Jump to content
Nikki

Questions and answers about liquid medications

Recommended Posts

Nikki

ADMIN NOTE Also see

tablets or liquid in withdrawal ?
 
How to calculate dosages?
 
Using an oral syringe and other tapering techniques
 
How to make a liquid from tablets or capsules
 
Making a Celexa solution yourself

 


 
 
I find this confusing. I just picked up Celexa liquid 10mgs/5mL is on the front of the package. I take 40mgs. Celexa I have 10mg tablets Should take 30 or 35mgs. of tablets and use the rest in liquid? ~ OR ~ 30mgs. Celexa and the rest in liquid. (yes I know I am being neurotic, tapering ain't easy for me) Most important how do I use the liquid to decrease 1/2 mg. The syringe he gave me is for 5mL. 1/2mg = 1/4mL? 1mg = 1/2mL? 5mL syringe = 10mgs? Somebody please straighten me out here ;) He gave me another syringe which is 1mL Confused here. Edited by Altostrata
added links

Share this post


Link to post
Share on other sites
Altostrata

10mgs/5mL means there are 2mg Celexa in each 1mL, a 2:1 ratio (twice as much Celexa as liquid).

 

1mL liquid contains 2mg Celexa

 

For example, if you want to take 8mg Celexa in the liquid, you would take 4mL.

 

If you're at 40mg Celexa and you want to take 36mg (a 10% decrease), you could take 30mg in tablets (3 10mg tablets) and 6mg in liquid (3mL liquid). You would have to fill a 1mL oral syringe 3 times.

 

(You may wish to get the 10mL oral syringes for this stage of your taper so you only have to fill a syringe once for a dose.)

 

Here are some equivalencies for a 10mgs/5mL solution of Celexa (2:1 ratio):

 

.5mg Celexa = .25mL liquid

1mg Celexa = .5mL liquid

2mg Celexa = 1mL liquid

3mg Celexa = 1.5mL liquid

4mg Celexa = 2mL liquid

5mg Celexa = 2.5mL liquid

6mg Celexa = 3mL liquid

7mg Celexa = 3.5mL liquid

8mg Celexa = 4mL liquid

9mg Celexa = 4.5mL liquid

10mg Celexa = 5mL liquid

Edited by Altostrata
corrected mg to mL, added 1mL equivalent

Share this post


Link to post
Share on other sites
Nikki

Thank you Alto...

 

I do understand the 2:1 ratio now. My problem is the five levels - lines in between each mL marking.

 

4mL_________

____

____

____

____@ this first line what is the decrease - an 1/8 or 1/4 or 1/2, etc.?

5mL_________

 

 

 

I want to fill the syringe up to that line. It is the smallest cut that I can make. It would be 9 something. What that something is I don't know.

 

Aside from numbers, ratios, percents, algebra, geometry, adding, subtracting, multiplying and division being my worst subjects....the reason I can't absorb is because of the Celexa.

I swear it has me blocked and unable to absorb :huh:

Hugs

Share this post


Link to post
Share on other sites
Altostrata

If there are 5 divisions between 4mL and 5mL, each of the chunks would be .2mL (.2 x 5 = 1.0mL) -- 1/5 of a mL.

 

If there are 10 divisions between 4mL and 5mL, each of the chunks would be .1mL (.1 x 10 = 1.0mL) -- 1/10 of a mL.

 

I have one 1mL oral syringe that has 5 divisions between numbers, and another that has 10 divisions. I have to carefully count the divisions each time I take a dose.

Share this post


Link to post
Share on other sites
Nikki

Bubbles I think I did this with Lexapro liquid back in 2007. Although the Pharmacist told me the Lexapro liquid was the same dosage as the pills.

 

I sat down and figured this out last night.

 

I am assuming when I fill the syringe and when I fill it to the line right above the 5mL line that I will have dropped 1/5mL. I still don't know what that equals in terms of mgs.

 

Once I get from 5mL to 4mL I know that will be a 2mg. drop in dose.

 

Right?

