Questions and answers about liquid medications, use by date, expiry

[mammaP]

Hope you can get what you need, GP's rarely have a clue! If it's losing potency can you get a script when it SHOULD run out if taking the recommended dose? Not sure if it would be possible or affordable but it shouldn't lose potency. We can be quite creative with tapers and dealing with GP's !

[scottly9999]

Hi MammaP

I'm not really taking the recommended dose, I'm taking what "I" need to take for my taper.

I'm taking about 0.075 of 1ml

Thats such a small amount - Lexapro is quite concentrated too.

My bottle lasts about 4 months.

It says to discard after 3  months after opening.

I've noticed with the 4 or 5 bottles I've been through that I seem to get WD quite badly at the end of a bottle, regardless of where I'm at in my schedule.

 

My current battle with WD has been the most crushing wave of depression I've ever known, lasted about 1.5 weeks.  Came on quite suddenly, and left even quicker.

Horrible horrible horrible.  Worst wave I've ever had.

 

So I'm really asking, have I been through almost a COLD TURKEY WD as if the active part of the medication has expired, did I put myself though CT and have almost got off the drug without realizing?

Coming out other side of the wave, I feel much clearer in my head than I have in a long time, and feel less medicated too.

Just asking if anybody else has had similar experiences to this with liquid SSRI's?

[Altostrata]

Discard 3 months after opening, and save yourself the confusion.

[mammaP]

Sorry to confuse you Scottly, I meant to discard the bottle after you would have finished IF you were taking the recommended dose. That will mean that you are discarding most of it at lower doses. I am good at confusing people    ! 

[scottly9999]

Ok

Update.

I picked up my script last night - and was told AGAIN they don't make the 10mg/ml bottle anymore - I had one last year sometime.

THis may be true, but I was told by another chemist that it's on the PBS here in Australia, and would cost a LOT more.

So still not a straight answer.

The chemist's website blatantly advertised the 10mg/ml bottle, not even mentioning the 20mg one.

<sigh>

oh well.

Saturday 16th marked the end of a horrific wave for me - crippling depression that lasted about 2 weeks, came out of nowhere and left just as quickly.

I had been suffering from very low motivation levels leading upto it, and all sorts... which is what led me to question if the liquid was "off".

 

On SUnday I felt good, like really clear in the head, and connected to surroundings.

EVen in my windows of relief over the last 18 months, I've not had this feeling.

I felt pretty much like I did pre-meds.

I started to think - have to effectively tapered off using "stale" liquid???

 

On Sunday - as part of testing this, I skipped a dose.

and Monday and Tuesday took only 1mg.

I was on 1.5mg of Lexapro (quite a strong SSRI).

This 1mg came from the "expired" bottle.

As of Tuesday night and this morning, I noticed that I was ALSMOST having brain zaps - could feel the tiny pulses, and started moving my eyes to see if they would develop into brain zaps (seems to be connected to eye movement)... but didn't happen properly.

ALso had a few hot flashes 0 liek really hot.  Had to take my shoes off at work yesterday - felt like my feet were on fire.

My mood has been fine - nice and stable.

 

I've taken those 2 symptoms that my drop from 1.5mg to 1mg on "expired" liquid was probably too big of a drop, and that the liquid was probably still active.

 

I've taken 1.2mg of my fresh bottle today.  That was 1 hour ago, no real changes yet.

 

Interesting though.

[scottly9999]

Small update

Ok - 2 days now of 1.2mg of Lexapro from a fresh bottle

And I'm positive I can "feel" its affects - albeit slightly, but none-the-less there.  Slightly less aware of surroundings, little slower thinking.

 

I really do think that I was effectively taking almost no Lexapro on the expired bottle.

[scottly9999]

Another update.

It's been 1 week since starting the fresh bottle.

I can report that I'm feeling more the slightly disconnected, MEH feeling of being on Lexapro - that was slowly fading for me on the older bottle.

I've also gone to 1mg, and feeling a few WD effects.

MOstly muscle aches and body pain - quite strong.

