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Tips for tapering off Prozac (fluoxetine)

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Altostrata

If you are looking for information about switching or "bridging" to Prozac to go off your antidepressant, read this ENTIRE topic: http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/


 

 

Prozac was the first popular SSRI, released in 1987, and was a substantial source of profit for Eli Lilly for many years. It became available in a generic form in 2001 (Lilly's fortunes subsequently plummeted).

It comes in 10mg, 20mg, and 40mg capsules, as well as a liquid (20Mg/5Ml), which is very helpful for tapering off. After a single oral 40 mg dose, peak plasma concentrations occur after 6 to 8 hours.

It also comes in a 90mg weekly capsule, containing coated pellets for delayed release adding 2 hours for peak plasma concentrations (very rarely prescribed).

It has the longest half-life of any SSRI. After you take it for a few days, half-life is about 16 days. Fluoxetine itself has a half-life of 2-4 days, but as it is processed, your body creates an active antidepressant metabolite, norfluoxetine, which has a half-life of 7-15 days. So Prozac keeps on extending its half-life as it is metabolized.

According to http://en.wikipedia.org/wiki/Fluoxetine , fluoxetine and norfluoxetine inhibit each other's metabolism, extending the half-life of the drug. Because the half-lives are so long, the full effect of Prozac on the brain may not be felt for several weeks.

fluoxetine (1-6 days) ---> norfluoxetine (up to 16 days) ---> other metabolites

Prozac is mainly metabolized by the liver enzymes identified by cytochrome P450 CYP2D6 and CYP2C9/2C19, and inhibits its own metabolism via cyp 2D6 and cyp 2c19, which means lower doses get metabolized faster. (Prozac and its metabolites are also mild to moderate inhibitors of CYP1A2, CYP2B6, CYP2C9, and CYP3A4.)

Is Prozac "self-tapering"?
Because of its very long half-life, Prozac has the reputation of being "self-tapering," meaning it requires only a short taper. However, some people do suffer withdrawal from Prozac, just as severe as other SSRIs. Because of the long half-life, withdrawal symptoms simply take longer to appear.

We suggest starting out with a slow taper of 10% per month for a couple of months; if no withdrawal symptoms appear, rate of taper may be increased -- but slow down if withdrawal symptoms arise.

Reduce by 10% per month to start
The 10% rule holds for Prozac, just like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)

See Why taper by 10% of my dosage?

Using fluoxetine liquid to taper
This is by far the easiest way to taper by very small amounts. It comes in a concentation of 20mg fluoxetine in 5mL of liquid, meaning there is 4mg of fluoxetine in 1mL. If you are taking 10mg Prozac now, the liquid equivalent would 2.5mL. If you want to take 9mg of Prozac, you would take 2.25mL of the liquid.

Always check the concentration of the liquid you get as it can vary among manufacturers, and adjust your calculations accordingly.
 
If your fluoxetine liquid contains 20mg fluoxetine in 5mL of liquid:

  •    1 mL= 4mg
  •    0.5mL = 2mg
  •    0.25mL = 1mg
  •    0.2ml = 0.8mg

You will need an oral syringe to measure out your dose of the liquid.

To use the oral syringe, you need a special cap to put on the bottle of liquid Prozac. The cap should have a hole in it, the tip of the oral syringe fits into this. Read this about oral syringes.

If your pharmacist doesn't have a cap, ask for a smaller medicine bottle with this type of cap. Pour some of your liquid Prozac into it and draw your dosage from the smaller bottle.

Here's an illustration of how to draw the medication from the bottle http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__2284

Also see http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__21391

See more detail about how to measure and taper Prozac-brand liquid here http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/page__view__findpost__p__41090

Making your own Prozac liquid
Prozac is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."

My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the Prozac is dissolved in water. (There may be particles swirling around, that's the filler in the Prozac capsule that doesn't dissolve.)

Your Prozac solution may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.

There are instructions for DIY Prozac solution here: http://depression.about.com/cs/sideeffects/ht/cranzac.htm

(A psychiatrist posts about it here.)

For very gradual tapering, for example, you can dissolve a 10mg capsule in 10mL of water to make a solution with 1mg Prozac in 1mg of water. To take 1mg Prozac, use an oral syringe to take out 1mL.

Refrigerated, it's supposed to be stable for 14 days.

This can be a very precise way to taper.

 

Using a combination of tablets or capsules and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

For example, if you are taking more than 10mg Prozac per day, you could get your prescription filled in 10mg capsules and take part of your daily dosage in a 10mg capsule and the rest in liquid.

