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Altostrata

Tips for tapering off Zyprexa (olanzapine)

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Altostrata

herewego, thank you for that excellent report about using Ora-Plus.

 

Please let us know how you do with olanzapine suspension refrigerated for 24 hours or more, if you try that.

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herewego

Hi Altostrata,

I took the 24 hr old refrigerated ODT Olanzapine/ORA-Plus solution last night and I slept a solid 8 hrs and felt groggy for much of the day, so I am thinking it must still be effective when kept refrigerated for that long. Perhaps when my doses are lower yet I can see if it lasts 48 hrs refrigerated like the crushed table form in water can.

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Evoldnahturt

I spoke to that compounding pharmacist again today and got him to further explain on the oxidation issue.  He said that the thieno group in the molecule, which is a sulfur (not sure if that's relevant), is what oxidizes.  He explained that this group doesn't seem to have any active metabolites, so the fact that it oxidizes, in his opinion, shouldn't be a problem.  I've learned not to trust pharmacists (or anybody in the medical field, for that matter) and like the fact that the idea that I came up with (using a scale and dividing piles) doesn't rely on that being true.  Possibly more importantly is that my method gets around the problem of trying to homogenize the drug in a solution, which I suspect may be a real problem.  I hope it doesn't feel like I'm beating you over the head with this.  Maybe your way is better.  I am just concerned that it may not be.  Even if I'm right, if you're not sensitive enough to dose reductions or updoses, it may not be a problem.

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herewego

Hey, I hear you. I totally agree that the olanzapine does not evenly disperse in just water alone but quickly sinks to the bottom. Do you have concerns with the olanzapine evenly dispersing in the ORA-Plus? Just eye - balling it, it seemed to me to evenly disperse and suspend in the ORA-Plus. But if you experienced otherwise or were told otherwise by a pharmacist please detail what you observed or heard. I certainly want to be successful at tapering and am open to using a good scale if need be. It's nice to know from your info that the olanzapine is likely evenly dispersed when you make it into a powder, so using a scale is an option too.

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Evoldnahturt

I wasn't able to see the Olanzapine in the ORA-Plus, so I couldn't tell how well dispersed it was.  I'm not sure at what point it would become a problem, but the pharmacist suggested that at low enough doses, it would become a problem for him.  My scoops came in the mail.  I intend to weigh ten scoops of Olanzapine on a scale.  I'll divide the weight by ten to get the average weight and use that to figure out how many mg (of the active ingredtient) is in a scoop.  I'll do that several times for each scoop size I have to get an average and figure out what the standard deviation is.  I suspect the scale will be less accurate than these scoops at this weight, but I'm not sure that I can prove that.  I'll post the results of the tests here.  I have a feeling these scoops are going to make the taper a lot easier will and allow me to get more consistent doses.  I played with the smallest scoop a little and roughly estimated that the taper from 2.5mg could last between 4.75 and 5.41 years before the piles become too small to manage.  The dose of Zyprexa would be 0.00684mg and 0.00294mg respectively.  The difference between 2.5mg and 2mg is about two months, so it should take about as long for you, herewego.  I should have a closer estimate after I'm done testing.  I'm going to have to order five more of each scoop so I can dump them all at once before the scale shuts itself off.  It might be around a week before I get to this.  If these scoops look like they're going to work out, I'll come up with a taper plan and will post the details of that as well.  I hope you're feeling well today.  Take care of yourself!

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Evoldnahturt

I should clarify.  The pharmacist said he would have no problem "doing the math" to dilute the Olanzapine to the right amount.  His concern was that at low doses, it wouldn't be homogenized enough to give you consistent doses.  He said his compounding "should" be safe at as low at 0.25mg.  The other pharmacists refused to compound at lower doses.  Some would go as low as 0.5mg and others would only compound 2mg.  He also mentioned that he would be able to homogenize it better in a liquid.

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Altostrata

Rather than confusing your pharmacist, you could ask him to compound at a higher dose, such as 1mg/1mL, and simply take less in a 0.5mL or 1mL oral syringe.

 

You will still need a prescription for any type of compounded drug.

 

What are you doing with the scoops?

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Evoldnahturt

I'm considering using scoops to measure when I get to amounts too low to weigh on a scale.

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herewego

If my ORA-Plus mixture seems to be working the lowest I will be able to go to is either .025 mg or .0125 mg. The .025 mg would be if I only dilute the 5 mg ODT in 20 mL. I will also try diluting it in 40 mL, but I am wondering if 5 mg of pill will dilute in the bigger amount of 40 mL - it may be too little amount of pill in too much solution, but I will see how it looks when I get to that point. Currently I am diluting the 5 mg ODT in a 10 mL solution of ORA-Plus & water.

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Altostrata

Yes, your 5mg tablet will make a suspension in 40mL. 40mL is not very much liquid.

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herewego

Good to know. I also just saw in the past few days the topic in tapering on using a syringe. I didn't know syringes could be found as low as 1 or .5 mL so that should help too.

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Astrid

the only thing i can find here are tablets & i'm wondering if it is safe to just cut off what one consider a 10%? & then just keep making the pill smaller as you taper along...

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erer

the only thing i can find here are tablets & i'm wondering if it is safe to just cut off what one consider a 10%? & then just keep making the pill smaller as you taper along...

That would not be very precise. As the amounts get smaller and smaller your cuts will be less and less accurate. 

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Evoldnahturt

the only thing i can find here are tablets & i'm wondering if it is safe to just cut off what one consider a 10%? & then just keep making the pill smaller as you taper along...

 

Hudgens did something similar to what you're suggesting with good results.  I agree that it would become very difficult to make cuts the closer you get to the end.  Listening to your body and long holds might mitigate the risk of getting sick:

 

http://survivingantidepressants.org/index.php?/topic/10072-hudgens-success-story/?p=181314

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Altostrata

We recommend making a liquid, which can be more consistently measured, or weighing tablet fragments with a scale, than trying to trim a tablet by eye.

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Evoldnahturt

We recommend making a liquid

 

Zyprexa isn't water soluble

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scallywag

We recommend making a liquid

Zyprexa isn't water soluble

Evold -- there are earlier posts in this topic about using a compounding liquid such as ORA-plus

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Miko789

 the only thing I can find here are tablets, is it safe to  cut orodispersible tablets quarters with a pill cutter?

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erer

Is Zyprexa/Olanzapine also an antihistamine like Seroquel? I cannot seem to find a conclusive answer to that question online.

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lucyinthesky
1 hour ago, erer said:

Is Zyprexa/Olanzapine also an antihistamine like Seroquel? I cannot seem to find a conclusive answer to that question online.

 

Yes, it is. Olanzapine reduces H1 receptor (Histamine).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485633/

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