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Rhiannon

How to make a liquid from tablets or capsules

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Altostrata

There are always uncertainties when you make any changes in these drugs, which is another reason they are dangerous.

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Rhiannon

It seems to the rule that you should not store your DIY liquid for more than 3-4 days.

 

Doesn`t that prove the fact that the liquid is losing it`s medical effect very fast? So even if make only 3 days worth of medicine, every dose is less effective that previous?

 

I`m noticing a pattern that I feel better when I take my 1st dose. Days 2 and 3 are downhill and things get a little better when I make a new patch. I can not be sure about this yet but I`m very scared to experiment any further.

 

Can you test this by just making it up fresh each day for a week or so, keeping a log of your symptoms, then experiment with two days at a time, then three?

 

As long as you don't make large changes abruptly, I encourage you to experiment and find out what works for you. All we have here are our own experiences, no real large-scale data, so the safest and best way is for everyone to become expert on herself or himself.

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Altostrata

Zoloft is available as a liquid in many parts of the world. Ask your pharmacist.

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rapunzel2

ks, that is not always so. Many people switch to liquid without a problem. Others experience it as too strong because a liquid is absorbed faster.

 

It's an individual thing. Once you make the switch, give it some time -- it takes about 4 days for your system to register a change in dosage -- and then see if you need to adjust the dosage of the liquid.

 

I have been wondering about the same thing. I suspect that the body absorbs the drug maybe differently, if it's swollowed in a capsule or drank in water solution? I'm thinking of going to prozac water solution soon, in order to make supersmall cuts. those seem to be better to me. 

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Rhiannon

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ORIGINAL TOPIC:  Making a Celexa Solution Yourself

-------------------------------------------------------------------------------------

 

On 11/30/2011 at 11:48 AM, Altostrata said:

Rhi, do you know how long the Celexa solution will keep in the fridge?

 

I just found this study which indicates that Celexa dissolved in water is pretty stable. It says they went as far out as 30 days and no degradation was seen when kept dark; maybe a little less if exposed to light in this study. This is great news for me, because I'm down to about 1 mg now and I can make 8-9 doses out of one tablet!

 

http://www.ncbi.nlm.nih.gov/pubmed/16050577

 

I use distilled or RO filtered water, which is naturally about pH 7 and should not contain significant amounts of any chemically active substances. (Other than water, that is.)

 

Edited by ChessieCat

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Rhiannon

Found this extensive article about stability of drugs in suspending agents like Ora Plus. It's a bit of a dense read but the basic take home message is that of the 60-something drugs reviewed only something like 8 are unstable in aqueous suspending medium. There's a list of those in the first paragraph.

 

Solution in water isn't quite the same as an aqueous suspending medium like Ora Plus, but for me it's close enough--if water was going to degrade the chemical it would do so in the Ora Plus as well.

 

However if you want to make your own, you can buy Ora Plus from Amazon and probably other places on the Internet.

 

http://www.ualberta.ca/~csps/JPPS9_3/MS_973_Review/MS_973.html

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Altostrata

Thanks, Rhi!

 

Those drugs that you can't mix with a suspending agent:
 

captopril, hydralazine hydrochloride, isoniazid, levothyroxine sodium, phenoxybenzamine hydrochloride and tetracycline hydrochloride

 

....Interestingly, the instability in these formulations is primarily due to interactions between the drug substance and the excipients rather than degradation of the active pharmaceutical ingredient by standard routes such as oxidation, hydrolysis, photolysis or thermolysis. This low percentage however illustrates the low risk associated with these dosage forms investigated. It may be concluded that when considering the safety and efficacy of liquid dosage forms prepared extemporaneously, it is thus important to consider not only the stability of the drug substance but the entire formulation.

 

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Abilifyneedhelp88

Does anyone know if you can use oraplus with Remeron instead of using water as a mixing agent??

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Altostrata

You can use Oraplus with Remeron if you wish.