Share this post


Link to post
Share on other sites
Altostrata

Correct.

1mg Celexa = .25mL liquid

4mg Celexa = 2mL liquid

1mL liquid contains 2mg Celexa

 

If one division = 1/5 mL, it would be 1/5 x 2mg Celexa = .4mg

 

If you take 4 out of 5 divisions, you are taking 1.6mg Celexa (4/5 x 2mg)

 

What I do is write down what I need to take and very carefully count the divisions for every dose.

Share this post


Link to post
Share on other sites
Nikki

FYI for anyone decreasing Celexa...

 

I am doing okay with it. I did not expect that.

 

I took the advise given here. I can't do a 10% reduction (or at least I could not do that in the past), so I knew I wouldn't start there.

 

I have made two cuts in three weeks. 1/5th mL and then another 1/5th.

 

Each time, I did get insomnia, heightened AM anxiety and that was about it. The anxiety leads to other things, like worry, and fear. Not so good. That is what takes me out.

 

It did subside each time. Thank You God....

 

I think I will bask in the good days for a short while and then make another 1/5th cut.

 

I have been busy and that's good for me too. Years ago I read a book "When I Got Busy, I Got Better". Very true for me.

 

In all of my tapers, I did experience fatigue which was probably from insomnia. I had aches and pains too. Basically I was not incapacitated and was always able to exercise heavily.

On occasion that would level me, but I guess I have good stamina. So busy is better for Moi :D

 

Hugs

Share this post


Link to post
Share on other sites
cats

Hi. I need some help to make sure I'm measuring correctly:

 

Here's a recap first:

-7 years on Zoloft 50mg twice daily as prescribed by my psychiatrist

-1 year on Zoloft 50mg daily...psychiatrist disapproved of this reduction, so only told him once, then did it on my own.

-1 week cold turkey...psychiatrist advised against going off AD, but finally said "Fine, come back in 3 months, and let me know how it's going."

-1 month on Zoloft 25mg daily

 

Yesterday I saw my psychiatrist. We discussed how things were going. I asked him to prescribe an oral suspension to assist me in my tapering. He obliged, but still prescribed dosage as if I was still on the 50mg twice daily. Aren't they supposed to listen to you???

 

Here's what I got:

180ML *SERTRALINE 10MG/CC ORAL SUSPENSION

TAKE 5ML TWICE DAILY FOR 7 DAYS,

THEN 5ML IN THE MORNING AND 2.5ML IN THE EVENING FOR 7 DAYS,

THEN 2.5ML TWICE DAILY FOR 7 DAYS,

THEN 2.5ML DAILY.

 

My plan is still to taper by 10% every 3 to 4 weeks.

 

Does this sound correct?

5ML oral suspension=50MG capsule

In order to taper by 10% from 25MG that I've been taking for the past month, I would take 2.25ML of this new oral suspension???

Any help is appreciated, as I'm not sure I'm doing this right.

Share this post


Link to post
Share on other sites
Altostrata

Are they supposed to listen to you? In a perfect world, yes. You may need to learn to "work" with this doctor, i.e. politely give him instructions about what you need.

 

First, check the concentration on your bottle to make sure it is 10mg/cc (same as 10mg/milliliter).

 

If it is 10mg/mL, you would take 2.5mL for a 25mg dose. A 10% reduction would be 22.5mg or 2.25mL, as you correctly calculated.

 

Your doctor's tapering plan is eccentric and too fast, figuring to get you off Zoloft in 4 weeks. When you run out of liquid in a couple of months, you'll have to refill the prescription (if you can) or ask him for another. You might say at that time you decided to take it slower.

Share this post


Link to post
Share on other sites
Meimeiquest

Does anyone know of a fabulous standardized bottle for carrying homemade suspensions in a purse or man-carrying-device? I found an amber bottle on Amazon, but it is too tall for a syringe (I am pouring into lid) and comes in 12-packs. Just pre-packaging in a syringe makes me nervous because solids can rest in the dead space and never make the mouth (although multiple rinsing into your mouth would probably take care of that, I guess, but really.)

