

I believe I found the same document here:  https://www.perrigo.com/files/rx/pdfs/pds173-Ora-Plus Sell Sheet.pdf

4/2001 - Clonazepam, .5mg (at bed); 5/2010: 1 mg; 9/2018: .5 mg; 10/20/2018: .47 mg; 10/24/2018: back up to .5 mg.  Began daily micro taper by liquid prep on 3/12/2021 (avg. 10% redux of last dose every 28 days).  At .17 mg/ml as of 12/24/2021.

4/2002 - Alprazolam, .25 mg (PRN), up to 2x/day.  DISCONTINUED 10/21/2018
5/2010 - Mirtazapine - 15 mg (at bed)
3/2012 - Aripiprazole - 2 mg (in A.M.) - Began reducing Dec. 30, 2018.  Daily micro-taper by liquid preparation.  DISCONTINUED 1/14/2021.

6/2012 - 500 mg  Metformin ER, 2 tabs, 2x/day.  DISCONTINUED April 2020.

Supplements: Multi Vit Calcium-600 mg x2 / D3-5000 IU / C-1000 mg x2 Fish Oil-1000 IU Magnesium-200 mg x2 / Zinc-50 mg / Biotin-10,000 mcg / Glutathione-500 mg / Quercetin-1000 mg

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  • 2 weeks later...

Hi,

 

What would be the rational behind the term "Compounding losses"? ( http://survivingantidepressants.org/index.php?/topic/3068-pharmaceutical-liquids-to-make-suspensions/ ) when solution prepared with a pharma compound liquid seems to loose part of its potency thus raising withdrawal symptoms to users who, without a correction, are subject to unwanted drug reduction. In the above link, the losses are estimated to 10%.

 

I understand it is not a common practice here to compensate these losses. What would be the reason?

 

Many thanks.

  • Given clonazepam (Rivotril) for Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD). Started with 0.5mg/night as from Nov 2013.
  • First taper initiated Nov 2016 after heart troubles led to ER. Taper dose: 1 drop (0.1 mg)/month. 10 days after last drop, reinstated to 0.5 mg following nocturnal creeping sensations in leg.
  • Second tentative in May 2017. Quickly went down to 0.2 mg in few days with no symptoms. Last 0.1 mg tapered via liquid taper (1+9) and reduction of 1/10 every average 2 weeks. Last dose taken Aug 12, 2017.
  • After 7 months honeymoon, huge wave following massive use of Melatonin (5 mg) asked by sleep doctor.
  • Recovered 65-70% after 14 months, still with lingering eyes floaters.
  • Completely functional in the daily life.
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  • JimH changed the title to JimH: What is the rational behind "compounding losses"?
  • Moderator Emeritus

See administrative update to post # 1 in this topic.  That should answer your question.

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022, and again finally 5/25/24.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

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On 10/6/2012 at 8:55 PM, Altostrata said:

the amount of measured powdered drug that sticks to implements and doesn't make it into the final liquid or capsules.

Hi,

 

When users prepared by themselves the alcohol-dissolved-benzo solution, most do NOT report the same loss. This kind of loss seems to occur most of the cases when the solution is made with a pharma suspension vehicle like ORA-Plus. As both nearly use the same working tools (pestle, mortar, spoon, cylinder, jar, syringe...) these alone do not explain all the losses. Furthermore, a number of people likened the loss to a cold-turkey stop. That leads to think that in some cases the losses could be more important than the estimated 10%.

