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Altostrata

Getting custom dosages at compounding pharmacies (US, UK, Canada, and elsewhere)

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Castor

I am getting compounded capsules of Seroquel from Johnson Pharmacy in Waltham, MA. They can create sustained-release capsules. They also appear to ship nationwide.


2006-11: rx-ed klonopin for anxiety from life trauma  

2011: accidentally c/t klonopin....lots of healing but reinstated on 20mg valium 8 months later after alchohol use (stay away from booze!)

-tapered valium over the course of a year  2012: hospitalized for 8 weeks after major s/a bc of failed valium taper and put on Seroquel 350mg xr and multiple drug trials w/SSRIs, mood stabilizers, etc. 2013: multiple hospitalizations and failed drug trials

-tapered all other drugs and "stabilized" on Seroquel xr and started tapering 2014: re-hospitalized after failed taper, added amitryptaline

-bounced around on different doses of Seroquel xr, maximum 600mg 

2015: finally found good doctor and therapist, tapered amilitryptaline to zero

=looking to start taper again from 550mg Seroquel xr but rough somatic symptoms, especially at night

-failed reduction of 12.5mg in late August, updosed back to 600mg seroquel xr, intense somatic sx at night

-starting in november, using compounded capsules to drop 3mg every 5-8 days

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Fresh

Anyone having capsules compounded should get a few quotes - the price range is astonishing!

 

I got quotes recently for 200 and 300 x 1mg capsules of pristiq (with slow-release additive).

Pharmacy 1:  $100 per hundred , so 300 caps.costs $300:00

Pharmacy 2:  $ 55 for 200 caps. , 300 caps. costs $80:00

 

About the "slow-release additive"  (necessary for pristiq and some other meds.):

""We are PCCA (Professional Compounding Center of America) approved pharmacy and we use PCCA ingredients for our compounds. PCCA has approved us to use Methocel (E4M) as the only ingredient for slow released formulated compounds. 

 
 PCCA approved pharmacies use Methocel (E4M) as their slow-released ingredient, however, we will have no access to other independent pharmacies's medical data on what slow-released ingredients would they use. "

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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ChessieCat

Put my Pristiq tablets in to be compounded today and I asked the compounding pharmacist about the slow release and he told me it is in the capsule, not added to the ground up tablet.

 

My compounder charges me $75 for 500 capsules based on a bulk order.  I provide my own tablets.  And he uses different coloured capsules for different doses :D

 

If anyone in the Sydney area is interested, please PM me and I can provide the details of this pharmacy.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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Altostrata

Chessie, that sounds like a brilliant solution to tapering Pristiq. How long does the prolonged-release additive extend the effect of the drug?


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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Bethsimmons

Roy Katz of www.customrx.com can ship to any state in the U.S. with a doctor's prescription. Roy will speak with your doctor to explain how it works. He is an expert in custom compounding Cymbalta and has helped hundreds from the Facebook group " Cymbalta Hurts Worse ". We have used him about 3 years with no complaints. About $60.00 a month. He will provide the paperwork for the patient to file insurance reimbursement if needed.
 


Dec. 29, 2016 -- Update

Update on Roy Katz, customRX. He is no longer practicing.

I am now working with a new compounding pharmacy in called Pharmacy Solutions. www.pharmacysolutionsonline.com - Important to ask for Michelle Wong.

They can fulfill prescriptions in 34 U.S. States. I'm working to get them up to speed on Cymbalta tapering, as well as co-coordinating with the prescribing doctor. There is a learning curve for sure as this drug is like no other for some people.

Edited by scallywag
add update on pharmacy

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Altostrata

BethSimmons, as I asked before, how does Roy Katz compound Cymbalta, other than put the beads into other capsules?


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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ChessieCat

I thought I would post this here to help anyone who is trying to calculate their doses for compounding.

 

I will be dropping by less than 10% so I hope to only have to hold for 3 weeks to start but I will have additional 2mg x 42 and 1mg x 21 if I need them.

 

Col 1 = No of days on the dose
Col 2 = dose
Other columns are how many tablets I need of each dose for the no of days

Col 1                2        3            4            5           6          7

No of Days     MG     20mg     10mg      5mg      2mg      1mg
21                   29       21                        21         39          6
21                   27       21                        21         21
21                   25       21                        21
21                   24       21                                     42
28                   23       28                                     28        28
28                   22       28                                     28
28                   21       28                                                 28
28                   20       28                                                    .