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Wildflower0214

Feel free to move this if it is not in the right place. I looked around and could not find any other place that looked more appropriate to post this question.

 

I will try to be as clear as possible.

 

In liquid tapers, the advice I have seen looks like this:

1)Make suspension

2)Pull % of liquid out that would equal your intended cut, throw it away

3)Pull doses for the day

 

It is easier for me to do it this way for some reason...

1)Make suspension

2)Pull doses for the day

3)Throw out excess liquid at the end of the day...this liquid is the % cut.

 

 

This way is ok...? There is a distinct possibility I am overthinking this, given my current mental state :(

 

I just don't want to make mistakes.

 

Again, please move this if it isn't in the right place.

 

Thx

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Wildflower0214

Btw...

 

I just purchased graduated cylinders from a school supply store. I was trying to avoid ordering them, as I needed them sooner.

 

Just another option for people looking for supplies....

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Altostrata

....

In liquid tapers, the advice I have seen looks like this:

1)Make suspension

2)Pull % of liquid out that would equal your intended cut, throw it away

3)Pull doses for the day

 

It is easier for me to do it this way for some reason...

1)Make suspension

2)Pull doses for the day

3)Throw out excess liquid at the end of the day...this liquid is the % cut.

 

...

 

Yes, that's fine. It depends on which is more convenient.

 

Thanks for the tip about graduated cylinders.

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Wildflower0214

ks, that is not always so. Many people switch to liquid without a problem. Others experience it as too strong because a liquid is absorbed faster.

 

It's an individual thing. Once you make the switch, give it some time -- it takes about 4 days for your system to register a change in dosage -- and then see if you need to adjust the dosage of the liquid.

What do people do when they have problems with liquid?

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Altostrata

They use a digital scale for weighing fragments or powders, or they have capsules compounded.

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Wildflower0214

They use a digital scale for weighing fragments or powders, or they have capsules compounded.

Can they compound capsules as small as I would need them for a taper off of .24mg dosed 6 times a day?

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Altostrata

Yes, they can. You will need a doctor's prescription for compounded capsules.

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Wildflower0214

May I make a suggestion...? And, this surely may not be the case for everyone. But, I felt the need to share my experience, as it may help someone in the future avoid an unneeded bump in tapering.

 

If someone is having a paradoxical reaction to the drug they wish to taper, it may be best to stay on whatever form of the medication they have been taking if at all possible, and refrain from switching over to a liquid.

 

My reasoning is this, if you are experiencing a paradoxical reaction that is so troublesome that you need to taper, switching to a liquid could exacerbate the problem. It is absorbed much quicker I have found, and unlike capsules or tablets, the effects tend to hit all at once. In some cases, this can lead to an even more profound paradoxical reaction.

 

I experienced this. I understand tapering is very individual, and everyone is not as senstive as I have become. But, I wanted to put it out there, simply for consideration.

 

I'm not sure this is the correct place for posting this. :(

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Altostrata

That's a very good point, JDM. Changing the form of a drug carries risks, too. Many people need dosage adjustment afterward. Dosage adjustment downward might be necessary if a paradoxical reaction is increased.

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JanCarol

Do you have a pill crusher?  Most chemists carry them, for people who cannot swallow pills, that might help get your pill more thoroughly crushed.

 

If I understand correctly, if you double the solvent (water), you will double the amount you take, in order to get your dose.

 

My calculator says that's 23.72 mil.  This does not mean that I know what I am talking about.

 

Could someone please advise..I just cannot work out the simplest of things at all right now. The only tablets I've been able to get hold off doesn't disolve very well..a lot is left stuck to the glass I use to mix the original solution and then the outside of the syringe. I'm thinking more water would be better. I disolve 50mg in tablet just now to 50ml water then take out 11.86. if I disolve it in 100ml what would I then take out? Wow, feel so daft.

