How to make a liquid from tablets or capsules

[Sottana]

I know tapering using milk is a thing in the benzo community as it suspends particles a bit better than water. Is there any reason this isn’t really a thing I see commonly discussed in the ssri community? Are there disadvantages to doing this with ssris instead of a water taper? I’ve recently found my Ora-plus has stopped agreeing with my stomach and i am trying to figure out what to do 

[ChessieCat]

51 minutes ago, Adili13 said:

I’ve recently found my Ora-plus has stopped agreeing with my stomach and i am trying to figure out what to do 

 

Some people use maple syrup.

 

Site search results:

 

https://www.survivingantidepressants.org/search/?q="maple syrup"&quick=1

[brassmonkey]

Unless you are making your suspension fresh daily, I would stay away from using milk because of the spoilage factor.  Here is part of an article I wrote on making suspensions from benzos. SSRIs can be handled in the same manner.

 

Because it is so thin, water is not always the best media for making a suspension. Even though it is quite fine in texture the powder made by crushing the tablets is still heavier than water and can settle out quite quickly. A better way is to use a thicker base material.

There are several commercially made “Suspension Medias” available online or through your pharmacist. Ora-plus and Ora-sweet are two of the most common, but a quick online search will bring up other alternatives. There are some ways to make your own which can work quite well also.

Believe or of not there are some people who have trouble drinking water because it is too “wet”. There is a product available at many drug stores or chemists referred to as “thick water”. It is thick enough to hold the powder in suspension quite well.

Making a homemade suspension media can work well too. A common one is to use maple syrup; you could also use corn syrup or other cooking syrups. There are quite a few recipes available online using a variety of materials. All these media would be used in the same manner as water following the directions given in other parts of this article.

Using fruit juice is also popular as a suspension media. Some juices are much thicker than water and suspend the powder quite will. They also taste much better. Because they contain fruit pulp it is hard to see if the powder is well mixed in. As warned above DO NOT USE GRAPEFRUIT JUICE, it reacts badly with many Benzos and can create a liquid that is dangerous to drink.

[ChessieCat]

19 hours ago, Adili13 said:

I’ve recently found my Ora-plus has stopped agreeing with my stomach and i am trying to figure out what to do 

 

You might be able to use water mixed with small amount of cornflour and cooked until it is thickened then cooled before using.

 

Other things that might work:  gelatine (make a very liquid jello/jelly), guar gum, xanthan gum.

[ryan1982]

Hey all- 

I’m considering slowly switching over to my own Lexapro suspension. Just so I understand, I can dissolve a 20mg pill in 10 ml of water and then add 10 ml of Ora-Plus and I should be OK to measure out my dose as a 1ml= 1mg correct?

[ChessieCat]

35 minutes ago, ryan1982 said:

Hey all- 

I’m considering slowly switching over to my own Lexapro suspension. Just so I understand, I can dissolve a 20mg pill in 10 ml of water and then add 10 ml of Ora-Plus and I should be OK to measure out my dose as a 1ml= 1mg correct?

 

Yes 10mL water + 10mL Ora Plus = 20mL liquid.  20mg tablet in 20mL liquid will give a 1:1 ratio or as you say 1mL liquid = 1 mg dose

[ChessieCat]

Just found a "wiki"

 

https://www.wikihow.com/Make-a-Liquid-Suspension-with-Ground-Pills

 

Abbreviated instructions:

 

Buy a safe sweetener like Equal or Sweet-N-Low. Sugar is not recommended. Secondly, it is important to also use a liquid sweetener such as blue agave syrup or monk-fruit liquid sweetener. They are easy to get at the grocery store.

 

Stir this well.

 

Once you have your cup with water, add some sweetener to it. Crush your pills thoroughly and add the crushed medication.

 

Stir this well.

 

Add the liquid sweetener. This gives a better taste but it is more important as a "binder" or what the pharmacists call "the vehicle". It helps bind the crushed medication in the same way medical syrup works

[stepht527]

Apologies if this information is already presented somewhere, but can you put your already drawn up dose into like a shot if juice or something to help with taste?

[ChessieCat]

7 hours ago, stepht527 said:

Apologies if this information is already presented somewhere, but can you put your already drawn up dose into like a shot if juice or something to help with taste?

 

Yes generally you can.  But some juices might react with the drug.  I know this can happen with grapefruit and some drugs.  If it was me, I would not be using a citrus juice.  Options would be apple juice (some people mixed their crushed tablet with apple sauce), cranberry (this is often mixed with Prozac and called cranzac), and possibly blackcurrant and maybe grape juice (without the alcohol !!!).

[NextStep]

On 12/20/2012 at 4:43 PM, Altostrata said:

Rhi's been doing this for ages and has a lab background, I'd trust her on this.

