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Varying dose concentrations in each refill?

taper mirtazipine sensitive headaches prescription

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#1 BuddhaMama

BuddhaMama

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Posted 13 February 2017 - 11:35 PM

So when I went to pick up my first batch of liquid Mirtazipine, I asked the pharmacist who the manufacturer was because I am sensitive to the difference in manufacturers for the same drug. He proceeded to tell me that "industry standard" for all pharmaceuticals is somewhere between 10-20% ( I think thats what he said, I can't remember exactly) as far as actual drug concentration goes. So, the 45mg tablets he used to make my liquid suspension could have 10-20% more or less than 45mg each. I am so sensitive that now I wonder how I'll ever start my taper. 

I went from 15mg tablets of one manufacturer taken for the last 5 months to doubling up on 7.5mg tablets of a new manufacturer (Aurobindo) so that I could slowly adjust to that "brand" before moving to the liquid suspension because the liquid was made from Aurobindo tablets at a compounding pharmacy. I just so happened to have these 7.5mg Aurobindo tabs left over from before I upped my dose, otherwise I would have just gone straight to the liquid and dealt with the adjustment.

Anyway, I have been on the new manufacturer for over a week and have been getting on and off intense headaches (my main WD symptom from an earlier taper trial of 25% cuts) and I don't understand why. Could it be that the concentration of these tablets is so different from what I was using that maybe they are causing WD symptoms even though I have't begun to cut my dose? I have 15 days worth left on the Aurobindo (now in a new Rx of 15mg tabs) and then I move to the liquid. I just don't know what's causing these headaches but I am inclined to believe they are withdrawal because they do not respond to ANY of my usual remedies.

Any ideas?? Thanks in advance. Also, please let me know if I need to move this post to a different forum page.


OFF Paxil 1996-1997 CT, no w/d sxs

OFF Celexa 2002 (6 months) CT, mild and brief w/d sxs

OFF Ativan 1mg-Cold Turkey 2014, WD Syndrome for several weeks despite intermittent use over 9 months rather than daily use.

OFF Lexapro 3 doses only February 2015 (increased depression)

OFF Paxil 3 doses only July 2016 (increased anxiety)

ON Remeron 15mg daily since AUG 2016 for PPD/PPA/PPOCD Tried cutting dose by 1/4 tablet  December 1, 2016, one week of intense withdrawal headaches, reinstated 15mg dose December 8, 2016.

ON bioidentical Progesterone cream 50mg/day originally started for self diagnosed estrogen dominance April 2015, continued use during pregnancy to alleviate hormonal headaches October 2015-July 2016, continued postpartum to help with mood July 2016-present.

Supplements: Magnesium, Fish Oil, Probiotics

Tried Methylfolate Sept 2016 to "potentiate" Remeron - ended up experiencing worsened side effects (mainly irritability bordering on rage) Discontinued after two doses.

BEGAN REMERON TAPER Feb 2 2017 by switching to different manufacturer of tablet mirtazipine (manufacturer that matches my liquid solution). Holding 15mg dose until adjusted. Plan to eventually do half liquid, half tablet (still 15mg), then all liquid (15mg), then .95ml of 15mg per ml liquid (a 5% reduction) depending on how I respond to adjusting from tablet to liquid.






Also tagged with one or more of these keywords: taper, mirtazipine, sensitive, headaches, prescription