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How to make a liquid from tablets or capsules

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Glosmom

Carefulprayerful,

A 10% reduction from 1mg takes someone to .9 mg NOT .09mg.  .09 mg would be near the very end of the taper.  You should never need to dilute the prescription liquid form of Risperidone.  People that are using tablets or capsules are diluting things down to get to easily measurable amounts.  The 1 mg per 1 ml liquid Risperidone is already in a very easily measured and titrated form.  No need to add water at all.   Not sure who told you that you have to dilute the liquid risperidone down further with more liquid because you do not have to do that.  Hoping you don't make this more complicated than it needs to be.  Best Regards, glosmom

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ChessieCat
3 hours ago, carefulprayerful said:

The prescription liquid is 1 mg per 1 mL.  At 0.09 mg and below, since the smallest measurement on a syringe is 0.01 mL, the reductions would be > 10%.  

 

I guess I could switch to a compounded liquid at any point to get it more diluted.    

 

Can you further dilute the prescription liquid?  (I asked a compounding pharmacist this question, and he said he wasn't sure if the compounded liquid would mix with water.)

 

 

From this site:  http://mcs.open.ac.uk/nlg/old_projects/pills/corpus/pil/data/JanssenCilag/Risperdal_Liquid/Risperdal_Liquid.html

 

"The liquid contains the following inactive ingredients: tartaric acid, benzoic acid, sodium hydroxide and water"

 

This means that it is okay to dilute the liquid with water.

 

Edited by ChessieCat

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ChessieCat
1 hour ago, Glosmom said:

A 10% reduction from 1mg takes someone to .9 mg NOT .09mg.  .09 mg would be near the very end of the taper.  You should never need to dilute the prescription liquid form of Risperidone.  People that are using tablets or capsules are diluting things down to get to easily measurable amounts.  The 1 mg per 1 ml liquid Risperidone is already in a very easily measured and titrated form.  No need to add water at all.   Not sure who told you that you have to dilute the liquid risperidone down further with more liquid because you do not have to do that.  Hoping you don't make this more complicated than it needs to be.

 

Yes this is correct:  "A 10% reduction from 1mg takes someone to .9 mg"

 

 

"People that are using tablets or capsules are diluting things down to get to easily measurable amounts. "

 

Yes, they do.  Some members find that they have difficulty accurately and consistently measuring small amounts.  Diluting the liquid may help them to do this.  Also, some members find that they need to reduce by very small amounts and diluting allows them to do this with greater accuracy.

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carefulprayerful
2 hours ago, ChessieCat said:

some members find that they need to reduce by very small amounts and diluting allows them to do this with greater accuracy. 

Yes, this is my case.  I would like to do a microtaper.  If I diluted the prescription liquid (an oral solution) in water, would I have a suspension or a solution?

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ChessieCat

It would be a solution.

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Jerome

The American Pharmacists Association Drug Information Handbook has begun inserting extemporaneous preparation procedures for suspensions of benzodiazepines and probably other drugs. As an example, on page 1190 of the 26th edition at the end of the monograph on lorazepam there is a section called extemporaneous preparations note:

"Commercial oral solution is available (2 mg/mL) 2 different 1 mg/ml oral suspensions may be made from different generic lorazepam tablets (Mylan Pharmaceuticals or Watson laboratories, sterile water, Ora-Sweet and Ora-Olus."

There follow extremely detailed instructions to the pharmacist for the preparation of 360 mL of suspension, one paragraph for Mylan and one for Watson. This would of course be scaled down, but I'm thinking it might be best for the pharmacist to make this solution, in fact they might insist on it. Another question is which doctor writes which prescriptions. I'd just as soon not even tell Kaiser about my outside doctor, but I don't think that will fly with controlled substances, and I'm not sure I'd want it to, anyway. It looks like Dr. shopping, even though the tiny amount involved makes that idea ridiculous. I'm seeking an outside doc because Kaiser will only treat me in their Chemical Dependency Program, I don't care for their method, and they don't have much flexibility.

Anyway, I have seen similar preps for a couple of other benzos in this same book and would guess there are some for other psych drugs. The book costs 35 or $40, but it might be worth it to be able to lay it down on the counter in front of the pharmacist alongside a letter from your doctor. Or you can get it from the library.

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Altostrata

Thanks, Jerome! Perhaps a pdf will become available.

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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 100thmarked 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.

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thecowisback

what's the difference between an oral syringe and a normal one? i just searched syringe on ebay and bought a couple of sizes. now i'm wondering if i've bought the wrong type. the one i'm using at the moment is one the vet gave me for my cats medicine and has a small opening.

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