 

If your doctor prescribes liquid and tablets or capsules at the same time, most likely, he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

 

Dividing contents of capsules into empty gelatin capsules
One way of tapering is to split up the powder in a capsule into smaller dosages. Go to a health food store and get empty gelatin capsules, the biggest they've got.

When you open up a Prozac capsule, you can carefully pour a fraction of the powder into empty gelatin capsules.

You won't have 5mg per capsule exactly, because it's difficult to eyeball the amounts.

If you want to be more precise, carefully pour the powder onto a piece of black paper and divide it into quarters with a knife, then scoop each 1/4 into an empty gelatin capsule.

See more about this technique at http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3033#entry3033

If you are very sensitive to variations in dosage, this method will not be precise enough for you to control your taper.

Divide up capsule contents with an electronic scale
If you want to be even more precise, weigh the powder in a capsule with an electronic scale, divide it up, and put it into empty gelatin capsules. The powder is very fluffy, though -- make sure it doesn't blow off the scale.

 

See Using a digital scale to measure doses

 

Have a compounding pharmacy make up capsules of smaller dosages
A compounding pharmacy will accurately weigh the doses and put them into capsules for you. See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3001#entry3001

Edited by ChessieCat
AS updated June 22, 2015/CC crossed out broken link

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Sally3

I am sorry to be so dense about this - I just cannot get this tapering straight with milliliters, milligrams, decimal points, etc. If anyone would be so kind to try to help me figure this out. I don't know if I tapered too slowly or too fast and I don't even know how much I am taking anymore.

When I started this I used a medicine spoon and my regular dose was 1 tsp per day. I divided the dose up into two doeses - 1/2 tsp in the AM and 1/2 tsp in the PM. From that dose I would extract 0.1 milliter in the am and the pm. Over the month, I would work my way up those five little ticks on the syringe until I got to the next milliliter marking of 0.2, then 0.3 etc. I finally worked my way up to 1 milliliter and extracted that from the 1/2 tsp twice a day. I then commenced extracting 1 milliliter plus starting over again at 0.1 and workig my way up.

I now extract 1 milliliter and 0.5 milliliter twice a day. Please tell me how many milligrams I am extracting - I don't know where I am or how much Prozac I am actually taking whether it's milligrams or milliliters.

I am sorry if this is so confusing....I don't know how to make it any clearer..I am holding for now but am having a hard time....thank you to anyone who can help me figure this out and how to go forward from here.

Sally3

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Altostrata

1 tsp = 5mL

.5 tsp = 2.5mL

1mL Prozac solution = 4mg Prozac

 

I now extract 1 milliliter and 0.5 milliliter twice a day. Please tell me how many milligrams I am extracting

1mL + .5mL = 1.5mL extracted from .5 tsp (2.5mL) = 1mL left (4mg Prozac)

 

You are taking 1mL (4mg Prozac) twice a day = 8mg Prozac

 

Why are you taking it twice a day? Prozac doesn't need to be taken twice a day.

 

The math would be easier if you drew the Prozac into the oral syringe (4mg twice a day or 8mg once a day) and took it directly from the syringe.

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Sally3

Thank you Alto for your help. When I started tapering I thought it would be better to do a two times a day dose. On Benzos that seems to help alot - to divide up your dose so I thought the same would apply to Prozac.

I just cannot get this math right - my syringe does not fit into the bottle of Prozac (it is a big bottle) so I have started now pouring it into a small container and tonight for the first time, I extracted it with the syringe.

If you feel it would be better to do this just once a day, then that is what I will do.

I am glad to hear that I am taking only 8 mg of Prozac - so that is all that I have left to taper...yay!!!! Down 12 mg of Prozac.....8 more to go.

If they would only make the syringes in mg it would be so much easier for us math challenged people.

Thank you so much!

Sally3

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Altostrata

Prozac needs to be taken only once a day. It has a very long half-life.

 

Sally, you need a special cap to put on the top of the Prozac bottle. It has a hole in the middle where you fit the syringe.

 

See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques on how to use an oral syringe.

 

Ask the pharmacist to show you how to do this.

 

If you can't get a cap for the Prozac bottle, ask the pharmacist for a smaller bottle with the special cap on it. Put some of your Prozac in the smaller bottle. Put the special cap on it. Draw your dosage from that.