 

Hi Altostrata. I'm in a country where liquid Citalopram isn't available and the psychiatrist I spoke with said she doesn't trust the compounding pharmacies here to make it for me. So, ChessieCat pointed me to this thread.

 

As I've read through this post about making one's own liquid I'm not seeing clear/definitive info around how long one can keep a "batch" without it spoiling and/or losing potency. Has anyone been able to get more solid info around this? It would be great to not have to dissolve a pill every day, but I would think it's very important to know for sure that there's no issue with this. 

 

Thank you.

[ChessieCat]

37 minutes ago, NextStep said:

I'm not seeing clear/definitive info around how long one can keep a "batch" without it spoiling and/or losing potency.

 

It is generally about 3 days.  So if you make a batch on the first day you can use that batch for 4 doses (the first dose is "0" day).  Store it covered in a dark container in the fridge.

[NextStep]

9 hours ago, ChessieCat said:

It is generally about 3 days.  So if you make a batch on the first day you can use that batch for 4 doses (the first dose is "0" day).  Store it covered in a dark container in the fridge.

 

Thanks. So sounds like it's not an exact science and just have to hope that the potency doesn't drop in those three days?

[ChessieCat]

19 hours ago, NextStep said:

 

Thanks. So sounds like it's not an exact science and just have to hope that the potency doesn't drop in those three days?

 

I've responded in your Intro topic.

[stepht527]

When making a liquid form from tablets, do you need to use any particular type of water (distilled vs purified etc), and do you need to further dilute it in juice or something? I cant imagine that tastes very good...Asking specifically about trazodone.

[brassmonkey]

Trazodone has a very low solubility in water, so you will have to work with a suspension and not a solution. Same thing only different. Here is some information on making suspensions for Benzos, the techniques would be the same for trazodone.

 

Information for Making Liquid Benzodiazepine Preparations By Brassmonkey - Benzo tapering and recovery - Surviving Antidepressants

 

You need to refer to section (7).

 

Edited June 6, 2022 by brassmonkey

[getofflex]

Can the beads inside of a capsule be dissolved in water to make a solution or suspension?  

Edited July 5, 2022 by getofflex

[brassmonkey]

You could use water to make a suspension with trazadone, but a suspension medium like ora-plus would work better.

[ChessieCat]

5 hours ago, getofflex said:

Can the beads inside of a capsule be dissolved in water to make a solution or suspension?  

 

What drug are your referring to?

 

You would need to consider if it needs to be taken multiple times a day.

 

The above cannot be done for Cymbalta:

  

On 5/7/2011 at 5:26 AM, Altostrata said:

Duloxetine (Cymbalta) is tricky to taper. It does not come in liquid form and cannot be compounded into a liquid. To protect the drug, each bead, mini-tablet, or flake inside the gelatin capsule has an enteric coating to protect the drug from stomach acid, which would destroy the drug. (It is absorbed further down in the digestive tract.)

 

The contents of a duloxetine capsule cannot be crushed dissolved in any liquid without destroying the active ingredient -- you would have immediate cold-turkey withdrawal.

 

[Altostrata]

5 hours ago, getofflex said:

Can the beads inside of a capsule be dissolved in water to make a solution or suspension?  

 

This can be done with venlafaxine (Effexor) but NOT duloxetine (Cymbalta).

 

Venlafaxine XR becomes immediate-release when the beads are dissolved.

[getofflex]

Sophdamon has sertraline as beads in capsules (Canada). But it turns out she is going to weight the beads to taper.  However, I was wondering in case this issue comes up again. 

[indario55]

Since titration is mostly used for its accuracy, I'm curious if it's ok to drink glass of water right after drinking suspension/solution. I see some people do that.

Doesn't it dilute your liquid medication?

[ChessieCat]

45 minutes ago, indario55 said:

Since titration is mostly used for its accuracy, I'm curious if it's ok to drink glass of water right after drinking suspension/solution. I see some people do that.

Doesn't it dilute your liquid medication?

 

Using a liquid is for accuracy in measuring the dose.  The dose is the amount of drug you take, not how much water it is mixed in or how much water you drink afterwards.

 

As an example:

 

10mg tablet in 10mL of water - to get a 1mg dose you drink 1mL of liquid

 

10mg tablet in 1L of water (1000mL)  - to get a 1mg dose you drink 100mL of liquid

 

You would still be getting the same dose of drug but you would be drinking different amounts of liquid because the 1L liquid is a weaker mixture.

 

If you drank more water after taking the dose above (either 1mL or 100mL of liquid) it isn't changing the dose of drug you have taken.  You have still taken 1mg of the drug.

[Morgan]

Should leftover solution that is more than a few days worth be refrigerated?