Also fatigue - feeling very rundown.

So currently feeling both WD and SSRI effect - not great.

 

I can cope, just.

[Hibari]

I too have a liquid suspension of one of my medications and as I wrote above, I too feel that my newer bottle is always a stronger than the tail end of my old bottle.

 

I also relate to the run down feeling.  I just made a small cut on one of my medications and I feel exhausted.  I say to you what I am saying to myself, this will pass and it's a time to very nice to ourselves.  It's a weird feeling to be in the not so great but not crisis state of wd. 

 

You've  come a long way and should be proud of what you have accomplished so far.

[scottly9999]

Hi Hibari

 

Yep - I'm telling myself, remember my windows - i'll get there again, and eventually always be in a window!

But wow - this experiment gave me some answers.

 

THe liquid doesn't seem to expire, BUT it did lose some action.

I felt LESS medicated on it, like the world felt less NUMBED out.

Now I'm on a fresh bottle, I've got both withdrawal flu-like symptoms FULL BLOWN, as well as the heavily medicated feeling.

 

Which leads me to another question...

When can I expect to feel "normal" again?

DOes that only come back after months of not having any SSRI in my system?

Or am I supposed to feel it in my windows?

My windows are really just mostly "no withdrawal effects", as oppossed to "feel normal".

 

Can anybody relate to that?

[geminigirl]

QUESTION:

 

I use a glass jar with a lid on it when I put 20 ml of water and then my 20 mg of celexa in.

 

The problem is, once the tablet is dissolved and I shake the jar to even disperse the drug, when I then quickly open the lid to draw out my dose fo the day with my oral syringe, there is liquid that comes out when I take off the lid. I am assuming it's okay because I shook the liquid, but still, I am worried that this will make my dose uneven.

 

I take 2 mg 5 times a day (to decrease akathesia as akathesia gets intolerable if I take a higher dose at once).

 

But ya, is this okay that some liquid comes out when I open the glass jar? I usualyl shake it pretty hard, like in an up and down motion as some of the celexa can settle to the bottle so I think mixing it up and down several times is important.

 

Does anybody have another idea of where to get a good glass jar so tha when I open the lid after shaking it, some of the liquid won't come out?

 

Maybe a glass jar with a plug rather than a lid? I just don't know where to buy those.

 

[SquirrellyGirl]

Hi geminigirl, 

 

This is not a problem if you shook well before opening your jar.  The only problem would be if you were mixing two doses, withdrew one dose but the lost liquid made the second dose less than it should be.  I wouldn't worry about this.

 

I like using these tubes from Amazon to mix my doses:  https://www.amazon.com/Karter-Scientific-Centrifuge-30x115mm-Conical/dp/B005Z4S3ZU/ref=sr_1_1?ie=UTF8&qid=1466361779&sr=8-1&keywords=50+ml+conical+tubes

 

Sure, 50 is way more than you need, but they seal nicely and very little liquid stays in the lid when you open it.  The white markings wear off eventually, so then you toss it and use a fresh one.  You can get them in 15 ml size as well.  https://www.amazon.com/United-Scientific-D1003-Polypropylene-Graduations/dp/B00ES3TIRG/ref=sr_1_1?ie=UTF8&qid=1466361862&sr=8-1&keywords=15+ml+conical+tubes

 

SG

[geminigirl]

Ok thanks.

 

Is there any place I can get 30 ml ones?

[SquirrellyGirl]

No, 50 ml is it, but that would work.  You can wrap the tube with tin foil to block light.

 

SG

[Lakelander82]

Why the need for a glass jar? I grind the tablet in a mortar and pestle then add a known quantity of water via a syringe, give it a good stir and then withdraw my suspension directly from the mortar via the syringe.

[Riffick]

Ok thanks.

 

Is there any place I can get 30 ml ones?

 

The tubes are sometimes known as "specimen tubes" or "sample tubes" and are available in 30ml.  

I'm in the UK so my suppliers will be different to yours but Amazon or eBay should have them.