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Sally3

Alto - I got a special cap- it didn't fit the bigger bottle of Prozac - I then got a smaller bottle (not a medicine bottle) but the liquid Prozac collected around the inside lip of the bottle and I couldn't get it all out....I am so frustrated with all of this. I talked to the druggist - he told me just pour some into a regular measuring spoon or open container and use the syringe to take out what I needed. So that is what I am doing. I will commence doing it only once a day since that is what you suggested...that may be easier with a larger amount. I am holding at 8 mg until the end of July....so confused by all this - no wonder my anxiety is at its peak....hope I settle down with all this tapering soon....I just need to be confident in what I am doing...

Thank you Alto...

Sally3

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amg2012

Alto or anyone with knowledge on this

 

Not doing badly on my Prozac switch and I am now putting the powder from my Fluoxetine into water.

It does not disolve... is this a problem ???

I shake it well before drawing out my dosage, but I cannot be certain I am getting accurate dosages.... :unsure:

I am now taking about 18 mg.??

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Sally3

Hi - haven't been here for awhile as I was holding my taper from Prozac at 8 mg - I have held for 4 months now and have started up the taper again.

I tapered 12 mgs over the last year and had waited one year to begin the taper after withdrawing from the Klonopin and still dealing with K sx.

anyway - I started tapering the Prozac and I decided after reading a blog by someone who tapered .10 every two or three weeks for 4 years, that I would go even slower. So I started tapering .01 ml of Prozac every three or four days. I first held for a week and then got brave and decided to do it sooner. I am now down .06 ml, and this has taken me almost one month.

 

This is my question....is it better to taper the smaller amount every few days OR taper by a larger amount and then HOLD for two weeks or so....just wondered if there is any benefit to either way to taper over the other.

I am having sx that are tolerable right now and don't want to upset things, but would be willing to cut a bigger amount and hold if that is a better way to do it and helps the brain more.

Any ideas, thoughts or opinions on this? Also someone told me that a doctor in the know also said that the taper at the last 1/3 of your tapering time should be equal in time to the first 2/3 of your taper. That the end of the taper is very crucial to getting off successfully.

Any thoughts about that?

Thanks again

Sally3

Thank you all!

Sally3

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Altostrata

....

Not doing badly on my Prozac switch and I am now putting the powder from my Fluoxetine into water.

It does not disolve... is this a problem ???

I shake it well before drawing out my dosage, but I cannot be certain I am getting accurate dosages.... :unsure:

I am now taking about 18 mg.??

 

amg, see instructions for making your own liquid Prozac above in this topic.

 

There may be particles swirling around, that's the filler in the Prozac capsule that doesn't dissolve.

 

Just make sure you shake your solution well before drawing from it with an oral syringe.

 

 

....

anyway - I started tapering the Prozac and I decided after reading a blog by someone who tapered .10 every two or three weeks for 4 years, that I would go even slower. So I started tapering .01 ml of Prozac every three or four days. I first held for a week and then got brave and decided to do it sooner. I am now down .06 ml, and this has taken me almost one month.

 

This is my question....is it better to taper the smaller amount every few days OR taper by a larger amount and then HOLD for two weeks or so....just wondered if there is any benefit to either way to taper over the other.

I am having sx that are tolerable right now and don't want to upset things, but would be willing to cut a bigger amount and hold if that is a better way to do it and helps the brain more.

Any ideas, thoughts or opinions on this? Also someone told me that a doctor in the know also said that the taper at the last 1/3 of your tapering time should be equal in time to the first 2/3 of your taper. That the end of the taper is very crucial to getting off successfully.

Any thoughts about that?

....

 

Sally, microtapering the way you're doing it is fine. The goal is to minimize withdrawal symptoms, and your method seems to be working well for you.

 

Yes, the end of the taper is crucial to success. Many people have a much harder time at the very end, when the dosage is so small. But if you get withdrawal symptoms, they're nature's way of telling you to go slower.

 

That doctor's description of the last 1/3 of the taper taking 2/3 of the time may not be entirely accurate, but it's going in the right direction. The rate of taper should slow towards the end.

 

(Sally, please update your Intro topic at http://survivingantidepressants.org/index.php?/topic/2439-sally3-i-am-new-here/ Thanks!)

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amg2012

Alto

 

Thanks for the response about filler floating around.... I also have half a capsule floating too. :lol:

I will shake it baby, shake it!

 

Also, I will read more in this section for more tips. My plan was to try to taper by approximately 10% every week.

Does this sound reasonable?

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jr1985

They recommend here to hold for a month after a 10% drop, at least for the first couple of months, then you might be able to go faster depending on how you felt with the first two drops.