 

A group of people attributes the loss to the reduced absorption of the solution by the organism when the digestion system treats differently dry tablets or suspended powder in solution made of various ingredients (cellulose, calcium sulfate, citric acid, sodium phosphate, anti-foam emulsion, preservatives...). To understand this position we can imagine what happens when the drug is taken with food in the stomach. If one drinks med solution during or right after a meal, the solution will be considered as part of the food and together with existing food will be retained and processed in the stomach until it is ready to pass to the small intestine where the drug is targeted to end up as this organ is ideal for absorption work with a much larger surface area for absorption compared to the stomach. The drug efficacy will definitely reduce following this "harsh" mechanical and chemical treatment. The same principle would apply when the solution is a viscous compounded solution or a thick fruit juice taken right after to "wash". They will be both considered as food and will undergo the same treatment as food. To see how our digestive system treats differently "solid" food and "liquid" food, let's take the example of people who drink alcohol with empty stomach vs during a fatty meal. Actually the way the meal is processed by our stomach can reduce the peak blood alcohol concentration (BAC) up to 50% relative to that produced when alcohol is consumed on an empty stomach. This can explain why it is easier to get intoxicated with the same quantity of alcohol when the stomach is empty.

 

Thanks to share your opinion.

  • Given clonazepam (Rivotril) for Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD). Started with 0.5mg/night as from Nov 2013.
  • First taper initiated Nov 2016 after heart troubles led to ER. Taper dose: 1 drop (0.1 mg)/month. 10 days after last drop, reinstated to 0.5 mg following nocturnal creeping sensations in leg.
  • Second tentative in May 2017. Quickly went down to 0.2 mg in few days with no symptoms. Last 0.1 mg tapered via liquid taper (1+9) and reduction of 1/10 every average 2 weeks. Last dose taken Aug 12, 2017.
  • After 7 months honeymoon, huge wave following massive use of Melatonin (5 mg) asked by sleep doctor.
  • Recovered 65-70% after 14 months, still with lingering eyes floaters.
  • Completely functional in the daily life.
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  • 2 weeks later...
  • Administrator

Pharmacists have a legal liability and may follow guidelines that lead to overcompensation for a theoretical "compounding loss." There are many factors that might cause a rough transition from tablet to liquid form of the drug.

 

Because liquid preparations are absorbed faster and initially might seem stronger, we do not recommend attempting any kind of increased dosage to compensate for a theoretical "compounding loss."

 

We urge people to make such adjustments after observing the effects of the transition. Depending on their reactions, some people might want to take a slightly reduced dosage, others a slightly increased dosage. Some people may not notice the change at all.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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12 hours ago, Altostrata said:

compensate for a theoretical "compounding loss."

Hi @Altostrata

 

For what I have witnessed from a number of taperers while using compound solution, this is not just a theoretical thing pharmacists advise under threat of legal liability. It actually happened in most cases and has triggered in the past incomprehension, worries and requests for help from a number of taperers. 

 

As for " initially might seem stronger," to be honest I have always read the opposite. A drop in effect, sometimes likened to cold-turkey, is what we have read in most cases. When we replied to not worry about it and the body will certainly adapt to this, then people usually accept and the taper smoothly resumed. When they are used to this first drop then it is no longer a problem going forward. 

 

Although I've learnt  that the problem can resolve itself with no need for special interventions, I have introduced this "Compounding losses" parameter in the calculator app only after reading about it from SA http://survivingantidepressants.org/index.php?/topic/3068-pharmaceutical-liquids-to-make-suspensions/. I thought SA had a clear, repetitive experience of this phenomenon behind the suggestion for it to be reinforced. I will change the app to remove this misunderstanding. 

 

Thanks.

  • Given clonazepam (Rivotril) for Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD). Started with 0.5mg/night as from Nov 2013.
  • First taper initiated Nov 2016 after heart troubles led to ER. Taper dose: 1 drop (0.1 mg)/month. 10 days after last drop, reinstated to 0.5 mg following nocturnal creeping sensations in leg.
  • Second tentative in May 2017. Quickly went down to 0.2 mg in few days with no symptoms. Last 0.1 mg tapered via liquid taper (1+9) and reduction of 1/10 every average 2 weeks. Last dose taken Aug 12, 2017.
  • After 7 months honeymoon, huge wave following massive use of Melatonin (5 mg) asked by sleep doctor.
  • Recovered 65-70% after 14 months, still with lingering eyes floaters.
  • Completely functional in the daily life.
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  • Administrator

The danger is someone might take a dose that's too strong for them and get bad reactions from that. We have lots of experience with this.