[Happy2Heal]

if there's anyone good with math who understands the whole "diluting a liquid with more liquid" and using a graduated cylinder to do what I think is called liquid titration, can you please PM me?

thanks

 

all the "maths" hurts my head, hahaha

 

I am taking 0.16mgs of liquid lexapro, which is also 0.16mls (its' a 1:1 solution)

i want to get the dosing more accurate, since the measurements are so small now.

I THINK I need to mix some of the liquid I have with water, and then take some out and throw it away and then drink the rest, at least that's the way I understand it

but I have NO clue how to do the math for this.

[scallywag]

H2H, it's better to answer your questions in the topic so that the information is available for all members and viewers of the site.

 

The easiest way to dilute a solution is to use a 10x or 100x amount of water. The thing we need to keep in mind is that a home-made solution has a much shorter shelf life than a commercially prepared one, probably 5-6 days to be safe.

 

If you were making a solution from your current liquid (1 ml lex liquid = 1 mg lexapro) for a single dose, I would draw 0.16 ml of liquid into a syringe and then pull water into the syringe to the 1.6 ml line. You'd have a 10 ml solution = 1 ml lexapro, where 1.6 ml = 0.16 mg lexapro.

 

To make multiple doses at once, let's use 5. 

lexapro liquid: 5 x 0.16 ml = 0.8 ml

water to make 8 ml = 7.2 ml

Mix those two amounts together and you'll have a liquid that has 5 doses of 1.6 ml = 0.16 mg lexapro.

[Happy2Heal]

I'm sorry, it's clear that I'm not asking the right question, or asking the question correctly........

 

I think I'm going to have to wait til my brain is able to handle this, and then I'll try again. 

 

 

 

in the meantime, maybe this will help explain what I"m trying to accomplish...??
 

I am having a hard time seeing the 0.16 dose in the syringe. Sometime I think I"m getting a bit more, sometimes a bit less. So I want to use like, say, 0.20 instead, which is easier to see. And then mix that with water.  I don't need to make up doses in advance, I don't think... I don't know. I guess it makes more sense to do up a few days doses at once...

 

I am trying, first of all, to get my current dose as accurate as I can.

once the 0.2 (for example) is mixed with water, I need to figure out how much to draw out and discard, I guess? before I drink what's left. To keep the current dose of 0.16

I don't know, it gets very confusing to me after this....

 

OR would it be easier to add say ten times as much, 2mgs right? to water, and then use that to draw up the dose? Oh crap I just confused myself again. maybe I should try playing around with some colored liquid and see if I can figure that out. Right now I am not able to think in abstracts very well.

 

Once I've got this all figured out, THEN, when I decide it's time to taper-  I want to use this method to taper down, so I'd need to figure out what to do after that, like, draw out a tiny bit more each time?? so that I am super micro tapering down very slowly and in very tiny decreases

 

 

does that make sense?

 

 

 

 

 

 

[Happy2Heal]

On 7/25/2017 at 7:55 AM, scallywag said:

To make multiple doses at once, let's use 5. 

lexapro liquid: 5 x 0.16 ml = 0.8 ml

water to make 8 ml = 7.2 ml

Mix those two amounts together and you'll have a liquid that has 5 doses of 1.6 ml = 0.16 mg lexapro.

 

ok, wait, this is probably what I should be doing

 

LET ME BE SURE I UNDERSTAND:
I put 0.8 mls of lexapro in a container with 7.2mls of water to make 8mls of diluted lexapro solution

 

I draw out 1.6mls per day and this is now my 0.16mg dose, just diluted

is this correct?

(in which case, I don't see how the graduated cylinder comes in, but I'll save that for some other time when my brain is working lol)

 

I will try this starting tomorrow

 

I will work out the decreases in doses later, for now I just need to get the current dose accurate

 

thanks, I guess this is the answer, it just didn't register for some reason :/

 

mornings are the worst for my brain, it doesn't seem to "come online" til about NOON

 

THANKS SO MUCH SW !!

 

[Pepper88]

QUESTION:  How many days do liquid suspensions last for?