[ChessieCat]

4 hours ago, Morgan said:

Should leftover solution that is more than a few days worth be refrigerated?

 

Generally a homemade liquid can be kept for 3-4 days in a covered container in the refrigerator.

[Dee54dee]

Hello. I am having trouble with figuring out the numbers for tapering 12.5 mg of venlafexine IR by 10% every 4 weeks. I just can't understand how to do this. Can someone please explain it to me?

[Deean]

need to know solubility of medication...

 

@brassmonkey

 

Hi Brass from CC - Thanks. Deean is also concerned about the solubility of Vyvanse.  See this post

 

 

______________________________________________

 

Hi there,

 

I had asked this question in another forum and was recommended by a moderator to put it in this topic.

 

"Is it imperative that I know the weight of a capsule "contents" and the percentage of active ingredient verses filler contents in the capsule I am diluting?"

 

I just read this from Brass Monkey in the Tips and Tricks for Tapering:

WARNING NOTE

In general, you will not be able to make a liquid from an extended-release drug. Either the drug will be destroyed in a liquid or the glue in the tablet will create a gum. You can make a homemade liquid with immediate-release drugs only. (The only exception is the type of venlafaxine XR in capsules filled with tiny beads – the beads can be dissolved in liquid.)

 

So, the medication I am planning to taper is Vyvanse - an extended release formulation.

There is a chewable tablet available (not coated).  Is this something I can consider making into a liquid?

I was bummed when I read your warning note.  However, I am optimistic that a solution (no pun intended) can be found.

 

Thanks very much! 

Dawn

 

 

Edited September 14, 2022 by ChessieCat
added topic title before merging with existing topic and added tag for BM

[brassmonkey]

According to Drugs.com Vyvanse does not come in an extended-release formula so you should be fine working with the powder from the capsules. That powder is highly soluble in water making so you can work with just about any ratio you would like. The easiest would be the volume of water equal to the strength of the capsule. This will give you a strength of 1:1 or 1mgai per 1mL of liquid. There are filler materials in the powder that will not dissolve but will settle to the bottom of the container. That is not a problem. Let the mixture stand for 24 hours before using and all the active ingredient should be dissolved.

 

"Is it imperative that I know the weight of a capsule "contents" and the percentage of active ingredient verses filler contents in the capsule I am diluting?"

 

This is not necessary, but the information could be useful later in your taper.

[Deean]

21 hours ago, brassmonkey said:

According to Drugs.com Vyvanse does not come in an extended-release formula so you should be fine working with the powder from the capsules. That powder is highly soluble in water making so you can work with just about any ratio you would like. The easiest would be the volume of water equal to the strength of the capsule. This will give you a strength of 1:1 or 1mgai per 1mL of liquid. There are filler materials in the powder that will not dissolve but will settle to the bottom of the container. That is not a problem. Let the mixture stand for 24 hours before using and all the active ingredient should be dissolved.

 

"Is it imperative that I know the weight of a capsule "contents" and the percentage of active ingredient verses filler contents in the capsule I am diluting?"

 

This is not necessary, but the information could be useful later in your taper.

 

It's strange because I've noticed some sources say that "Vyanse is available in an extended release form only"...I wonder why the dichotomy?!  Could that be a typo perchance?!  And if so, why so many sites have the same info... Hmmm....

 

There is also a recommendation to "Consume the entire mixture immediately. It should not be stored."  Would you know what the reason is for this?  Wondering if they are saying that the active ingredient could break apart?

 

Anyway, thank you for your response and information.  This eases my mind.

 

ChessieCat was suggesting that:  "To make it easier and to get a more accurate dose you can increase the amount of water." 

I'm wondering when you said by doing an equal water to strength ratio, that you meant perhaps easier to calculate?

 

Also, ChessieCat said: "Generally homemade liquid can be keep covered in the refrigerator for 3-4 days."  Does this timeline change for different drug types?  Wondering if I should find out the storage time of dissolved Vyvanse?

 

Roger on the knowing the weight, and percentage of active and filler further down the line of tapering.

 

Cheers much BrassMonkey!

 

Deeane

 

[brassmonkey]

Some ADs degrade quite quickly when exposed to air, moisture and light. This happens to be one of them. So, it is not a good idea to store the homemade liquid, because by tomorrow it will not work as well. Other ADs can store quite well as a homemade liquid which is where CC got her information. Vyvanse is an exception.

 

The 1:1 ratio I suggested is primarily for ease of calculation. Two parts liquid or ten parts liquid to one part active ingredient are the other most common rations.