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Natureboy

Why would the pdoc prescribe Prozac 10mg every other day instead of Prozac 5mg daily. I read smaller doses are metabolized more quickly. Is 5mg a small dose and 10 is not metabolized as quickly??

 

On the odd day I take Prozac 10mg I have unpleasant symptoms for the first 7 hours. The even day without Prozac I feel much better dreading the next day.

 

I was also told not to miss a day by a post here. My order was to miss a day. Should I take 5mg each day? No my pdoc will not answer the question except the caps are cheaper and cannot be broken in half. Just take them and don't ask too many questions.

 

If I taper do I take the percentage of the daily equivalent or the percentage of the every other day dose?

 

Another solution I found on another web site to be very useful is to buy from Amazon or retailer a milligram scale. First weigh all contents of capsule and divide by the milligram size of cap. Do not weigh the empty capsule. The easiest way is to tare the scale and add powder in the milligrams you want to take then dump in warm glass of water and chug. They cost about 30 bucks.

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Altostrata

Doctors tell patients to skip doses because they don't have a clue about what tapering means.

 

Yes, take 5mg per day. You can open the capsules. Do NOT skip doses.

 

You can weigh Prozac with a scale if you care to, but making a solution (see instructions above) or buying Prozac solution is a lot easier.

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Natureboy

Why would the pdoc prescribe Prozac 10mg every other day instead of Prozac 5mg daily. I read smaller doses are metabolized more quickly. Is 5mg a small dose and 10 is not metabolized as quickly??

 

On the odd day I take Prozac 10mg I have unpleasant symptoms for the first 7 hours. The even day without Prozac I feel much better dreading the next day.

 

I was also told not to miss a day by a post here. My order was to miss a day. Should I take 5mg each day? No my pdoc will not answer the question except the caps are cheaper and cannot be broken in half. Just take them and don't ask too many questions.

 

If I taper do I take the percentage of the daily equivalent or the percentage of the every other day dose?

 

Another solution I found on another web site to be very useful is to buy from Amazon or retailer a milligram scale. First weigh all contents of capsule and divide by the milligram size of cap. Do not weigh the empty capsule. The easiest way is to tare the scale and add powder in the milligrams you want to take then dump in warm glass of water and chug. They cost about 30 bucks.

 

Truth has rough flavors if we bite it through. George Eliot

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Sally3

Thank you Altostratos for your reply to me - I will continue micro tapering as I have been doing. Just wanted to respond to let you know that I read your reply and feel better knowing that what I am doing is OK. Thank you again...appreciate your help and advice.

Sally3

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strawberry17

Sally3 I wonder if my blog is the one you are referring to. I am tapering liquid Prozac and am in my fifth year, now down to 0.90ml. I reduce by 0.10ml and hold it from 5 weeks to a few months depending on what's going on in my life. Interesting the way you're doing it, never thought of doing a micro taper every few days. If you listen to your body and mind and if you are feeling well doing this, then it's working.

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Altostrata

Measuring Prozac-brand liquid

The concentration of the Prozac liquid from the pharmacy can make measurements confusing.

 

Usually, it contains 20mg Prozac in 5mL of liquid. (Check the label on your bottle.) If 20mg = 5mL, then there are 4mg in 1mL.

 

If you are taking 1mL, you are taking 4mg Prozac. To make a 10% reduction, you would decrease by .1mL (.4mg Prozac). A 5% reduction would be .05mL (.2mg Prozac).

 

Measuring Prozac-brand liquid dosage tables

At 20 mg/5ml (4mg Prozac in 1mL solution), if you wish to take

  • 20mg Prozac, take 5mL liquid
  • 10mg Prozac, take 2.5mL liquid
  • 5mg Prozac, take 1.25mL liquid
  • 2.5mg Prozac, take .625mL liquid
  • 1mg Prozac, take .25mL liquid
  • .08mg Prozac, take .02mL liquid
  • .04mg Prozac, take .01mL liquid
Using a syringe to measure Prozac-brand liquid dosage

If you are using a 10mL oral syringe (photo here), and there are 5 ticks between 1mL and 2mL, each division is .2mL (2/10 mL).

 

At 20 mg/5ml (4mg Prozac in 1mL solution):

  • .2mL (1 tiny division on 10mL syringe) = .8mg Prozac
  • .4mL (2 tiny divisions on 10mL syringe) = 1.6mg Prozac
  • .6mL (3 tiny divisions on 10mL syringe) = 2.4mg Prozac
  • .8mL (4 tiny divisions on 10mL syringe) = 3.2mg Prozac
  • 1.0mL (5 tiny divisions on 10mL syringe) = 4.0mg Prozac
If you are using a 1mL oral syringe (photo here), and there are 5 ticks between .10mL and .20mL, each division is .02mL (2/100 mL).