21                   19                    21           21         42
21                   18                    21           21                     21
21                   17                    21           TBA
21                   16                    21           TBA
21                   15                    21

Row 1                         196       Later       105       200        83

Row 2                           200                     100       200      100
Row 3                           20mg                   5mg     2mg      1mg

Row 4                           4000                    500      400       100     5000
Row 6                                                                                        50
Row 7                                                                                        50 tabs needed

Rows below the underlining are the start of my next batch of compounded tablets.

Row 1 = total number of capsules needed of that particular dose
Row 2 = rounded to nearest 100 (which is the minimum quantity of a dose)
Row 3 = is just for ease of seeing what quantity I need of each dose for ordering
Row 4 = this is the total of the dose to work out how many 100mg tablets are needed
Row 6 = Row 4 total divided by 100mg tablets
 


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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DoctorMussyWasHere

South African Resources

 

Not much to say about resources in South Africa. They are few and far between.

Needless to say the psychiatrist at Valkenberg Psychiatric Hospital had never heard of slow tapering, Fagron, compounding pharmacies etc.

 

So thanks for the WWW and the other SA.

 

 

Meds Pricing

Our meds pricing is controlled and available online here.

 

 

Compounding Pharmacies

There appear to be two main compounding pharmacies in South Africa:

The Compounding Pharmacy, and Fagron Pharmaceutical Compounding Services.

 

Fagron has a branch in Cape Town, which is why we chose them.

They barely put a markup on making up doses of Risperidone to a 0.1 microgram or 0.0001mg decimal point accuracy.

(although to be honest I didn't try weighing the pills to check, not that I could.)

 

They were extremely professional. More like a laboratory than a pharmacy.

  1. Email them your prescription with the new doses, preferably specified by the prescribing doctor.
  2. They will contact you in 3 days to collect or deliver.
  3. Each taper range is in its own bottle, marked with a very small number: 1, 2, 3, 4, etc
  4. Each dose is in a blue capsule

 

 

Fagron Pharmaceutical Compounding Services

http://www.fagron.co.za/

Fagron Cape Town
+27 (0)21 933 5545
Email: cpt@fagron.co.za


Fax: 086 619 4632
61

Clarendon Street


Parow Valley


Cape Town



Fagron Johannesburg
+27 (0)11 675 5331
Email: jhb@fagron.co.za


Fax: 086 619 4398
55

14th Avenue


Northcliff EXT. 17


Johannesburg



Fagron George
+27 (0)44 873 4158
Email: grg@fagron.co.za


Fax: 086 613 1467


Unit 60
14 CJ Langenhoven Street


George

The Compounding Pharmacy

https://www.compounding.co.za/
2 Eaton Ave
Cnr Bryanston Dr.
Bryanston
Co-ordinates: -26.046316 | 28.021929
Email: pharmacist@compounding.co.za
Email: orders@compounding.co.za
Phone: 011 463 0310
Operating hours: Mon-Fri 8.30am – 5pm  ( closed public holidays)


I am here as a supporter to certain individuals undergoing withdrawal, and to learn from and contribute to the forum where possible.

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Ttgreat54
On 3/4/2012 at 10:20 AM, Altostrata said:

In the United States, these compounding pharmacies will fill prescriptions by mail:

Hi Alto,

To order these meds, do i need a prescription from my dr ??

Great infomation here, TY


Prestiq 50 mg : 2010 - 2016

Prestig 100 mg: Oct 2016- July 2017

Prestiq 50 mg : July 2017 

Along w/ Adding in....

Effexor 37.5 July 2017 w/Prestiq

Trazodone 1-2 pills 4 sleep

Only took EFFEXOR 8 DAYS, STOPPED

TRAZODONE 4 days, STOPPED

 

TAPERING PRESTIQ ONLY : 50MG

BEGUN JULY 27, 2017 Still doing this to Stabalize At this Dose.

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scallywag
4 hours ago, Ttgreat54 said:

Hi Alto,

To order these meds, do i need a prescription from my dr ??

Great infomation here, TY

States vary in what they require for pharmacies to fill prescriptions.  Most reputable online pharmacies will require you to have a written prescription.  Contact (call or send a message via the contact us page on a website) several of the pharmacies listed and ask what they need to fill from you in order to ship you the medication your doctor has prescribed.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Ttgreat54
18 hours ago, scallywag said:

States vary in what they require for pharmacies to fill prescriptions.  Most reputable online pharmacies will require you to have a written prescription.  Contact (call or send a message via the contact us page on a website) several of the pharmacies listed and ask what they need to fill from you in order to ship you the medication your doctor has prescribed.

Ty Scally,

Yes I did contact them, waiting to here back.

Ty


Prestiq 50 mg : 2010 - 2016

Prestig 100 mg: Oct 2016- July 2017

Prestiq 50 mg : July 2017 

Along w/ Adding in....