[Deean]

31 minutes ago, brassmonkey said:

Some ADs degrade quite quickly when exposed to air, moisture and light. This happens to be one of them. So, it is not a good idea to store the homemade liquid, because by tomorrow it will not work as well. Other ADs can store quite well as a homemade liquid which is where CC got her information. Vyvanse is an exception.

 

The 1:1 ratio I suggested is primarily for ease of calculation. Two parts liquid or ten parts liquid to one part active ingredient are the other most common rations.

Okay, cheers.  Very good to know.

You had said in your previous message: " Let the mixture stand for 24 hours before using and all the active ingredient should be dissolved."...I am confused because of your earlier comment about it not working as well the next day.  Can you please clarify?  I want to be super careful on this.  

10-4 on the ratio info

 

Thanks much

[brassmonkey]

It's all a balancing act. Chemically you need to allow time for the AI to move into solution, but in this case, you can't wait too long because the AI will start to degrade. You will probably be fine just letting it sit for four or five hours before using it. The big thing is consistency, doing it the same way every time, so the solution is the same every time, will help give a consistent dose. Which is what the body is really after.

[Deean]

On 9/17/2022 at 11:15 AM, brassmonkey said:

It's all a balancing act. Chemically you need to allow time for the AI to move into solution, but in this case, you can't wait too long because the AI will start to degrade. You will probably be fine just letting it sit for four or five hours before using it. The big thing is consistency, doing it the same way every time, so the solution is the same every time, will help give a consistent dose. Which is what the body is really after.

Fair enough.  Roger on the "doing it the same way every time". 

I'm not super-concerned about storing extra...I don't mind mixing it each morning - will help to engrain the routine and consistency of it all. 

Does it take long for the AI to move into the solution?  For example, if I do up the mixture, and wait say 10/20 minutes...would this be enough time?  Or is it just a matter of watching the solution to see when the filler stops dropping away?

Thanks brassmonkey, as always. 

Deean

[brassmonkey]

The majority of the AI should dissolve fairly quickly, say half an hour, but I would wait several hours to make sure it is all dissolved. There are several factors involve, such as liquid temperature, ambient temperature, stirring time etc. that will make a difference and cause slightly different times from day to day. So, letting it sit a little longer would be a good idea.

[Deean]

7 hours ago, brassmonkey said:

The majority of the AI should dissolve fairly quickly, say half an hour, but I would wait several hours to make sure it is all dissolved. There are several factors involve, such as liquid temperature, ambient temperature, stirring time etc. that will make a difference and cause slightly different times from day to day. So, letting it sit a little longer would be a good idea.

okay, will do

as I take it fairly early in the morning...I will get myself a rooster to get up extra-early! 😉

No, it's all good...I'm up pretty early usually anyway.

Alright...will start gathering supplies and making my way towards the October 1st start date.

Keep ya posted.

Cheers again brassmonkey - a plethera of knowledge!

Deean

[Deean]

On 9/18/2022 at 12:11 PM, brassmonkey said:

The majority of the AI should dissolve fairly quickly, say half an hour, but I would wait several hours to make sure it is all dissolved. There are several factors involve, such as liquid temperature, ambient temperature, stirring time etc. that will make a difference and cause slightly different times from day to day. So, letting it sit a little longer would be a good idea.

Hi again brassmonkey,

 

Well tomorrow is supposed to be my first day to start tapering.

I did a practice run-through today and have 2 questions that I feel are important to ask.

1.  If I am doing a 10-1 ratio, can I not take the smaller amount of mL's of mixed solution out of the container, and then just drink the rest that is left?

For example.  If I have 200 mL's of solution and I need to take  150mL's to get my proper dose (just random numbers here)...can I not take out 50mL's and dump that...then drink the rest?  Does it matter if I consume the filler ingredients at the bottom of the container?

Asking because it seems more practical to do that, rather than syringe out 150mL's leaving 50 mL's at the end.

Is there a specific reason that we shouldn't have the filler contents?

 

2.  So after letting my "practise run" solution sit for a couple of hours, there is quite a bit of sediment at the bottom.  How do I know that the medication actually is dissolved?   I guess I am asking for "unseen" proof...but, I am a little hesitant as this is my first time.

 

I guess I have a 3rd question...

Does it matter if I pour the distilled water from its original bottle into a measuring cup and then into the glass container I am using to dissolve my medication?  (rather than pulling it out with a syringe and putting it into the container).

 

I would love to start tomorrow, so will check back early morn to see if you've had a chance to respond....however, as this is a last-minute post, I realise I may have to be patient, and start the taper when all the ducks are lined-up.  

 

Thanks brassmonkey,

 

Deean

 

  

[ChessieCat]

34 minutes ago, Deean said:

1.

 

No there is no issue doing that, provided that you do it the same way for the whole of that dose reduction cycle.  And when you take a tablet you consume the filler bits.