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Using an oral syringe and other tapering techniques

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Rachelina

Determined Anna, I'm terrible at using the quote function, so I'll just give my answers one by one. I'm interested in what others have to say too!

 

1. I wouldn't worry. I usually keep 3 to 5 syringes in rotation and use them until they become so "sticky" (i.e. they don't move smoothly so it's hard to get to the right line) that they are unusable. I use them way more than 6 times each and they seem fine....I can't think of any reason why accuracy would decrease over time. 

 

2. This is a concern for me. Honestly at the dose that you are at, I don't think that tiny variation makes much of a difference, but as you get lower in dose, it becomes a greater percentage of the whole. I am super excited to try the syringes mentioned by Cleerity in the post below yours, because it looks like there is hardly any space at the tip for that variation to occur. I also have little tricks to reduce that variation, like I keep trying until I get an amount that's not about to drip out but the tip isn't totally empty either. 

 

3. Yes - I am using .5 mL syringes and SkyBlue found a .25 mL syringe. But I'm probably going to switch back to 1 mL because of the tip variation thing - unless they make a .5 mL in the same style. To me tip variation is more important than having smaller increment markings. The .5 mL ones I'm using actually don't have smaller increments, but I think SkyBlue's .25 mL syringe does.

 

4. I don't know! I was wondering the same thing about the really tiny doses. But .34 mL isn't such a tiny dose. My dose is currently .37 mL, which equals .74 mg of Paxil. And it's substantial, not a lot but like a tiny sip. So it's strange that you could barely feel it entering your body. Maybe it just seemed small compared to the larger amounts you were used to?

 

Hope this helps, and best wishes with your taper!

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DeterminedAnna

Thank you everyone for the responses since my recent questions. In particular @Rachelina.. thank you for the reassuring words.

I've been looking over the weekend for a microlitre syringe (scary prices), but thanks to your comments I realise I may not need to go so low – I've found a .5ml syringe that I might be able to get shipped to the UK. Also, thinking laterally, I'm wondering if a pipette – the kind of thing that's more like a dropper – would work as well? As I'm based in the UK I'm trying to source here to avoid big shipping fees, and found there's some veterinary suppliers that sell teeny weeny pipettes. I'll share links on this thread when I've found something that fills me with confidence, not more questions or uncertainty.

 

All being well, I won't need to make any practical changes to my oral syringe setup for some time yet. One of the more pervasive themes of advice on this site is to be as consistent as possible, and not tinker too much with variables. And that's why when I get any equipment, I want to be 200% sure of my choices, so I don't have to buy an alternative item soon after and risk a series of tiny variations in my tapering.
 

As for one of my questions and one that you've also pondered @Rachelina – about ultra tiny doses of medicine – I was reading online over the weekend, doing searches for 'effects of tiny doses of medicine' and I came across the term 'microdosing'.

 

Sometimes having the correct term is the only way to find the information you're seeking, and information that's relevant and reliable. On my Google search for 'microdosing' the results are currently dominated by recent studies of LSD microdosing. But – and I'd really need someone with more pharmaceutical experience to vet this – I got the impression that microdoses still have an effect on the body. And, as such, microdosing is getting interest because it can be used to reduce the risk of adverse effects in clinical trials, meaning humans can be used in early trial phases, rather than other, less reliable methods, like animal testing. Maybe I'm being too simplistic, but if micro doses didn't have an effect on the body, then such studies would be a pointless waste of time and money from the outset, and wouldn't be happening.

I might be late to the party on the subject of microdosing – some of the articles I found date as far back as 2010. And microdosing might have already been discussed elsewhere on this forum, but it has given me reason to think my concerns about tiny doses are unfounded. It's also reminded me that, ultimately, everything in the human body happens at molecular level (not sure if that's the right term), so even a few microlitres – which will be many, many molecules – of Seroxat will have an effect.

Thanks again everyone, and for the reassurance and info Rachelina. 


PS. I never ever set out in my life to become an expert in oral syringes, but it looks like I might be at the end of this. Something else to put on my resume! 😉

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ChessieCat
12 hours ago, DeterminedAnna said:

 

I've been looking over the weekend for a microlitre syringe (scary prices), but thanks to your comments I realise I may not need to go so low – I've found a .5ml syringe that I might be able to get shipped to the UK.