Effexor 37.5 July 2017 w/Prestiq

Trazodone 1-2 pills 4 sleep

Only took EFFEXOR 8 DAYS, STOPPED

TRAZODONE 4 days, STOPPED

 

TAPERING PRESTIQ ONLY : 50MG

BEGUN JULY 27, 2017 Still doing this to Stabalize At this Dose.

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ChessieCat
2 hours ago, Oceanrat said:

As I try and navigate a messy situation here. And figure out why my taper has gone so awry, I sent my compounded Zoloft to an independent lab for analysis (I know it’s extreme but when you’re suffering in this manner you go to extremes). I’m not saying all compounding places are this way, but here were my findings. The Zoloft was supposed to be 40mgs. I sent 3 capsules in, the active ingredient in 3 were:

35.1

39.3

42.3

not sure if that’s causing my problems, but wanted to share how far off they’re. Now I guess I attempt to bridge over to full liquid, but feeling , well not so confident . 

 

 

 

Edited by ChessieCat

Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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DWeb

I'm having a very hard time finding a compounding pharmacy that will compound Pristiq for me. Most of them just say it's impossible. I called the Peoples RX in Texas and they no longer ship out of state. 

 

Does anyone have a good solution for finding a compounding pharmacy that will do slow release formulations that can either mail to me in Washington OR is actually in Washington State?

 

Thanks


Current: Pristiq 50 mg and Wellbutrin 200mg

dweb-tapering-off-pristiq

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ChessieCat

I am tapering by getting my Pristiq compounded.  I've gone 75mg to 4mg using this method.  My Intro topic link is in my signature.

 

To find a compounder:  http://www.pccarx.com/Resources/FindACompounder

 

Also see this topic:  Please see this topic:  Tips for tapering off Pristiq (desvenlafaxine)


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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DWeb
19 hours ago, ChessieCat said:

I am tapering by getting my Pristiq compounded.  I've gone 75mg to 4mg using this method.  My Intro topic link is in my signature.

 

To find a compounder:  http://www.pccarx.com/Resources/FindACompounder

 

Also see this topic:  Please see this topic:  Tips for tapering off Pristiq (desvenlafaxine)

 

Yeah, I went to PCCAR and looked for compounding pharmacies. Called about 10 or 12 and none would work with Pristiq. I'm learning how lucky you were to find someone local that would do that for you. 

 

I've read all through the Pristiq tapering topic and think I'm just going to have to go the Effexor route. I've created a introduction topic and will update there. 


Current: Pristiq 50 mg and Wellbutrin 200mg

dweb-tapering-off-pristiq

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ChessieCat

I have contacted the pccarx because I think it is important for them to know that 1) it is possible to compound Pristiq if they don't already know this, and 2) to advise their members that it is possible

 

I have provided my compounding pharmacist's contact information in the above and following correspondence.

 

I have also contacted these pharmacies:

 

https://paramountpharmacy.com/contact/

 

https://www.keycompounding.com/contact/

 

I will let you know if I get a response from them.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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ChessieCat
On 3/17/2019 at 11:22 AM, ChessieCat said:

I have contacted the pccarx

 

And received the following response:

 

I have not provided Ranel's address because it may change in the future if this person leaves the organisation but this is the one I used and you can send it   Subject:   ATTN:  Clinical Compounding Pharmacist

 

customerserviceexternal AT SYMBOL pccarx DOT com

 

Thanks so much for contacting us regarding this.  There are definitely some options on compounding this product and we are happy to assist a pharmacy with the knowledge on how to do this.  We have many member pharmacies within the state of Washington that are PCCA members and would be able to assist this patient.  Do you know where in Washington State your contact is located?  If you can provide that information I can direct them to a pharmacy that is a PCCA member.  That pharmacy is welcome to contact me through our members only website or by calling customer service and I can assist them with a formulation. 

Thank you and have a wonderful day!

Ranel A. Larsen, Pharm D, RPh | Clinical Compounding Pharmacist

PCCA | 9901 South Wilcrest Dr. | Houston, TX 77099-5132

Ph: 800.331.2498    

Fax: 800.874.5760 | PCD Fax: 713-234-6009

www.pccarx.com


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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ChessieCat

This has been added to Post #1 of this topic:

 

Quote

 

 

MOD NOTE:  If you cannot find a pharmacist who will compound your drug I suggest you contact the main compounding organisation in your country and ask them if your drug can be compounded and if it can, to advise you of a pharmacy who can do the compounding for you.  Or you could ask the compounding pharmacy to contact the compounding organisation.