 

I've heard the phrase "it'll last for a few days in the fridge" but I want to get more specific. For instance, if I made a large suspension on day 1 at 11pm, can I still take portions from it on day 3 at 11pm? Does the potency of the drug wear off the older the suspension/ how does the "expiration" date work? Any insights would be appreciated.

Edited August 31, 2018 by Songbird
add title info, merge topics

[Altostrata]

Yes, 3 days should be fine. I wouldn't keep it longer than 5 days. Keep it in a dark bottle in the refrigerator.

[Pepper88]

Thank you Alto.

[Nic1974]

Can you use maple syrup as a suspension agent for mirtazapine

 

[ryan1982]

Hi all,

I’ve been weighing my Lexapro pills for the duration of my one year taper. As I continue down the path of getting to zero, I’m concerned about the accuracy of my scale when I get to the very small doses. I’m currently on 2 MG twice per day, which is manageable to weigh at .025 grams. However, I’m wondering if people make the leap to liquid medication (from the pharmacy) because it’s easier to manage?

 

On the flip side, should I expect withdrawal symptoms to ramp up once I make the switch over? Has it been worth it for those that have made the leap?

[bubbles]

I've never weighed pills, so take this with a grain of salt. I've read that some scales are less accurate at lower weights, so some people get around that by adding a weight to the scale. So, if you are trying to weigh 0.2grams and you think the scale might be less accurate, they put a, say, 1gram weight onto the scale and therefore aim at a reading of 1.2 grams. Did your scale come with tare weights?

 

I used the liquid lexapro when I was tapering that drug. It tastes nasty but it was easy to taper. I made a huge mistake when I first got the liquid - I totally misread the label and grossly underdosed myself. I was meant to drop from 20 to 18mg, but actually went to 1.8mg!!! Not good, and it was very scary but once I figured it out and updosed again it was okay. But it was also totally my fault as I misread the label.

[ryan1982]

@bubbles- thanks so much. Great to meet you and I appreciate your reply!

 

Excellent idea about the weights. I do have some so that would work perfectly. 

 

Did you switch from pills to liquid? We’re there any issues in doing so? Did you use the liquid from the manufacturer?

 

I’m on 4 MG of Lexapro and I’ve been on about a 6 month hold. Frankly, I don’t feel great as I don’t think my CNS has totally calmed down after all my medication jumps early in the year before I knew what I was doing. However, if I don’t get moving then I’ll be poisoned by these drugs forever. How long did it take you to taper Lexapro? Did you reduce by 10%? I was thinking about trying to start at 2.5% per month and see how that goes. Any thoughts or advice? I’m terrified to start again...

[bubbles]

I went straight from tablet to liquid. This was a long time ago and I don't think there was any advice to cross-taper in those days. As it turns out, it in some ways probably worked in my favor to do it the way I did - it was severe enough that it was fairly quickly obvious what had gone wrong! I did the proprietary liquid. If I could do it again I'd read the label more carefully, and do the recommended cross-taper.

 

I tapered Lexapro much too fast. I tapered slowly enough to avoid the zaps, but too fast to avoid a nasty crash after being off for a little while. I wouldn't recommend it. (I've made peace with it - I had some nasty side effects and that drove the pace to a certain extent. This time around I had a better solution for the side effect so the urgency wasn't there.) This time I'm actually taking longer and often making smaller than 10% drops and I am being more successful.

[Gridley]

ryan,

 

I wouldn't taper until you feel stable--stable being not perfect or great but more or less the same symptoms every day, no wild swings.  

 

I've been tapering Lexapro for two years using the Brassmonkey slide method, which is a way of making micro-taper reductions weekly as opposed to a larger reduction each month.

 

The Brassmonkey Slide Method of Micro-tapering

 

I use the Gemini-20 scale.  Accurate so far at 4.1mgai (active ingredient).  Bubbles' suggestion to add a 1 g weight to the scale when I get lower seems a good one.

 

Your idea of 2.5% per month to start makes sense.