 

 

Where to get oral syringes

 

From the above post:

 

On 5/2/2011 at 6:56 AM, Altostrata said:

 

Where to get oral syringes

Many pharmacies carry the larger oral syringe and, as Brandy implies, veterinarians carry them, too, to give animals medication.

 

 

 

12 hours ago, DeterminedAnna said:

Also, thinking laterally, I'm wondering if a pipette – the kind of thing that's more like a dropper – would work as well?

 

Other members manage fine without these.  I know Rhiannon uses them but she's a lab technician.  From:  making-a-celexa-solution-yourself

 

On 5/2/2011 at 1:00 PM, Rhiannon said:

 

Then I add enough water to bring it up to 20 mL total. I mix it well and then draw up my dose for the day, and then pipette it straight into my mouth followed by a pipette full of water (both to rinse the pipette and to dilute the "shot"!)

 

My current dose is 5.25 mg of citalopram, so given the dilution I'm using (10 mg in 20 mL) I measure 10.5 mL as my daily dose.

 

All of this could be adapted easily to using syringes for measurement instead of a pipette. (And if you are more delicate than me you could measure it into a spoon or cup rather than squirting it straight into your mouth.)

 

But using pipettes is really easy too, very simple to learn and do.

 

 

12 hours ago, DeterminedAnna said:

PS. I never ever set out in my life to become an expert in oral syringes, but it looks like I might be at the end of this. Something else to put on my resume! 😉

 

None of us set out to be experimented on with psychiatric drugs either.  Some of the members, who have to crush their tablets, weigh their doses and make up capsules say they feel like druggies.  Either a druggie or a chemist.  A complete contrast.

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Cleerity
21 hours ago, Rachelina said:

Thanks for all that info, Cleerity! Nice to find another syringe geek :) 

 

I will definitely check out those syringes. Do you find they stay smooth even after reusing them for weeks? Every brand I've used has been smooth at the beginning, but then gradually lost that smoothness over time until becoming unusable.

 

Well, I have not used them for weeks, yet.  I will see how it goes.

 

I just read more of this topic and see that the tape trick (to preserve the markings) was already mentioned a few times over!  

 

I am also interested in the microliter syringes mentioned in the topic, so will be looking into those as they may be helpful as I get to a really low dose.  

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ChessieCat
13 hours ago, jozeff said:

🤗🤗

Well, a syringe has what is called a dead volume. This is the volume that doesn't come out the syringe when you empty it! This only applies for the first check mark, in this case the first ml. If you empty a 5 ml syringe let's say from 5 ml mark to 4 ml you gave exactly 1 ml liquid. Same for 4 to 3 ml same for 3 to 2 ml. Same for 2 to 1 ml. Same for 1 to 0 ml, but in the latter case you will have some dead volume left in the syringe. You should left this in the syringe because it is designed this way!

 

So, if you suck up liquid in a syringe let's say from nothing to 1 ml mark. Thet total volume of liquid in your syringe is maybe 1.2 ml. This is 1 ml + 0.2 ml dead volume. If you empty the syringe it will release 1 ml. The 0.2 ml dead volume stays in the syringe.

 

If you taper using syringes use the 5 ml syringe from 5 to 1 ml if possible. Below 1ml use the 1 ml syringe. 

Never fill a syringe with another one because the dead volume messes up your calculation.

 

If you need let's say 4.6 ml you take the 5ml syringe and fill it to 4 ml. 

Empty this in a small cup, leave the dead volume in the syringe (the liquid that stays in the tip).

Fill your 1 ml syringe to 0.6 ml mark and empty it in the same cup., Leave the dead volume in the syringe.

Drink your liquid and flush you cup with water and drink that too. 

Flush your syringe with water and throw that away. Dry the tip of syringe with some toilet paper.

Don't drink de dead volume because you will be getting more than 4.6 ml...

 

Hope this is clear. It's important to do the same every day. That way you get the most accurate dosage.

 

I use a volumetric pipette for this (an old one from the lab) but this is not necessary. A syringe will do, I mean we are not talking about 1/1000 of a mg right? One day 5.45 mg and next day 5.46 will be ok. Such a small difference is negligible.

