How to make a liquid from tablets or capsules

[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.

[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.

[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?

[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.

[Altostrata]

Refrigeration delays the growth of bacteria and mold in your homemade liquid, which was not made under sterile conditions.

[Happy2Heal]

I have a question about making a suspension with my Seroquel tablets. I expect it it the same sort of problem with most tablets.

 

I did a practice with letting the tablet disintegrate (not dissolve, neither the binders, fillers, nor the Seroquel itself will dissolve). The tablet disintegrates in water pretty quickly but the itty bitty specks always have a few larger specks in there with them. I suspect this might be from the coating on the tablet not wanting to totally let go, but I'm not sure. It's just a very thin coating. Is this a concern? I have tried crushing with mortar and pestle or back of spoon and find this so difficult (doing it in water and rinsing everything into the jar) and my mental state so poor that I can't deal with it. So I want to know if I can just ignore the fact that the itty bitty specks are not exactly the same size.

 

there's a suspending liquid called Ora Plus  ;amazon.com sells it

https://www.amazon.com/PADDOCK-LABORATORIES-Ora-Plus-Suspending-Vehicle/dp/B000GGHSQM

[Cabinhope]

Just read this whole thread to see if there is a post about the transition you speak of above, Alto. Why is it that there IS a transition....if the dose remains the same. I've been transitioning over to liquid Trazodone and honestly it feels like I'm on a totally different drug...different planet. It's profound, very spacey and out of it. Would love to understand what's going on. It doesn't seem like there would be such a big shift from letting a tablet dissolve in the stomach to dissolving the tablet first before it hits the stomach. Does everyone have this? Is it this way with each drug?

[scallywag]

Think about it this way, which is going to be digested faster: a hunk of salt or the same quantity of salt dissolved in water?

The liquid is absorbed faster by your body. And if you are taking no other medications, you may metabolizing lower doses more quickly than previous higher doses. If you are taking other medications, you still may be metabolizing more quickly; it depends on whether the other meds use the same metabolic enzymes and pathways.

[Elexis]

Hi,

 

Apologies if I've posted this in the wrong place, I'd  posted in my intro thread but don't think anyone had seen it.

Just got a quick question about making liquid solutions:

 

I'm currently tapering off Betahistine. I crush an 8mg Betahistine tablet and add 16ml of water. Is it okay to crush two 8mg tablets in 32mls of water and keep them in the same jar?

 

I ask because I tried doing a 'bulk' lot of betahistine solution last night - six tablets in the equivalent amount of water. There's always plenty of powder visible swirling around regardless of how many tablets I use at a time and then it all collects at the bottom of the jar.... could loads of powder collecting at the bottom make it very difficult for any of it to dissolve?

 

Thanks guys

 

[Altostrata]

Elexis, you can make a liquid from multiple tablets as you've described. I would keep notes about the recipe, just to make sure you maintain consistency.

 

Be careful about storing homemade liquids. It's best not to keep any amount past a week. Like any edible, they can grow mold or bacteria and go bad.

[Elexis]

Thanks Altostrata I take around 3 tablets a day so it'll make life so much easier being able to do it in bulk.

Will keep the 7 day limit in mind and make sure to wash the jars out.

[Elexis]

Hi,

 

I used to dissolve my tablets in water after crushing them but I've recently tried just dissolving them as they are. It seems to work fine, they're very water soluble it appears.

I'm unsure as to the best way to do a bulk solution - would it be better to measure out the water, chuck all 4 tablets in at once and just leave them to dissolve or would it be best to dissolve one tablet at a time?

 

Thanks!

[Altostrata]

In your case, I might put all 3 tablets in at once and let them sit for 10 minutes or so. They should all dissolve, with some gentle shaking.

 

It's usually not a good idea to make a bulk solution, you'd want to keep it at most a week or 10 days, in the fridge.

[Elexis]

Thanks Alto!

 

I'll make sure to only keep it a week, I'm still on really high doses of that particular medication so I expect it will only last me a few days.

 

Is it okay to leave it sitting at room temperature while the tablets dissolve?

[scallywag]

Room temperature will allow the tablets to dissolve more quickly. Refrigerate after and shake before withdrawing your dose.

[Elexis]

Thanks guys!

[Hibari]

Need help in checking my math:. 

I would like to switch over to a liquid/water suspension of my dosage of Lamictal, which is now 17.50mg.   

 

I have both 25mgs tablets and 5mg tablets. 

