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Gussy

Dr dropped Gussy's Mum's olanzapine from 5 mg to 2.5 mg?

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Gussy

Hi all you good Folk, I haven't posted in this group for a long-time. I posted a little bit in 2017 when I got  to 0 with my effexor taper, which was far too fast. There was no choice for me given my scenario, so I know how devastating withdrawal can be from these drugs. I'm a moderator in an  effexor group. My dear Mum, bless her angelic soul, has been on these drugs longer than she hasn't, and although i.ve told her much about the need for very careful tapering and drs cluelessness around this her dr has reduced her dose of olanzapine from 5-2.5 mg. I.ve told her to write down anything at all that.s out of the ordinary and tell me. My dad.s watching out for her but from his dr believing position i feel he wont be of much use to her. Nor will her dr. I guess i.m asking if wd symptoms are in the same park between effexor and olanzapine. I think i already know the answer but just want to be aware of any possible different wd symptoms between them. Another probably difficult to answer question, might dropping from 5-2.5 olanzapine be similar to dropping effexor from 75-37.5? You know, entering the danger zone as the lower end is approached? Her drs reduced her effexor from 225-112.5 in 37.5 increments over quite a while and she.s well and truly stable from that. I do cringe at the size of the drops and am frustrated by the belief some of my family have in the "wisdom" of drs in this regard. I know how dangerous this is. I.ve told her much about wd so hopefully she.ll be on red alert and ready to consider my help when the need arises. I saw a link on how to prepare a liquid solution here with olanzapine and will have a good look at it. Thanks for your time.

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Gridley

Welcome back, Gussy.

 

As you know, WD symptoms are pretty much all over the place in variety, but I think you're talking generally about the same type of symptoms whether from effexor or olanzapine.

 

You've already guessed the answer to your second question: the low end reductions could cause more problems than the high end.

 

Sorry you and your mom are having these doctor/drug problems.

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Gussy
8 hours ago, Gridley said:

Welcome back, Gussy.

 

As you know, WD symptoms are pretty much all over the place in variety, but I think you're talking generally about the same type of symptoms whether from effexor or olanzapine.

 

You've already guessed the answer to your second question: the low end reductions could cause more problems than the high end.

 

Sorry you and your mom are having these doctor/drug problems.

Can a liquid form of olanzapine be made at home somehow? Will it be absorbed properly etc?

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Gridley
45 minutes ago, Gussy said:

Can a liquid form of olanzapine be made at home somehow?

Quote

 

Yes.  I have excerpted the instructions from our post about tapering olanzapine.  The full post is here:

 

Tips for tapering off olanzapine (Zyprexa)

 

Here are the excerpted instructions:


Using a liquid to taper: Make your own liquid
However, like other drugs that are not particularly soluble, you can make a suspension, as our member Rhi explains. Also see http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/


According to http://www.pharminfotech.co.nz/manual/Formulation/mixtures/olanzapine.html

  Quote

Olanzapine (as crushed Zyprexa® tablets) is stable for up to 6 hours at room temperature and up to 48 hours refrigerated in water and the following beverages; orange juice, apple juice, cola and milk.

 

The preparation and stability of a liquid olanzapine preparation for oral administration in hospitals

The Pharmaceutical Journal Vol 265 No 7110 p275-276 August 19, 2000

 

  Quote

 

....We have found that Zyprexa tablets 10mg, crushed and suspended in Guy's hospital "paediatric base", provides a more palatable liquid oral olanzapine preparation than crushed tablets suspended in water.

....

Zyprexa tablets (3 x 10mg) were halved and then crushed using a mortar and pestle and the powder suspended in 30ml Guy's hospital formula base for paediatric mixtures (paediatric base), a syrup-based mixture containing carboxymethylcellulose BP, methylhydroxybenzoate BP and propylhydroxybenzoate BP.3 Each batch of olanzapine suspension was stored at 2?8C in a 50ml amber glass bottle in the dark.

....

The suspension settled quickly and powdered tablet fragments formed a visible layer on the bottom of the glass bottle. Experience with the analogous clozapine suspension3 has shown that the need for vigorous shaking must be emphasised to nursing staff who may be asked to administer the suspension to patients. As with the clozapine suspension, informal assessment of the palatability of the olanzapine suspension has shown it to be well tolerated, some patients in fact preferring it to tablets.

....
No tests of microbiological stability have been performed although paediatric base is preserved. It therefore seems prudent to recommend a shelf-life of two weeks when the product is stored in a refrigerator. Such a shelf-life is adequate for hospital use. We have no information on the bioavailability of olanzapine from the suspension, although it seems unlikely that olanzapine bioavailabilty will prove to be less than that from Zyprexa tablets.