 

We do not recommend adding 10% in active ingredient when making a compounded preparation. We advise making an adjustment in dosage, if necessary, afterward.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 11 months later...

So, I've been looking all over the internet, and it seems that the suspension liquids can not be bought directly in France.

I will check in a pharmacy, but I'm pretty skeptical.

However, I have found you can buy thickening agents, made with either maltodextrine, Alginic acid, Potassium Bicarbonate, or modified Corn Starch. 

Would any of these be safe to use ?

December 2020 : got prescribed 20 mg paroxetine (paxil) for an anxiety disorder

Tried tapering in July 2021 by taking 20 mg every other day and failed.

 

Started tapering with the 10% method in January 2022 and switched to an oral suspension. 20 mg = 10 ml

Turned out to be a bit hard. Continuing with 5% drops approx.

 

25 January 2022 : 9 ml / 24 February 2022 : 8,1 ml / 06 April 2022 : 7,3 ml / 2 June 2022 : 7 ml / 11 July 2022 : 6,5 ml / 09 August 2022 : 6,3 ml / 26 August 2022 : 6 ml / 18 Septembre 2022 : 5,8 ml / 17 December 2022 : 5,7 ml / 04 January 2023 : 5,6 / 17 January 2023 : 5,5

 

Xanax from december 2020 to January 2021 / Omeprazol on and off for GERD since december 2020 : 20 mg / Birth control pill since february 2021.

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Tapering Paxil as an oral suspension is really working for me. Because of the shortage, I am slowly accepting the fact that I'll have to make my own liquid, since I really don't feel comfortable crushing pills. However, I've tried dissolving it in water, and it does not distribute evenly at all. Even after stiring and shaking, the particules go back to the bottom to fast for me to have the time to take the right dosage. If someone has some advice, it would be greatly appreciated.

December 2020 : got prescribed 20 mg paroxetine (paxil) for an anxiety disorder

Tried tapering in July 2021 by taking 20 mg every other day and failed.

 

Started tapering with the 10% method in January 2022 and switched to an oral suspension. 20 mg = 10 ml

Turned out to be a bit hard. Continuing with 5% drops approx.

 

25 January 2022 : 9 ml / 24 February 2022 : 8,1 ml / 06 April 2022 : 7,3 ml / 2 June 2022 : 7 ml / 11 July 2022 : 6,5 ml / 09 August 2022 : 6,3 ml / 26 August 2022 : 6 ml / 18 Septembre 2022 : 5,8 ml / 17 December 2022 : 5,7 ml / 04 January 2023 : 5,6 / 17 January 2023 : 5,5

 

Xanax from december 2020 to January 2021 / Omeprazol on and off for GERD since december 2020 : 20 mg / Birth control pill since february 2021.

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  • Administrator

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I have actually checked these threads and didn't find anything about tickening agents in general or the thickening agents I mentionned. Maybe I missed it ?

December 2020 : got prescribed 20 mg paroxetine (paxil) for an anxiety disorder

Tried tapering in July 2021 by taking 20 mg every other day and failed.

 

Started tapering with the 10% method in January 2022 and switched to an oral suspension. 20 mg = 10 ml

Turned out to be a bit hard. Continuing with 5% drops approx.

 

25 January 2022 : 9 ml / 24 February 2022 : 8,1 ml / 06 April 2022 : 7,3 ml / 2 June 2022 : 7 ml / 11 July 2022 : 6,5 ml / 09 August 2022 : 6,3 ml / 26 August 2022 : 6 ml / 18 Septembre 2022 : 5,8 ml / 17 December 2022 : 5,7 ml / 04 January 2023 : 5,6 / 17 January 2023 : 5,5

 

Xanax from december 2020 to January 2021 / Omeprazol on and off for GERD since december 2020 : 20 mg / Birth control pill since february 2021.