Share this post


Link to post
Share on other sites
Altostrata

You can get a small bottle from the pharmacy. Mine gave them away for free.

 

There have been times when I pre-filled an oral syringe and carried it in a closed container, I can't remember what it was. Maybe a yogurt container? Or a medicine bottle? I figured if any solution leaked out of the syringe, I'd put water in the container and drink it out, but it didn't leak.

Share this post


Link to post
Share on other sites
areyouthere

Hi,

The liquid lexapro I will get is 10 mg/ ml and so I will need to dilute that. It says it is mixed with ethanol. What liquid can I use to dilute this highly concentrated liquid?

 

Thanks,

 

RU

Share this post


Link to post
Share on other sites
Altostrata

Can you get a 0.5mL or 1mL oral syringe instead? It will measure to hundredth of a milliliter.

Share this post


Link to post
Share on other sites
areyouthere

Can you get a 0.5mL or 1mL oral syringe instead? It will measure to hundredth of a milliliter.

Yes. Actually I have a 1 mL , glass pipette so I can measure accurately to tenths of a mL. I wasn't thinking… sorry.

 

But I'm still curious about it. I know water wouldn't work… but how about ever clear liquor? 

Share this post


Link to post
Share on other sites
Altostrata

Is this a compounded solution?

 

From the manufacturer, Forest, of Lexapro oral solution:

Lexapro oral solution contains escitalopram oxalate equivalent to 1 mg/mL escitalopram base. It also contains the following inactive ingredients: sorbitol, purified water, citric acid, sodium citrate, malic acid, glycerin, propylene glycol, methylparaben, propylparaben, and natural peppermint flavor.

 

 

Are you sure yours is diluted with alcohol? What is the manufacturer?

Share this post


Link to post
Share on other sites
Altostrata

Are you reading the label? Otherwise, I'd double-check the ingredients with the manufacturer. If the base is alcohol, ask them about dilution.

Share this post


Link to post
Share on other sites
Rhiannon

I would ask the pharmacist or as Alto says, the manufacturer. 

 

It may be fine to dilute with water. We mix water and alcohol all the time, it's not a problem. I think Everclear is something like 50% ethanol.

 

But I'd see if you can get the info from manufacturer or pharmacist first, before experimenting on your own.

Share this post


Link to post
Share on other sites
areyouthere

I  

 

It may be fine to dilute with water. We mix water and alcohol all the time, it's not a problem. 

Yes.. I will check on all of these details but..

 

When you mix alcohol with water the total volume changes. Maybe that is not a problem? 

 

I discuss all of this with my P doc tomorrow. Wish me luck. He's been supportive of my taper in the past but I always worry he will suddenly buck it. Now would be a very inopportune time for that. My strategy? Tell him up front at the beginning of the appt. exactly what I need for prescriptions and then let him listen to himself talk ( his favorite thing) ending with a reminder from him that he got his agree from the Mayo clinic … usually that does it. I walk out of these stupid appts. with the prescriptions I need to get of these damn drugs.

 

RU

Share this post


Link to post
Share on other sites
Rhiannon

I'm sorry, I don't understand, isn't "dilution" the same as "total volume changes"? I mean isn't that sort of the point?

 

Love your description of visiting the doc! Ha! yep.

Share this post


Link to post
Share on other sites
areyouthere

I'm sorry, I don't understand, isn't "dilution" the same as "total volume changes"? I mean isn't that sort of the point?

 

Love your description of visiting the doc! Ha! yep.

Thanks! What I mean is if you add 10 ml of water to 10 ml of alcohol you don't get 20 mls of liquid. You actually get less than that. So that would mean that the number of mgs. of lexapro per ml couldn't be calculated using 20 mls as the denominator.

 

Seriously . I don't want to confuse things here and Alto feel free to delete this discussion.. I would get that. At this point it's just a discussion of curiosity… not intelligence … particularly  on my part!!!

 

I don't want to confuse any tapering issues here.