 

 

Guy's hospital "paediatric base" appears similar to Ora-Plus suspension base, which is commercially available:

 

http://www.perrigo.com/files/rx/pdfs/pds173-ORA-Plus.pdf

 

  Quote
....ORA-Plus is an aqueous-based vehicle consisting of a synergistic blend of suspending agents that have a high degree of colloidal activity. The suspending agents form a structured, gel-like matrix which suspends particles and allow for little settling. ORA-Plus is buffered to a slightly acidic pH to help reduce degradation of medicinal agents through oxidation. An anti-foam agent is incorporated in ORA-Plus to allow for vigorous shaking with minimal foam.
 

Ingredients

Purified water, microcrystalline cellulose, carboxymethylcellulose sodium, xanthan gum, carrageenan, calcium sulfate, trisodium phosphate, citric acid and sodium phosphate as buffers, dimethicone antifoam emulsion. Preserved with methylparaben and potassium sorbate.....


If you want to experiment further with dissolving the tablet:
 
https://www.caymanchem.com/pdfs/11937.pdf

 

  Quote
Olanzapine is sparingly soluble in aqueous buffers. For maximum solubility in aqueous buffers, olanzapine should first
be dissolved in DMSO and then diluted with the aqueous buffer of choice. Olanzapine has a solubility of approximately
0.5 mg/ml in a 1:1 solution of DMSO:PBS (pH 7.2) using this method. We do not recommend storing the aqueous
solution for more than one day.

 


 

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Gussy

Hi Gridley. Wow thanks for the detailed info you.ve provided. You.ve gone to quite an effort here and it.s much appreciated. It sounds like the idea is to mix it at 1mg/ml of water if done at home and shake it well before extracting the required dose. It also sounds like it might have to be used quite quickly after preparation. Do you know if others in the group taper their olanzapine by crushing their tabs and mixing with normal water at home? Mum had her 1st half dose last night and did notice some differences. After having a quick look at a receptor saturation/occupancy article about seroquel with some references to olanzapine i can see how significant the drop from 5-2.5 is. Thanks again for all this info. I.ll have a good look through it. Gus.

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Gussy

Sorry, I have another question. Might it be able to be typered by 10% by weighing the tablet and using a little nail file or something to file off 10% of the total weight? or might this just be filing off fillers etc and not give an accurate 10% reduction of the active drug? Does this make sense?

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Gussy
12 hours ago, Gridley said:

Welcome back, Gussy.

 

As you know, WD symptoms are pretty much all over the place in variety, but I think you're talking generally about the same type of symptoms whether from effexor or olanzapine.

 

You've already guessed the answer to your second question: the low end reductions could cause more problems than the high end.

 

Sorry you and your mom are having these doctor/drug problems.

Sorry, I've asked a few more questions without quoting your post so you may not be aware I was asking you questions. You may also be having some sleepy time. In my usual fashion I have another, if a liquid preparation were made might it void and extended Release Property of olanzapine? Is olanzapine an extended release drug like the effexor I took or does it not matter? Thanks again for all your help. Gus

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Altostrata

Hello, Gussy. 

 

How did your Mum react to the decreased dosage? If after a week she seems okay, it's possible she can tolerate this decrease. I wouldn't do the same from 2.5mg olanzapine, though.

 

Why is she taking olanzapine?

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Gridley
10 hours ago, Gussy said:

if a liquid preparation were made might it void and extended Release Property of olanzapine? Is olanzapine an extended release drug like the effexor I took or does it not matter?

Making a liquid voids any extended release property, but the best I can tell Olanzipine is not extended release.

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Gussy
6 hours ago, Altostrata said:

Hello, Gussy. 

 

How did your Mum react to the decreased dosage? If after a week she seems okay, it's possible she can tolerate this decrease. I wouldn't do the same from 2.5mg olanzapine, though.

 

Why is she taking olanzapine?

Thanks for your reply Alto. It.s been a long time since we.ve spoken. I hope you.re well. I know she takes it to help her sleep. I don.t know if its anti p use is also wanted. Last night was her 1st at the lower dose. She woke during the night and may.ve struggled to get back to sleep. She said she felt a bit anxious this morn but it passed. I think she.s a little worried about possible consequences. Sorry my feedback isn.t very informative. I still have a vision in my mind of her in a hospital bed from when i was little, i found out later she.s had a breakdown and was having shock treatment. She had ect done a few years back and got switched to effexor (from aropax/paxil i believe) after taking a turn which after finding a lot more out about this stuff i think was brought on from tollerance wd. Thank you very much for your opinion here, i will pass it on. 

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Gussy
16 minutes ago, Gridley said:

Making a liquid voids any extended release property, but the best I can tell Olanzipine is not extended release.

Thanks for your reply. I.ll double check the box. Surely it.d say xr on it if it was. Gus.

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Gussy

A little update. It.s been 5 days and so far so good. I know this can change. Gus.

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Gussy

Can i expect the likelihood of wd to decrease as time goes on with this drop or should i stay on alert for a good while? Some in the group i.m in report being good for a good while then get struck by wd. I wonder if the same could happen with this drug? Thanks again for your help, Gus.

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