 

At 20 mg/5ml (4mg Prozac in 1mL solution):

  • .01 ml (1 tiny divisions on 1mL syringe) = .04 mg Prozac
  • .02 ml (2 tiny divisions on 1mL syringe) = .08 mg Prozac
  • .03 ml (3 tiny divisions on 1mL syringe) = .12 mg Prozac
  • .04 ml (4 tiny divisions on 1mL syringe) = .16 mg Prozac
  • .05 ml (5 tiny divisions on 1mL syringe) = .20 mg Prozac
Increase dilution to make measuring easier

Increasing the dilution might make measuring easier. For example, you may wish to make it 1mg = 1mL. To do this, add 10mL (40mg) of the 20:5 solution to 30mL of water. Now you have 40mL of liquid containing 40mg Prozac, or 1mg in 1mL.

 

If you wish to take 4mg Prozac, take 4mL of the diluted liquid. A 5% reduction would be .2mL, for a dose of 3.8mL (3.8mg Prozac).

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strawberry17

Hope this isn't a stupid question, is tap water ok or should you use bottled water? will a pharmacist do this for me do you think?

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Squirel

quick question. is fluoxitine prozac? do they behave exactly the same? same half life?

thanks

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Jemima

Fluoxitine is generic Prozac. Theoretically it should be exactly the same, but generic versions sometimes use different fillers and there have been occasions when generic versions of some antidepressants haven't been monitored very closely for quality, at least here in this country. Depending on how strict France is about approving generic drugs, it may be safe there. The FDA has been very lax in monitoring generic drugs.

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Sally3

OK - I am going to try to type this in a coherent way so that it will be understandable to all who care to answer.

I am tapering off of Prozac and have been since August of 2011 after having waited a hear to heal from a Klonopin c/t.

I am still suffering and don't know if it's from Klonopin c/t or the prozac taper. But I want to continue tapering so I need some advice or an OK that I am doing it right.

Here goes:

I have a 1 ml syringe with 50 little black ticks on it with the numbers 1 to 10 and it looks like this

////.1////.2////.3////.4////.5////.6////.7////.8////.9////1ML

 

I am assuming that each little tick is worth .02 ml.... so that each little tick all together adds up to 100...is that right? Right now I dose my prozac twice a day - morning and evening. At this point I fill up the syringe in the morning to 100 ml and delete 17 little black ticks which is .34 ml of prozac out of the syringe. (I cannot subtract it out of the Prozac bottle itself because I don't have a top that fits on the bottle for the syringe. The bottle mouth is too big. Anyway this seems to be working fine.) That leaves me with 33 little black ticks (or .66 ml) of prozac still in the syringe which I then put in my mouth.

And then in the evening I fill the syringe up to 100 ml and subtract 17 little black ticks out (which is .34ml) and that leaves me with 33 little black ticks (or .66 ml) of prozac which I then put in my mouth. Now my next cut will be in 3 or 4 days and it will be 18 little black ticks for three days in the morning ... and then I will cut 18 little black ticks from my evening dose.

So in 6-7 days I will have cut .04 ml - is that right? (.02 ml cut 3 days apart = .04 ml in 6 days).

And that will leave me with .62 ml to go twice a day...until I cut again...

Is this correct? Is this too big of a cut? I am confused about the 10% cut and how much to do and how often? I have not stabilized in a month...and don't know what to do anymore. Just keep going even with no stabilizing?

 

And yes my Prozac is 20 mg/5 ml so there is 4 mg in each milliliter - right?

So how many mg am I down - I started with 1 ml twice a day....so that was 2 ml total ...which would = less than 10 mg...maybe around 8 mg.

So with 34 ml gone - how many mg is that? How much more do I have to go?

I am sorry to be so dense about all of this....but if you could explain it to me in the simplest terms possible, I would be so appreciative.

Thank you again for listening and for any help you can give me..

Sally3

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strawberry17

Hi Sally

 

If you take out 18 little ticks that leaves you with 32 ticks on your syringe. Which would be 0.64ml twice a day. If you're taking a total of 1.28ml a day that = approximately 5mg a day. (praying my calculations are correct!)