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JanCarol

Hi there. I'm currently tapering off Lexapro. I managed to get the liquid, but I could only get a 20 mg/ml solution. Extremely inconvenient for tapering. I've made 2 reductions of 1 mg each in the past 12 weeks or so, I'm currently on 18 mg. I want to make progressively smaller reductions now though, so I'm just wondering if there is any way I could dilute the liquid Lexapro to get a less concentrated solution for tapering?

Many thanks, Alex.

 

Oh wow.  You want to suspend your supension!

 

It would depend on what it is suspended in?  I'm thinking it won't just be water - and that the Ora Plus product mentioned earlier in this thread (available from Amazon) may be the right kind of thing.

 

Great question.  I am out of my depth here, and a smarter, more experienced liquid tapering mod will be along soon to correct me or enhance what I have said here.

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LoveandLight

So I'm having trouble with particles of zoloft sticking to the glass when I'm dissolving the original mixture. It only sticks at the waterline. I've tried un sticking with a spoon or disolving in half of the water and then using the rest to swill round the glass only to settle and stick immediately.

 

I cannot remember having this problem with this brand before..maybe they have added a film coating where there was not one before.

 

So my options are to keep doing this whilst worrying about the accuracy. Changing brand again to something without a film coating but this is tricky as the chemist does not always have this in. Going to liquid sertraline from the doc which I'm sure I had a bad reaction to or buying a scale and cutting measuring my dose. Which would also mean adjusting obviously with this change in how it is absorbed.

 

Unless anyone has any other ideas.

 

So nervous about the whole thing.

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JP904

I'm currently dissolving my Citalopram into water to taper. I'm putting 20 MG into 120 ML of water and then I just take my other 20 MG tablet whole. I'm using a plastic syringe type thing (the ones you get from target/publix/wallmart at the pharmacy). I wait about 30 min for it to dissolve and then swish the jar before I extract. I'm up to 30 ML so I have to extract 3 times. I swish the water around each time before.

 

I always extract from the middle of the jar, but can't seem to consistently get the same amount out each time. After each one I look to see how diluted the water looks in the syringe and sometimes it looks more full of medicine than others. I can't figure it out. 

 

I've been having a really hard time even when tapering less than 5% every 2-3 weeks. Since I have to taper as little as 5% at a time I can't do dry cuts, so this method seems to be my only option. 

 

Any ideas? I've been falling asleep between 5-9 am a lot lately and it's lasted over 2 weeks now and it's been 3 weeks since my last reduction. 

 

 

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Altostrata

You could get a prescription for liquid citalopram or have it made by a compounding phamacy. Or, you may wish to use a pharmacy liquid instead of water. see the early posts in this topic.

 

120mL of water is quite a bit of water. Did you find the tablet would not dissolve in any less?

 

How are you measuring the water?

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JP904

You know, I got a smaller jar and it makes it 100 times easier to be precise. I used 120 ML to make it dilute it more so the taper is easier. I measure the water with a graduated cylinder. I'm using the same exact method as I did for my Klonopin taper, which worked smoothly. 

 

I don't get this. It's been over 3 weeks since my last 5% taper. I up-dosed a week ago. Still, my sleep is so out of wack. Before the past month I was falling asleep around 3. Not it's moved to anywhere from 5-7 am. I feel tired, but don't at the same time. It gets better for a few days and I can fall asleep at a reasonable time, but then goes right back. It's really getting to me. I'm really ******* annoyed and just don't understand. In the past I have felt like this for a week max after a taper and then it's gone back to normal and stayed, but this just doesn't seem to follow any sort of pattern and I have no control. It just seems like I have a few years ahead of me before I am close to normal from this. 

 

Does this happen to other people? Could it be that sometimes it just takes extra long for the chemicles in the brain to balance? 

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Altostrata

One thing that I actually transitioned to, which might make a difference, is before I was putting the full 40 mg into the liquid titration. Now I only put 20 mg in and take the other 20 mg. I did the math to make sure I maintained the same taper, but I wonder if it can be harmful to take liquid and a regular pill at the same time. 

 

JP904, there is no harm in taking part of your dose as a tablet and part as a liquid.