 

RU

Share this post


Link to post
Share on other sites
Rhiannon

Are you sure your compounded solution is mixed with 100% ethanol? It seems to me like it would be more likely to be a mixture with some simple syrup or something (say that five times fast). 

 

I'd try just experimenting. When you mix ethanol and water it's true you get a bit of volume loss but depending on the quantities involved it might not be significant. As always, the important thing is to make sure that whatever you do, you do it consistently. If you have to adjust the solution slightly to get a dilution that works for you, just make sure that you do it the same way every day. The important thing isn't necessarily the absolute numbers, it's the proportion, as you taper down. 

 

Does that make any sense? I think I may be confusing myself and I actually know what I mean.

Share this post


Link to post
Share on other sites
areyouthere

Are you sure your compounded solution is mixed with 100% ethanol? It seems to me like it would be more likely to be a mixture with some simple syrup or something (say that five times fast). 

 

 

No. I'm not sure yet. And I agree completely with your statement of consistency. 

 

See the doc in a few. You can be sure I won't be asking him any of these questions… the dude just LOVES to throw out clinical mumble jumble … and all I want to say is "cough up the prescriptions dude…I can figure out the rest".

 

I really hate to talk about him this sarcastically… he really DOES have a good heart.

 

RU :) 

Share this post


Link to post
Share on other sites
Altostrata

Read the label rather than rely on what the doc says.

Share this post


Link to post
Share on other sites
finding123

Hi there,

 

I am currently tapering off Prozac liquid and I am down to 0.9ml a day. My doctor has pointed out to me today that the bottle of medicine expires after one month of opening it. Each bottle is 70ml, so if I open a new bottle every month I would be wasting a lot. I wondered what everybody else does? Is it considered unsafe / unwise to take the medicine more than one month after opening it? 

 

Thank you.

Share this post


Link to post
Share on other sites
Altostrata

If you use it past expiration, it may or may not be a consistent strength. Generally, it's a good idea not to use a liquid past its expiration date.

 

To reduce expense, you can make your own Prozac liquid, read this topic from the beginning Tips for tapering off Prozac (fluoxetine)

Share this post


Link to post
Share on other sites
clarabella79

Hi finding123,

 

I'm currently using a combination of 5mg tablet + a very small quantity of Paroxetine liquid(currently 1.2ml daily) to taper and I haven't been throwing the bottle of liquid away after the 1 month mark. I mentioned the 1 month expiration warning on the bottle to one of the GPs at my practice and he said it can - as Alto said - start to degrade and lose some of its potency after it's been open a while. From personal experience, I've found it's ok for about 7 weeks. After that, I can tell it isn't working as effectively and I start my next bottle. I guess cost isn't as much of an issue for us here in the UK (I notice you're from Liverpool), as we only have to pay £8.20 (around $13 USD) for a bottle of liquid. It's still useful to know that you can make a liquid from tablets, though, if you happen to run out and can't get to the docs.

 

Well done on getting to such a low dose of Prozac, by the way :)

Share this post


Link to post
Share on other sites
Colonial

Hi, I'm reading Clarabellas post from July, saying her liquid paxil expires in a month from "opening"?

 

When I get my liquid from the pharmacy, it has the general use by one year on the label, and when I asked what the manufacturer expiration is, they said it was almost 2 full years from the date I received it.

 

I noticed she is from England, is their formulations different?

 

I'm currently using a bottle I got about 6 months ago, but says is still good for another 5 months/

 

Thanks!

Share this post


Link to post
Share on other sites
Skyler

Hi, I'm reading Clarabellas post from July, saying her liquid paxil expires in a month from "opening"?

 

When I get my liquid from the pharmacy, it has the general use by one year on the label, and when I asked what the manufacturer expiration is, they said it was almost 2 full years from the date I received it.

 

I noticed she is from England, is their formulations different?

 

I'm currently using a bottle I got about 6 months ago, but says is still good for another 5 months/

 

Thanks!

 

colonial.. you already have a liquid suspension?  I put the link thru with the idea you needed to make your own.. which many folks here do.  But you already have some on hand?