 

PCCA - Professional Compounding Centers of America (includes:  Bahamas, Canada, US, Singapore, Taiwan, Thailand, Australia, New Zealand, Philippines, Malaysia)

https://www.pccarx.com/Resources/FindACompounder

 

 

 

If anyone knows the name of a compounding organisation in their country please post here and I will add the details.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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Altostrata

Added pharmacy.ca in Canada to

 


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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DavidfromTexas

As far as choosing the best Compounding Pharmacy, does PCAB Accreditation really matter?


ANTI-DEPRESSANTS (approximates):

2000--2009/10. Zoloft, mid-high dosage. Alprazolam, as needed, rarely. 

2009/10--2016/17. Cymbalta, 90 mg

Early 2017--Mid-2017. Cymbalta, 60 mg

Mid-2017--Jan 2018. Cymbalta, 30--60 mg, reduced in 30 mg increments w/o physical w/d symptoms, possibly some emotional w/d symptoms. Mar 2018--Early 2019. Back on Cymbalta, fluctuating dosages from 30 to 90mg. Reduced from 60 to 30, then from 30 to 0 again, this time WITH very light physical w/d symptoms. Back to 30mg. Early 2019--April 2019. Cymbalta, 30mg. Down from 30 to 0. Physical w/d symptoms again. Back to 30mg. May 2019. Cymbalta 30 mg. Down to 20 mid-month. Started taking every other day in final week of the month. 

Jun 2019. Cymbalta 10-ish mg. Started “eyeballing” about half of the beads in the capsule. Taking every other day, then at mid-month every 4 days. 

July 2, 2019. Took last dose of “eyeballed” 5-ish mg. July 24, 2019. Took first reinstatement dose of 2mg. Dropped down to 1mg (6 beads) the very next day.

Aug 6, 2019. Up-dose to 1.33 mg. Aug 30, 2019. Up-dose to 1.5 mg. 

SUPPLEMENTS

Vitamin D3 4,000 IU/day

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marie123

I luckily found a compound pharmacy to help with tapering mirtazapine. They are located on Long Island, New York. They have two locations, one in Westbury and one in Carle Place. I was able to give them my mirtazapine pills and they compounded them (liquid) while I waited. The cost is $15. They also give you a couple of syringes and will help you with the math. There are two locations, Westbury and Carle Place. I went to the Carle Place one. Their website is www.carmandrugs.com. Marie.


10/13--10/14 Ambien. Started tapering 1/14  Jumped 10/14.  Done.                                                                              

3/14        7.5 Remeron  still taking this.                              

2/14         75 Trazodone   -    Tapered by dry cutting all the way down.

1/16        4 mg Trazodone  -  Jumped. Bad mistake. Got hit with late withdrawal 6 weeks later. Had to reinstate.

4/16        Reinstated 1 mg, updose to 2 mg Trazodone

2/19        .04 Trazodone. Walked off.  Done.

10/3/19  Started 7.5 Mirtazapine taper cut to .073 gram weight, pill weighs .076

4/5/20    New Mirtazapine Taper - Compound Liquid 7.35 mg April '20, 7.25 mg May, 7.05 mg June, 6.99 mg June, 6.78 mg July, 6.57 mg Aug, Sept 6.35 mg, Sept 6.24 mg, Sept 6.21 mg.

 

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plantsrule
21 minutes ago, ChessieCat said:

getting-custom-dosages-at-compounding-pharmacies-us-uk-canada-and-elsewhere

 

I suggest you also post your question is the above topic.

 

You also ask your compounding pharmacist for assistance.

 

 

I'm working with a compounding pharmacy.    I'm wondering if anyone has had luck getting Kaiser Permanente to write compounding prescriptions for tapering. 

Also, if Kaiser won't do it,  should I ask for a prescription for 20mg so it's easier to weigh?     


Cymbalta/Duloxetine

2012-2014 - Cymbalta/Duloxetine 60mg

2015- Duloxetine compounding pharmacy taper from 60mg at 5mg per month, ~10 months.

March to June 2016 – off Duloxetine. 

June 2016- Tried many different drugs to treat sever anxiety: Paxil, Prozac, Latuda. 
July 2016- Reinstated Duloxetine 60mg.  
8/24/20- Reduced from 60mg to 30mg of Duloxetine.  (I thought I could do this due to my whole food plants only diet and vigorous exercise routine, huge mistake!)

9/6/20 – Reinstated 60mg due to unbearable withdrawal symptoms: non-specific anxiety, anger, agitation, sore eyes, weight loss, headache, trouble staying asleep, and dizziness. 

9/11/20 – I’m feeling much better after reinstating 60mg, but still a little anxious. 

 

I want to do a 10% monthly taper from the last dosage once I stabilize on my initial dose of 60mg

 

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