 

I have a 10ML syringe and from reading the beginning part of this thread, this is my plan. 

Take the 10ML syringe and fill it twice with water and put it into a small container.   This would equal 20ML of water

Then fill the 10ML syringe 1/2 way with water, which would equal 5ML of water

Total amount of water-25ML

 

Next I would dissolve my 25mg tablet in the 25ML of water.

When it's dissolved:

First draw up10ML of liquid and take that

Then draw up 7.50ML of liquid and take that.

 

Does this seem correct?

 

 

[artSet3561]

Perfect.

 

I personally make up 100ml at a time in a regular kitchen measuring jug. Add two 50mg tabs screw the top on a use for a few days, saves faffing every day. Same difference ?

[Hibari]

Thank you for your confirmation.    With my foggy brain, it has taken me may readings to finally understand what to do. 

[Hibari]

Is anyone doing a hard tablet and liquid suspension combination?

 

If so, how do like it or find it to be helpful. 

 

I feel like I would like to try that to keep enough of the medication in my system as I taper.   Right now I switched completely to a water suspension for accuracy but think I may need more stability as I go lower.

[music321]

Note regarding the following:  I am not a health care professional.  I am presenting my understanding of a laboratory technique, and I might be entirely wrong.  I am not advocating that you taper or discontinue medication without the care of a doctor.  This is not medical advice.

 

The practice of diluting medication might be useful knowledge for some on this site.  The method to which I'm referring is known as "serial dilution".  The goal of this method is to start with a known volume of a solution (in mililiters) containing a known mass (in miligrams) of medication.  Knowing this, and then knowing the concentration of your target solution will allow you to figure out how much water (or ethyl alcohol, as the case may be) must be added to the original solution to produce a target solution of a desired concentration.

 

The value of this approach is as an alternative to measuring small quantities of powdered or beaded medications.

If you are interested in how to do the calculations, you can search online.  Doctors are trained in this technique, so it's easiest just to ask your doctor to do the calculations for you.

 

Let's say we have the liquid form of a medication that contains a known amount (in mg) of the actual medication.  You can use a "graduated cylinder", which might have a capacity of 5 ml, 50 ml, 100 ml, etc. to measure out precise amounts of liquid.  Your doctor can tell you how much liquid to take, and how to properly measure liquid with a graduated cylinder.  He'll tell you about the "meniscus", etc.  If you bring your graduated cylinder and a little water to the doctor, he could show you how things are done.

 

Measuring liquid with a graduated cylinder becomes problematic and serial dilution becomes useful when the amounts of medication-containing-liquid become too small to be accurately measured with a graduated cylinder.  Let's say, for example, that 5 ml of a liquid contains 5 mg of a medication.  This means that 1 ml of the same liquid will contain 1 mg of a medication.  0.1 ml of the same liquid will contain 0.1 mg of the medication.  Let's say that we want to take 0.1 mg of medication.  Our graduated cylinder might not be accurate enough to reliably measure 0.1 ml.  So, what do we do?  What if we dilute our original liquid (with water, alcohol, or whatever is appropriate) so that 10 ml of a new solution contains 0.1 mg of the medication?  Then, in order to reliably measure out 0.1 mg of the medication, we don't have to try in vain to measure out 0.1 ml, we can measure out 10 ml instead.  With the original solution (the one that is concentrated), making a measurement error of just the tiniest drop will cause huge errors in our measurements.  However, this same tiny drop will cause far less of an error when using a diluted solution.

 

If your doctor is willing to prescribe this method of taking medication, make sure that you obtain a new, unused graduated cylinder from a reliable source.  You don't know what sorts of chemicals/medications might have been measured in a used graduated cylinder.

 

[ramarko]

Hi SA!!

two days ago I prepared 10ml of purified water with 10mg of lexapro and the pill dissolved very fast but it always remains powder on the bottom of the small jar I am using.

I tried shaking, moving, mixing and everything and I sill see the powder on the bottom of the Translucent water.

Any advices?

If I take 1ml of this preparation it will not be at all 1mg. is there any way to have 100% dissolved liquid lexapro home made?

I also tried adding 10ml more resulting of 20ml with a 10mg pill and I got the same result... pill not dissolving 100% still powder there.

 

Maybe I did something wrong?

 

Thanks!