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  • Moderator Emeritus
1 minute ago, souim said:

I have actually checked these threads and didn't find anything about tickening agents in general or the thickening agents I mentionned. Maybe I missed it ?

 

Specific posts from recent discussion (might not have found all of them):

 

how-to-make-a-liquid-from-tablets-or-capsules/583638

 

how-to-make-a-liquid-from-tablets-or-capsules/583392

 

how-to-make-a-liquid-from-tablets-or-capsules/583503

 

how-to-make-a-liquid-from-tablets-or-capsules/583569

 

how-to-make-a-liquid-from-tablets-or-capsules/583256

 

Search results for ora in this topic how-to-make-a-liquid-from-tablets-or-capsules:

 

https://www.survivingantidepressants.org/search/?q=ora

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thanks, I was not looking for the right thing.

December 2020 : got prescribed 20 mg paroxetine (paxil) for an anxiety disorder

Tried tapering in July 2021 by taking 20 mg every other day and failed.

 

Started tapering with the 10% method in January 2022 and switched to an oral suspension. 20 mg = 10 ml

Turned out to be a bit hard. Continuing with 5% drops approx.

 

25 January 2022 : 9 ml / 24 February 2022 : 8,1 ml / 06 April 2022 : 7,3 ml / 2 June 2022 : 7 ml / 11 July 2022 : 6,5 ml / 09 August 2022 : 6,3 ml / 26 August 2022 : 6 ml / 18 Septembre 2022 : 5,8 ml / 17 December 2022 : 5,7 ml / 04 January 2023 : 5,6 / 17 January 2023 : 5,5

 

Xanax from december 2020 to January 2021 / Omeprazol on and off for GERD since december 2020 : 20 mg / Birth control pill since february 2021.

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  • 6 months later...

Has anyone had experience compounding Trazodone and/or Diazepam using this solution?  I cannot get liquid Trazodone in the US and I am scared to rely on liquid Diazepam as there was a 4 month supply chain stoppage for it.  Even though I'm not planning to taper either of these in the immediate future, I am planning ahead.

Put on Zoloft in late 2002 at almost 18 years of age.  Was never told to get off the drug by the dumbass child psychiatrist who I know hate forever, and was given mistaken information of how I needed to stay off of it.  Tapered off very fast (a few month taper) in summer of 2011 (about an 8.5 year history).  Had an amazing month in Costa Rica drug free.

Crashed fall of 2011 (passive suicidal ideation, arms and legs shaking uncontrollably during the date, insomnia, severe crying spells, doom, derealization) and was put on Lexapro and a benzo (I think Lorazepam).  Was so afraid of repeating that so I stayed on Lexapro but tapered off the benzo very fast (a month). 

Entered abusive marriage in 2015 and started having unbearable symptoms such as burning arms and body, insomnia, deep depression, and anxiety.  I felt I had no supportive environment to talk about the abuse, and instead went to a PCP for medical relief: I was put on Klonopin (1 mg a day, I think) and Trazodone (50 mg a day) by PCP in early 2016.

Unsuccessful too-fast Klonopin taper 2017-2018 (jumped off at 0.125 mg at psychiatrists' urging me to do a fast taper) and went back on it late 2018.

Been tapering off Klonopin since 2020 (Divorce process underway) and much later, switched to diazepam. 

Switched from 0.0625 mg Klonopin to 2 mg Diazepam around September 2021.  Tapered Diazepam from September 2021-August 2022.  As of August 2022, been taking around 0.5 mg Diazepam.  But I did something foolish and temporarily went back on expired crushed powdered Clonazepam for a month or so because I was afraid of running out of Diazepam. (I say around because I was using a liquid formulation, then the liquid formulation is no longer being produced by manufacturer, and I am cutting/crushing pills).

As of October 2022, here are my drugs and dosages: Lexapro 10 mg, Trazodone 50 mg, Diazepam 0.5 mg. 