 

 

[xyz]

i am tapering lexapro, i use the same brown bottle.

i am at 0.6mg- my last bottle lasted 4 or 5 months. i didn't see any difference.

i had wave and window, but nothing out of the ordinary.

however, i have saved 5 unopened bottles just in case my prescription runs out (a bit paranoid) and i think i won't even use them to finish my taper.

[ryan1982]

Y’all are all very helpful and I appreciate your responses so much. I’ll definitely roll with the Lexapro liquid made by the manufacturer once I get a little more stable. I’m going to eventually have to do it so I’m interested to try it. 

 

Thanks for everyone’s thoughts and advice. Have a wonderful holiday!

[Cleerity]

I have discovered that when titrating using a syringe to dose liquid preparations, not all syringes are created equal.  

 

To achieve accuracy in dosing, it is important to use a syringe that is, as I call it, a “smooth operator.”  This means one in which the plunger glides effortlessly through the tube, without gripping the sides.  This is important for accurate dosing.

 

When the plunger is gripping the inside of the tube, one has to apply more pressure than needed to get it to move, often moving past the point of the desired dose.  This causes one to have to back the plunger up, again drawing in more medicine, to make another attempt at achieving an accurate dose. With a grippy plunger, I found myself doing this over and again.  Frustrating.

 

The syringes I was having trouble with are made by CareTouch and I found them on Amazon.com.  I do not recommend these, despite their very positive reviews.

 

The ones that are working for me are by BSTEAN, also found on Amazon.com:  https://www.amazon.com/gp/product/B06ZZ4BZ15/ref=oh_aui_detailpage_o04_s00?ie=UTF8&psc=1

 

I am using their 1 ml syringes.

 

A couple nice things about the syringes from BSTEAN is that: (1) they have every 100^thmarked and, (2) the plunger tips go all the way to the end of the tube.   Though, it is not a show stopper if the plunger does not go all the way to the end of the tube, as one can just suck the little remaining drop of liquid out.

 

I am sure there are other syringes out there that are “smooth operators” like the BSTEAN brand.  Just know that if you find yourself with a grippy plunger, you can change it out for one that works better.

 

Another trick when using the syringes for liquid dosing is to apply a strip of clear, glossy scotch tape over the length of the numbers.  This will keep them from rubbing and washing off, giving you an extended life on the syringe.  I read about this trick from other users, one on Amazon.com and also in @RubyJ's topic.

[ryan1982]

Hey all,

The more I've thought about it, I'm wondering if the shock to my system by switching from branded Lexapro to generic liquid is worth the pain and suffering.  I can't for sure say that the change will be difficult but most everything during this time has been tough and I foresee this being no different. 

 

I'm on 4 MG of weighed pills (2 x per day at  2 MG) and I'm a long way off from needing to have really small doses.  Clearly, I'm concerned that the scale isn't giving me 100% accurate measurements but I'm pretty nervous to switch over to liquid.  

 

Thoughts on my concerns?  Has anyone done this process and how did it go?

[Gridley]

Some people do well on the liquid, some don't.  

 

We recommend a gradual crossover:

3/4 tablet, 1/4 liquid for 3 to 7 days

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

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

all liquid thereafter

 

I've found the scale to be sufficiently accurate.  Remember, you're weighing pill weight, which is many, many times  larger than milligrams of active ingredient.  The slight variances in pill weight have not been a problem for me.

 

 

[ryan1982]

Interesting. Is it possible to get all the way down to zero using pills and a scale?

 

Lastly, could I do better on liquid than a branded version of a drug? I feel OK but not great. I imagine that’s just how I’m going to feel in withdrawals though. 

[ryan1982]

Oh, and thank you so much. I really appreciate the help, Gridley. 

[ChessieCat]

23 minutes ago, ryan1982 said:

Is it possible to get all the way down to zero using pills and a scale?

 

BrassMonkey used a scale all the way (weigh 🤣) to the end of his taper, tiny little dose 0.016mg

 

 

Edited January 6, 2019 by ChessieCat
addedc quote