[ChessieCat]

From the very first post in this topic:

 

2. Measure the water (or pharmacy liquid)

• With an oral syringe: Draw room temperature (not hot, not cold) water into an oral syringe and convey it to the container. A 10mL (10cc) or 20mL (20cc) oral syringe is handy for this purpose.[br][br][br]
  
  For example, if you wish to make 30mL of a solution, fill the 10mL syringe 3 times with clean water and inject it into your container.
• With a graduated cylinder: For example, if you wish to make 30mL of a solution, fill the graduated cylinder to the 30mL mark and pour it into the container.
• With a 100cc (100mL) medicine bottle: Fill carefully to the 100cc or 100mL line. You'll have to bring the bottle up to your eye level to do this. Please note the measurements on these bottles are less exact than the graduated cylinder.

To mix, put the cap on the container, tightly, and shake it gently. You will be able to see particles swirling around in the water (some of the filler used in tablets and capsules is insoluble).
 
Wait until the tablet chunks are dissolved before taking a dose.

[Altostrata]

On 11/7/2017 at 4:04 AM, Drugrage said:

i Am onsdag att really low doser and have a lot of tablets. Buying new liquid lexapro on Sweden costs anout 50 dollars and i domt need the whole bottle.

 

When i solve tablets in water do i get white particles which sinks to the bottom. Is this the coating or the actual active ingredient?

I dont feel comfortable just take a part of the liquid because those particles sink down really fast so if it actually is active ingredients do i have a problem.

 

 

 

 

Please read this topic from the beginning.

[Jony]

On 27/07/2012 at 3:44 AM, Altostrata said:

A liquid preparation of an antidepressant or other psychiatric drug makes controlled tapering much easier. Taking part of your dosage in tablet form and part in liquid form makes the transition from tablet to liquid go smoothly

 

This sentence made me curious...

 

Take 10 mg from a tablet is not the same thing that take 10 mg in liquid form from the pharmacological point of view. At least in a transition phase, since the absorption is different...Over time time it becomes indifferent, of course...

 

But it drives me to other question: taking 5 mg from a tablet and 4 mg from liquid, is not the same thing that taking 9 mg from liquid. I mean, each one has its own  pharmacokinetic.

 

How far is this important during the tapering of low doses?

[kesh]

On Friday, December 29, 2017 at 6:00 PM, Jony said:

 

This sentence made me curious...

 

Take 10 mg from a tablet is not the same thing that take 10 mg in liquid form from the pharmacological point of view. At least in a transition phase, since the absorption is different...Over time time it becomes indifferent, of course...

 

But it drives me to other question: taking 5 mg from a tablet and 4 mg from liquid, is not the same thing that taking 9 mg from liquid. I mean, each one has its own  pharmacokinetic.

 

How far is this important during the tapering of low doses?

It probably depends on a few things.

 

For a long half life drug like prozac or diazepam each dose just tops up what is already in you a fraction, so if that small top up takes place over 15 minutes or 2 hours may not matter.

 

If you take a pill of an easily water-soluble drug on an empty stomach with a warm drink you are probably going to absorb it almost as quickly as a solution. But if you take a pill with a heavy meal and switch to a liquid on an empty stomach it's going to be very different. Or if you dissolve your liquid in a bottle of mineral water and sip it over the course of two hours, you may mimic a pill taken after a large meal.

 

So many variables.

[JamesF]

Hi, could anyone advise how to make a liquid diazepam/valium solution without using alcohol. I can buy all the correct measuring products and do the process, I'm just confused about exactly how to prepare the solution of homogenous valium liquid. 

Some say to use alcohol to dissolve it but I definitely won't do this, since I'm intolerant to it. What can I use instead? 

Thank you

[Shep]

4 hours ago, JamesF said:

Hi, could anyone advise how to make a liquid diazepam/valium solution without using alcohol. I can buy all the correct measuring products and do the process, I'm just confused about exactly how to prepare the solution of homogenous valium liquid. 

Some say to use alcohol to dissolve it but I definitely won't do this, since I'm intolerant to it. What can I use instead? 

Thank you

 

Information about the different benzos and what liquid to use is posted here:

 

Benzo Tapering Nuggets - liquid tapering information

 

I've posted with more information specific to your individual taper here in your benzo thread. 

 

[JamesF]

On 1/26/2018 at 9:11 AM, Shep said:

 

Information about the different benzos and what liquid to use is posted here:

 

Benzo Tapering Nuggets - liquid tapering information

 

I've posted with more information specific to your individual taper here in your benzo thread. 