 

 

Good luck!!!

 

Jozeff

Analytical chemist

 

 

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SkyBlue

 

Actually we are talking about measuring to the 0.001 mark (thousandths of a mg)--incredible, but true! The microliter syringe is what has enabled me to continue my taper at the 2% rate, which at the tiny doses I am now on, needs to be measured in 5/1000 of a mg. 

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Rabe

Have you water tapered the whole time?  

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jozeff

Ok, when we approach the 0.1 mg area we have to make smaller increments of course. 

 

I assumed we all have plenty of tablet/liquids. In the Netherlands the healthcare assurance pays the medication. If I need 2 mg of citalopram I dissolve 10 mg and throw away 8 of them. That is not true for everybody of course.

 

I would rather dilute my solution and take a larger volume then use a concentrated solution and take a tiny volume. This is less accurate, especially when you don't have professional equipment.

 

A microliter syringe will do just fine. 

 

I also assumed people jump of meds at 0.1 mg so the 1/1000 wouldn't be necessary. I don't know how I will be tapering myself. Maybe I need to go much lower than 0.1 mg citalopram before jumping off.

If I need 0.01 mg I would dissolve my 10 mg pill in 1 liter and drink 1 ml and flush the rest down the drain. This is very spilling behavior but it is accurate.

 

I was trying to assist Carmie with her syringe issue. It is interesting to hear your solution to these problems.

 

Cheers

 

 

Jozeff

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ChessieCat
9 hours ago, jozeff said:

If I need 2 mg of citalopram I dissolve 10 mg and throw away 8 of them.

 

You don't have to throw it away.  You can keep it for covered for several days in the fridge.

 

9 hours ago, jozeff said:

I also assumed people jump of meds at 0.1 mg

 

No, they go much lower than that.  When to end the taper and jump to zero?

 

9 hours ago, jozeff said:

If I need 0.01 mg I would dissolve my 10 mg pill in 1 liter and drink 1 ml

 

If I was making my own liquid I would be increasing the water to be able to measure my dose more accurately.

Edited by ChessieCat

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Figgy

HI,  I am starting this new content because I have a questions I am hoping one of you can help me with.  I have been tapering off 5mg of Lexapro for more than a year.  I am closing in on needing to use a 1 ml syringe to continue my taper. 

 

I have  rubber stoppers I bought online that you shove into the top of the bottle of liquid lexapro so you can put the syringe in the hole, tip the bottle upside down and draw out your dose.

 

I cannot find any stoppers for a 1 ml syringe.  They are all too big to fit this small syringe tightly.  Does anyone know where I can find a stoppers for a 1 ml syringe?  It is SO much easier and less messy than pouring the dose out into a cup and trying to draw it up....much less wasteful too.

 

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ChessieCat

Vets use very small syringes for animals.  You could ask if they use bung/stopper also called bottle adapter plug and if you might be able to purchase one.

 

You could also enquire at a compounding pharmacy.

 

Found these online but you'd have to enquire if they would fit the size syringe you are using.

 

https://www.totalpharmacysupply.com/staysafe-trade-self-sealing-bottle-adapters-24-mm.html?refSrc=613678&nosto=nosto-page-product1

 

https://www.totalpharmacysupply.com/bottle-adapter-plugs.html?refSrc=609907&nosto=nosto-page-product1

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Idlehnds
1 hour ago, Figgy said:

HI,  I am starting this new content because I have a questions I am hoping one of you can help me with.  I have been tapering off 5mg of Lexapro for more than a year.  I am closing in on needing to use a 1 ml syringe to continue my taper. 

 

I have  rubber stoppers I bought online that you shove into the top of the bottle of liquid lexapro so you can put the syringe in the hole, tip the bottle upside down and draw out your dose.

 

I cannot find any stoppers for a 1 ml syringe.  They are all too big to fit this small syringe tightly.  Does anyone know where I can find a stoppers for a 1 ml syringe?  It is SO much easier and less messy than pouring the dose out into a cup and trying to draw it up....much less wasteful too.