As of February 2023: Lexapro 9 mg, Trazodone 50 mg, Diazepam 0.5 mg

April 18th, 2023: Updosed to 9.2 Lexapro, still Trazodone 50 mg, Diazepam 0.5 mg

July 3rd, 2023: 10 mg Lexapro, still Trazodone 50 mg, Diazepam 1 mg (updose); Dates I took Propranalol plus dosages: July 22nd (40 mg), July 17th (40 mg), June 29th (20 mg), June 16th (20 mg), May 20th (5 mg)

 

 

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  • 7 months later...

Questions about liquid tapering methods

 

I'm looking at which tapering method works best for me. Clearly the popular options are compounding with a pharmacy or liquifying the pill with water. But I am specifically afraid of making my own accurate water mixture with olanzapine. The drug doesn't easily disperse in water and I'm concerned that stirring may not provide an accurate dose. I know many people are happy and successful with this method but I'm anxious and for my peace of mind I want to be sure of dose accuracy. Why do obviously very knowledgeable taperers not use agents like Ora-Plus to help keep drugs such as olanzapine suspended in water? Would this not help to obtain more accurate doses?

 

I contacted a compounding pharmacy and they told me that, rather than compounding olanzapine with water which lasts only 14 days (impractical in my case), they can also compound with 'fixed oil' which they say lasts 180 days. This sounds much better. I am wondering why I haven't heard of this before on this site? What is the drawback of this approach?  Is it too costly? Are there agents in the compound which are of concern? Is this like Ora-Plus or another of the compounding agents. Thanks.

Edited by manymoretodays
merged, title added

Olanzapine (5mg) started June 2023 - This is the only drug I'm currently taking, haven't used any other psych drugs.

After 4 weeks dropped to 2.5mg for 5 days then dropped to 1.25mg for 3 days, withdrawals commenced. I then took a single dose of 3.75mg. Then went to 2.5mg. since July 19

Hoping to hold at 2.5mg  and GODWILLING I will STABILIZE.

I can't tell WD symptoms from Long Covid symptoms. I think a bit of both, and I think my quick earlier taper has made the LC symptoms worse ... what to do.

Update: Sept 28 2023: -2.5%   Oct 5: -2.5%   Oct 12: -2.5%   Oct 19: -5%   Oct 29: -5%   Nov 10: -5%  2.0mg  Nov 20:  -5%  1.9mg  Nov 30:  -5%  1.8mg  Dec 12:  1.75mg   Dec 22: 1.70mg Dec 29: 1.65mg Jan 06/24: 1.60mg  Jan 14: 1.55mg Jan 25: 1.50mg   Feb 12: Updose to 1.55mg  Apr 25: 1.50mg  May 22: 1.45mg  Jun 5: 1.40mg  Jun 25: 1.35mg

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Hi N2deep,  @N2deep  I did see your question in your topic too, and then merged your new topic here, as I think fits best.

 

And you are familiar with the Tips for tapering off Zyprexa(olanzapine) topic too?

If not you might go through that topic to see if your question(s) are answered.  Or to see if you find anyone who has posted there using oil as a suspending agent.

 

I do see that olanzapine is not water soluble.  And was surprised that the compounders told you a water suspension was good for 14 days!  I've always told people to go with less time(and of course I am not a pharmacist either, just cautious).

 

What was the cost of the fixed oil liquid compound?  Did they give you a quote?  How concentrated would it be?  The milligram to millileter( or cc)?  You would want a concentration that would allow for ease of measurement for the lower doses.  Often final doses are well below 1 mg in dose.  Would those be measurable with the smallest syringe that measures 1 mL or less?

Things to consider is all I'm after there.

 

And I don't know if there are other drawbacks to the oil itself.  What is the oil that they would use?

 

Right now, I'm not sure if there have been discussions around doing suspensions in oil here.  I'm guessing there have been.  Whether they have been olanzapine specific I don't know.  We don't have specific specific topics on everything and do try to get similar topics merged for best usage by our members.

 

Anyway......hoping you might get some more input here.

Edited by manymoretodays

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022, and again finally 5/25/24.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

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