Share this post


Link to post
Share on other sites
Colonial

my paxil is liquid, yes.

 

but my xanax are the scored pills

 

I was just wondering why Her liquid paxil says 1 month but the date on mine is a year, dont want to be using it if that's an issue.

Share this post


Link to post
Share on other sites
Altostrata

Different formulations. Please go by the labeling on your bottle. If you have questions, ask your pharmacist.

Share this post


Link to post
Share on other sites
scottly9999

Hello Fellow Survivors!

 

Just a question thats been running through my head.

While tapering down on Lexapro - and finally convincing chemists here in Australia if liquid Lexapro IS available (yes it is) - although it seems most chemists are reluctant to give you the 10mg/ml bottle, and really push towards the 20mg/ml concentration (I believe it's the PBS pricing or something that does it).

 

I've noticed that I always seem to run into withdrawal symptoms and more problems towards the end of a bottle.

Now as I'm taking only about 2mg or even 1.8mg or 1.5mg, the bottle lasts me a long time.

I opened my current bottle at the beginning of January this year, and it's now mid April.

I'm still on the same bottle, albeit not much left.

I've had horrible withdrawal symptoms lately.

The bottle says discard after 3 months.

Now most medicine has a use-by date, but I was wondering if anybody has had experience of liquid Lexapro (or any other SSRI for that matter) that might lose it's potency over time??

It almost feels that way to me.

Share this post


Link to post
Share on other sites
mammaP

As I understand it the bottle starts to lose potency once opened. Do you keep it in the fridge where it is cool and dark? I'm sure I read that medicines which  are exposed to light deteriorate faster which is why they are usually in brown bottles. 

Share this post


Link to post
Share on other sites
Hibari

Hello Fellow Survivors!

 

Just a question thats been running through my head.

While tapering down on Lexapro - and finally convincing chemists here in Australia if liquid Lexapro IS available (yes it is) - although it seems most chemists are reluctant to give you the 10mg/ml bottle, and really push towards the 20mg/ml concentration (I believe it's the PBS pricing or something that does it).

 

I've noticed that I always seem to run into withdrawal symptoms and more problems towards the end of a bottle.

Now as I'm taking only about 2mg or even 1.8mg or 1.5mg, the bottle lasts me a long time.

I opened my current bottle at the beginning of January this year, and it's now mid April.

I'm still on the same bottle, albeit not much left.

I've had horrible withdrawal symptoms lately.

The bottle says discard after 3 months.

Now most medicine has a use-by date, but I was wondering if anybody has had experience of liquid Lexapro (or any other SSRI for that matter) that might lose it's potency over time??

It almost feels that way to me.

I'm so glad you mentioned this.  Since my cuts are getting smaller, my bottle is lasting longer as well.  I too have felt that my wd is a bit more intense even though I haven't made a cut since mid March and I have been feeling pretty stable. 

Share this post


Link to post
Share on other sites
scottly9999

Hi Guys

 

It's an interesting topic for sure.

The bottle is a brown glass bottle, I just keep it in the cupboard, so it's dark all the time, except for the morning when I take it out - and a reminder that I'm STILL taking this "poison"!!!

I'm about to get a repeat - annoyingly the GP's won't give me a script for a repeat, just the one bottle... and I have to explain it each time to a perplexed GP as to what and why.

Man the drug companies have done a great job of NOT informing the doctors as to what this stuff CAN do to people.

I have met 1 GP over the years who WAS supportive of a slow taper, and was quite serious about it.  He seems to have since retired.

 

I've met a few people who have either stopped cold turkey, or 2.5mg every few weeks, and has a few brain zaps, but after that, they were fine.

WOW.

 

I'll report how I feel once I get a new bottle.

I'm HOPING to get a 10mg/ml bottle - as more accurate - and has the nozzle for an oral syringe.

And if the chemist doesn't have that exact bottle, they say they need to speak to the GP to get permission to give me the 20mg/ml

<sigh>
The GP has no idea in the first place.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×

Important Information

By using this site, you agree to our Terms of Use.