 

Thank you Shep Do you know how much propylene glycol would be required for dissolution per mg of valium? 

Further, I'm wondering if after dissolving in propylene glycol then mixing with water, would it be evenly distributed and stay dissolved?
 

[JamesF]

Just to add to the above. Will a propylene glycol + valium + water mix "keep" in the same state for some days after mixing ? Does it need to be stored in a particular way?

 

Apologies I'm not very good at finding information in my current state

 

Thank you. Jay

 

 

[Dabhob33]

I just picked up prescribed Liquid Valium (Roxane, with non alcohol suspension).  I’m currently holding at 11mg (down from 20mg since Oct 2017) for the past 2 weeks, starting 3 weeks today.  Symptoms are rough - mostly burning body, squeezed head, cog fog, fatigue, ruminating that I’ve permanenrly damage myself with the drugs I’ve taken and ECTs.  

 

Has anyone taken commercial Liquid Valium, even Roxane?   Reactions?   Any feedback is appreciated.   

 

I hope youre doing well. 

 

Dabhob33

 

 

[Dabhob33]

On 1/26/2018 at 4:11 AM, Shep said:

 

Information about the different benzos and what liquid to use is posted here:

 

Benzo Tapering Nuggets - liquid tapering information

 

I've posted with more information specific to your individual taper here in your benzo thread. 

 

This is a month old, but there is a liquid Valium made by Roxane, owned by West-Ward.  They have one that uses an alcohol suspension and another using a non-alcohol suspension.  Hope this helps.   My Dr prescribed it for me and I will be starting it relatively soon.  

 

http://www.west-ward.com/en//Home/Content/Roxane Landing Page

[dignan]

I have a question regarding the halfway point of a water titration taper. I am looking to see what others have done in my situation and the results they’ve experienced.

 

I am presently tapering mirtazapine via water titration. I am now approaching 15mg, the halfway mark of the taper. 

 

Method Before the Halfway Point

 

I drop a 30mg drug tablet into 60/ml of water to form a drug solution. That means, for every 1mg of drug tablet, there is 2/ml of water. Up to this point, I have removed drug solution with syringes and consumed the remaining solution in the cup, the “dose.” The solution in the syringes is discarded. At present, I remove nearly half the drug solution from the cup; however, soon there will not be enough solution remaining to reliably pull up with a syringe.

 

Method After the Halfway Point

 

Do I now inverse the process? That is, do I now remove the “dose” with the syringes and discard the cup?  I mean, it looks like this is the only way to proceed. However, there are several issues with this.

 

Potential Issues

 

Removing 30/ml of drug solution theoretically removes 15mg of drug. Whether I am actually removing 15mg of drug, who knows. The most important thing thus far has been consistency as opposed to accuracy. But inverting the process causes a major shift in consistency.

 

1a. It seems clear I will be taking the same amount of drug solution. However, am I taking the same amount of drug? Do more or less drug particles get sucked into the syringe? 

 

1b. Is there any experiment to clarify this? I can see lots of white particles (the drug/filler or both) in both the syringes and cup. I am trying to see if I can evaporate the water and measure the particles left behind.

 

2. What about the drug left behind in the syringes? I use four syringes per taper. Even if I rinse the syringes, there will invariably be drug left behind there. This seems like a loss I must accept.

 

3. I am very sensitive to changes and conduct a micro taper (.05mg cuts) so a significant change to the “dose” will definitely be felt. I am concerned that the “dose” may change.

 

What have others done in my situation? What were the results?

[Altostrata]

1 hour ago, dignan said:

Do I now inverse the process? That is, do I now remove the “dose” with the syringes and discard the cup?  I mean, it looks like this is the only way to proceed.

 

You can do this, or you can continue with your current method.

 

By the way, you don't have to discard more than half of your homemade suspension, you can refrigerate it in a sealed container for the next day.

 

As explained at the beginning of this topic, making a suspension with water is not perfect, although many have successfully tapered with this method. We advise shaking or stirring before you take it, to distribute the particles more or less evenly.

 

Making a suspension with a pharmacy liquid such as Ora-Plus may more reliably distribute the particles if you are concerned about that.

[Lakelander82]

If you double the liquid you’re dispersing your tablet in, do you increase the margin for error or increase accuracy for that matter? I disperse 25mg of Sertraline in 25mls of water but I’m thinking of dispersing it in 50mls of water instead for ease of use. What are the moderators thoughts on this? 

[brassmonkey]

You would increase the accuracy.