 

 Hi Figgy.  Ask them for a small bottle to put the liquid.    I then bought this https://www.amazon.com/Syringe-Luer-Slip-Needle-Non-Sterile/dp/B01N01TO2O/ref=sr_1_1?keywords=1+mg+syringe&qid=1554933131&s=gateway&sr=8-1

 

You just put the dropper in and extract it from there.  Super easy.  I wouldn't worry about finding  the rubber stopper stuff.

 

Theres like 50 of them in there that you can reuse about every 3-4 times you use it.  Just rinse it with water.  

 

Easy solution :)

 

 

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Colonial

 

I'm having trouble finding the smaller 0.5ml and the 0.3 ml syringes WITHOUT the needles manufactured "in" them.

If anyone sees them in their "online" purchasing travels please let me know! 😉

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Altostrata

@Figgy @Colonial here is our topic about using an oral syringe. Read the posts above.

 

Contact medical supply stores for oral syringes. Many pharmacies carry them, so do veterinarians.

 

I have gotten small bottles with the correct cap for a small syringe from Walgreen's, for no charge. Be sure to describe the cap, it screws on and has a hole in the middle. The ones I got were blue plastic. A lot of pharmacy staff know nothing about oral syringes, you have to describe exactly what you want.

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Figgy
On 4/10/2019 at 8:24 PM, Altostrata said:

@Figgy @Colonial here is our topic about using an oral syringe. Read the posts above.

 

Contact medical supply stores for oral syringes. Many pharmacies carry them, so do veterinarians.

 

I have gotten small bottles with the correct cap for a small syringe from Walgreen's, for no charge. Be sure to describe the cap, it screws on and has a hole in the middle. The ones I got were blue plastic. A lot of pharmacy staff know nothing about oral syringes, you have to describe exactly what you want.

Thank you.  I will try Walgreens.  

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ktp
On 1/22/2019 at 6:27 PM, SkyBlue said:

 

"Actually we are talking about measuring to the 0.001 mark (thousandths of a mg)--incredible, but true! The microliter syringe is what has enabled me to continue my taper at the 2% rate, which at the tiny doses I am now on, needs to be measured in 5/1000 of a mg."

 

I've read through most of this thread on tapering liquids, and it appears that people are actually trying to measure impossibly tiny amounts of liquid.  What i havent seen is reasonable dilution instructions.  Seems to me that when you're down to such tiny doses, why not further dilute the med so you can take a larger (and thus easier to measure) amount to get your tiny dose?

 

For example, liquid Prozac comes in a concentration of 20mg/5ml.  If you're trying to take 1mg of drug, you need to drink 0.25ml of the liquid.  I submit that this is too tiny an amount to easily measure with any accuracy. 
pun-intended SOLUTION: Dilute the whole 120ml bottle with another 120ml of water, dropping the concentration to 10mg/5ml or 2mg/1ml.  that lets you take a far easier to measure 0.5ml to get your 1mg dose.  For easier measurement, add more water, "do the math", and take much more accurate doses than you'll ever achieve with super-tiny syringes.

 

For me, I'm planning to mix my own liquid prozac from 20mg capsules.  To get the "standard" mixture of 20mg/5ml, put 20 caps in 100ml of water, so a 20mg dose is 5ml of that solution.  5ml is pretty easy to measure to within 0.1ml with just a normal cheapo 5ml syringe.


Then as my taper continues, I'll simply add fewer caps to the same 100ml of water and continue taking 5ml doses.
 

When i want 17mg of drug, i can put 17 of the 20mg caps into 100ml of water and drink 5ml of the solution.  all easy measurements.

 

... put one 20mg cap in 100ml of water to get 1mg by drinking 5ml.


and when i want 0.1mg, I'll put one 20mg cap in 1000ml (yep a whole liter:-) and drink 5ml.

 

I hope that makes sense and i hope it will help with at least one person's micro-dosing.

 

 

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ChessieCat
Posted (edited)
2 hours ago, ktp said:

I've read through most of this thread on tapering liquids, and it appears that people are actually trying to measure impossibly tiny amounts of liquid.  What i havent seen is reasonable dilution instructions.  Seems to me that when you're down to such tiny doses, why not further dilute the med so you can take a larger (and thus easier to measure) amount to get your tiny dose?

 

If a member isn't able to work out diluting to measure their dose more accurately, they usually ask for assistance and the mods provide help.

 

serial-dilution

 

Edited by ChessieCat

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