 

MrDenton, please read this topic from the beginning.

 

Some sediment is normal when making your own liquid with water.

 

Cutting up the tablet may help it dissolve faster.

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Altostrata

The syringes will always be in the liquid measure of milliliters. You need to make the conversion to milligrams yourself.

 

If you're not getting the math -- it involves proportions of milligrams of drug to milliliters of water -- you will need someone to help you with it.

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Altostrata

hello I have a question, I like the water titration but am unsure about the residue on the side of the container, for example if I'm tapering Nortriptylene which is water soluble from 10mg to 9mg I use the 1:1 mixture and draw out 1ml and pour out the remaining 9 ml, i'm using glass and there is usually residue left do I add water swish it around and drink the residue? thanks

 

You are removing 1mL and drinking 9mL? How are you feeling using your current method? If you are feeling okay, be consistent and don't worry about the residue (it may be filler or the coating from the tablet).

 

I have the same question for Paxil .

Lots of residue in the small jar .

I was at 30mg - last October , I dried cut 3 mg to get 27mg  ( 10% )

Switched to water solution on Dec 6th : 30mg in 10 ml of water , I take 7.5 ml ( down to 22,5 ml - additional 10% )

Maybe some of the medication is lost on the walls of the jar....Been having real vivid dreams

Would a higher dilution help ?

 

You may find it more convenient to take part of your dosage in tablet form (20mg) and the rest in liquid, tapering the liquid part. See Tips for tapering off Paxil (paroxetine)

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Altostrata

The transition to liquid can be eased by taking part of your dose in tablet form and part in liquid. If you are tapering, you would reduce the liquid part until it's gone, then consider either a smaller tablet dosage plus liquid or switch entirely to liquid.

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Djones1984

When I make my liquid I have been stirring it with a plastic fork handle and than draw it up would this be not a good idea?

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Altostrata

If you do it the same way each time and it works, it's fine.

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Fresh

Can someone tell me please:

 

How long does a suspension made with water last for in the fridge?

 

Does a suspension made with distilled water or a pharmacy suspension liquid last longer?

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Altostrata

My rule of thumb has always been no more than a week, unless I get explicit stability information from a pharmacy or online.

 

This applies to suspensions made with distilled water or pharmacy liquid.

 

The major risk is spoilage from bacteria or mold, as with other opened foods in the refrigerator.

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Colonial

I had a really rough time changing from the paxil CR pills to the liquid paxil.  It's the whole reason I started my thread here.

 

http://survivingantidepressants.org/index.php?/topic/9562-colonial-worsening-withdrawal-symptoms-changing-from-paxil-cr-to-liquid-suspension/page-1#

 

With the Paxil, the controlled release tablets work different than the liquid.  I also think our bodies become accustomed to absorbing it in a certain form, and it takes time to adjust.  If you're having symptoms  just from the change, I'd wait more than a week before lowering it.  I didn't, and I regretted it.

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Colonial

I don't know if "used" to it is the correct phrase, as I started the taper immediately.  But my symptoms were worse at the beginning from not giving myself the month recommended before the tamper. The change over to the liquid is already a "reduction" in a meaningful sense, which is why your having the symptoms.  It's not staying in your system as evenly as the CR Tablet.  Which is why it's recommended to wait a month from the change before you start tapering.  In a very real sense, you're already in withdrawal.

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Lakelander82

Any of you find the drug residue on the sides of the glass jar a problem? I add a small subset of liquid from my syringe to my Sertraline 50 mg tabs (halved for quicker dissolution). I then swirl the glass jar and add the rest of the liquid rinsing the side of the jar, trouble is I have to swirl the jar again to ensure even distribution of the drug but as a consequence the residue occurs again on the sides of the jar. How much of a problem is this in terms of reduced dosage of the drug going into the syringe?

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Altostrata

A lot of those bits are filler and coating of the tablet. If you keep to the same method (same equipment, same steps, same order) each time, whatever loss there is due to this residue will be consistent -- don't worry about it.

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