 

Here is a link to the Prozac tapering thread and if you scroll to the bottom you'll see Alto's post about diluting liquid Prozac to make 1mg/1ml, which is what I'm thinking about at the moment: http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/

 

My Prozac is the same i.e. 20mg/5ml therefore 4mg = 1ml.

 

I wrote this out for myself:

 

20mg = 5ml

19mg = 4.75ml

18mg = 4.50ml

17mg = 4.25ml

16mg = 4ml

15mg = 3.75ml

14mg = 3.50ml

13mg = 3.25ml

12mg = 3ml

11mg = 2.75ml

10mg = 2.50ml

9mg = 2.25ml

8mg = 2ml

7mg = 1.75ml

6mg = 1.50ml

5mg = 1.25ml

4mg = 1ml

3mg = 0.75ml

2mg = 0.50ml

1mg = 0.25ml

 

I try not to go by calendars/schedules, and go by how I am feeling when it comes to making a reduction, but, I'm not sure if this works the same when micro tapering?!?! But anyway I would always say if you're really feeling it and feeling very anxious and in withdrawal, hang fire for a little while until you feel comfortable to go again.

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MissSerene

Anyone ever try cutting their fluoxetine dose by 5 percent every two weeks rather than 10 percent per month? Any real difference between these two, or does it just depend on any WD symptoms that crop up?

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Altostrata

It could work very well for you. Listen to your body and keep notes of your symptoms on paper.

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Lilu

Anyone ever try cutting their fluoxetine dose by 5 percent every two weeks rather than 10 percent per month? Any real difference between these two, or does it just depend on any WD symptoms that crop up?

 

Wow, I've been reducing my med by 10% every week!  Why such long holds?

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rapunzel2

I read smaller doses are metabolized more quickly. 

 

Where could I find info about that? It seems that my prozac withdrawal comes faster after the drop, as I'm going down on the quantities.

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Altostrata

It's related to liver enzymes (P450 cytochromes). When you go lower, the liver is less loaded up, and the enzymes can metabolize the drug faster.

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rapunzel2

I just started making my own liquid with tap water and tapering down from 20mg to 19,5mg. 

those particles that don't dissolve - they are just a filling and not important, right? the drug itself dissolves completely and evenly?

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Altostrata

You need to stir the liquid so the particles are distributed evenly, and draw from the middle of the liquid. See post #1 in this topic.

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rapunzel2

You need to stir the liquid so the particles are distributed evenly, and draw from the middle of the liquid. See post #1 in this topic.

 

yes, I understand that. but my question was - those particles are not the actual drug, as I understand? the actual drug seems to dissolve without problems?

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Altostrata

Often the particles are binder or the coating on the tablet. Some drugs are more soluble than others. Even the less soluble will form a suspension in the water, which may or may not be visible as particles.

 

Making a liquid with Prozac has a very long, successful history.

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DePrssd5

Hi Everyone,

 

Just a quick question about the bridging method to Prozac.

This is what I understood about the topic because my Doc suggested that I dropped my current AD 50mg pristiq then take 2.5ml Prozac which is the equivalent dose.

this is what I understood with the topic

 

example

1st week 50 mg pristiq + 1.25ml Prozac taken at the same time(like both)

2nd week 50mg pristiq+2.5 ml prozac

3rd week dropped pristiq

 

OR

1st week 50mg pristiq + 1.25 Prozac

2nd week 25mg pristiq + 2.5 ml Prozac i know there is no 25 mg pristiq but i can cut it in half

3rd week dropped pristiq

 

please I need some clarity on this as Im confused especially with my doc advise.

 

thank you,

DePrssd5

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Altostrata

What is the amount of Prozac in each milliliter?

 

Either method you outlined would be an overlap, which is desirable. The second method will expose you to immediately released Pristiq when you split the tablet. As you've been taking it as extended-release, this might cause a problem for you.

 

On the other hand, the first method, dropping the Pristiq altogether, is a bit of a leap of faith. Landing could be bumpy.

 

Either way, you might have some bumps. Or not.

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indigo

I have been tapering prozac solution from the pharmacy. It's horrible stuff, thick like dish liquid and smells like chemical mint

(I've been swallowing my dose in a large gelatin cap so not to gag). Just realized that this solution is ,or is partly, propynol glycol, a chemical

I don't want in my body. I'm thinking of changing my prescription back to capsules and mixing the powder with water.

However, the suspension of the drug in water makes me nervous because of possible inaccuracies in dose.

I'm down to a very low dose and acutely sensitive to even hairline drops down the 1 mL syringe.

Does anyone know of a liquid that mixes better than water but is less harmful that propynol glycol?

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