Need to convert dose from MG to Mils and how to use syringe for dose

 

I have super Benzo brain and can't think or work any bloody thing out!

 

I need to dose 0.25mg using liquid, I will be diluting 5x2mg pills (=10mg) in 20mls of Vodka and adding 80mils of water to make 100mls.

 

I will then need to draw a 0.25mg dose from the liquid out, how do I convert that to mils on a syringe and which line on the syringe?

 

And which is the best size syringe to make it easier a 1mil or 10mil or another size?

 

 

Nova  :smitten:

 

I have super Benzo brain and can't think or work any bloody thing out!

 

I need to dose 0.25mg using liquid, I will be diluting 5x2mg pills (=10mg) in 20mls of Vodka and adding 80mils of water to make 100mls.

 

I will then need to draw a 0.25mg dose from the liquid out, how do I convert that to mils on a syringe and which line on the syringe?

 

And which is the best size syringe to make it easier a 1mil or 10mil or another size?

 

 

Nova  :smitten:

The concentration of the liquid you’ve described is 0.1mg per mL (10 divided by 100 = 0.1).

 

So 2.5mL of the liquid would equal 0.25mg (2.5 times 0.1 = 0.25).

 

In terms of accuracy, a 3mL syringe would be the preferred size to measure 2.5mL. However, a 1mL syringe could also be used.

 

Fyi … If you will only be using 2.5mL of the liquid per day to begin, 100mL would last about 40 days (100 divided by 2.5 = 40).  If this is the case, please be aware that the shelf-life of liquid dosage forms is  typically much less than that of solid dosage forms due to lower stability (e.g. liquid dosage forms are more susceptible to chemical degradation).  Also liquids that do not contain a preservative are prone to microbial contamination.

The concentration of the liquid you’ve described is 0.1mg per mL (10 divided by 100 = 0.1).

 

So 2.5mL of the liquid would equal 0.25mg (2.5 times 0.1 = 0.25).

 

In terms of accuracy, a 3mL syringe would be the preferred size to measure 2.5mL. However, a 1mL syringe could also be used.

 

Fyi … If you will only be using 2.5mL of the liquid per day to begin, 100mL would last about 40 days (100 divided by 2.5 = 40).  If this is the case, please be aware that the shelf-life of liquid dosage forms is  typically much less than that of solid dosage forms due to lower stability (e.g. liquid dosage forms are more susceptible to chemical degradation).  Also liquids that do not contain a preservative are prone to microbial contamination.

Thanks Libertas 

 

The liquid would equal 1mg per 10 mils, so on a  10ml  syringe I'd need to pull 2.5mil =  .25mg (1/8mg) and if I wanted to put .5mg (1/2mg)  it would be 5mils on a 10mil ?

 

Nova  :smitten:

You’re welcome.

 

Yes, 5mL of a liquid with a concentration of 0.1mg/mL would equate to 0.5mg of drug (5 times 0.1 = 0.5).

 

In the interest of risk reduction, here are some suggestions for your consideration about using and storing a do-it-yourself liquid:

 

(1) Shake the liquid well before you measure each dose.  Why? You may have read posts by some members claiming that do-it-yourself liquids are solutions not suspensions. At this time, we are not aware of credible evidence to support this claim.  Adequate shaking prior to dose measurement increases the likelihood of obtaining more accurate and consistent doses by distributing undissolved drug as uniformly as possible throughout the liquid.

 

(2) Do not filter out (or refrain from drawing up) visible particles in the liquid (it’s possible the particles contain drug).

 

(3) Store the liquid in a light-resistant container (to limit photodegradation) with a tight lid (to limit evaporation).

 

(4) Make smaller rather than larger batches to decrease the risks of drug degradation and microbial contamination.

 

 

PS In case you are interested in learning more about how to select the proper syringe size given the volume of liquid you wish to measure, here’s a video:

 

Using the Right Liquid Oral Syringe and Giving the Correct Amount

Dana-Farber Cancer Institute

 

You’re welcome.

 

Yes, 5mL of a liquid with a concentration of 0.1mg/mL would equate to 0.5mg of drug (5 times 0.1 = 0.5).

 

In the interest of risk reduction, here are some suggestions for your consideration about using and storing a do-it-yourself liquid:

 

(1) Shake the liquid well before you measure each dose.  Why? You may have read posts by some members claiming that do-it-yourself liquids are solutions not suspensions. At this time, we are not aware of credible evidence to support this claim.  Adequate shaking prior to dose measurement increases the likelihood of obtaining more accurate and consistent doses by distributing undissolved drug as uniformly as possible throughout the liquid.

 

(2) Do not filter out (or refrain from drawing up) visible particles in the liquid (it’s possible the particles contain drug).

 

(3) Store the liquid in a light-resistant container (to limit photodegradation) with a tight lid (to limit evaporation).

 

(4) Make smaller rather than larger batches to decrease the risks of drug degradation and microbial contamination.

 

 

PS In case you are interested in learning more about how to select the proper syringe size given the volume of liquid you wish to measure, here’s a video:

 

Using the Right Liquid Oral Syringe and Giving the Correct Amount

Dana-Farber Cancer Institute

Brilliant advice!  thanks very much Libertas 

 

 

Nova  :smitten:

You are most welcome, nova 1. I’m sending all good thoughts your way for a successful taper.

You are most welcome, nova 1. I’m sending all good thoughts your way for a successful taper.

Thank you so  much its really appreciated 🙏  :smitten:

The concentration of the liquid you’ve described is 0.1mg per mL (10 divided by 100 = 0.1).

 

So 2.5mL of the liquid would equal 0.25mg (2.5 times 0.1 = 0.25).

 

In terms of accuracy, a 3mL syringe would be the preferred size to measure 2.5mL. However, a 1mL syringe could also be used.

 

Fyi … If you will only be using 2.5mL of the liquid per day to begin, 100mL would last about 40 days (100 divided by 2.5 = 40).  If this is the case, please be aware that the shelf-life of liquid dosage forms is  typically much less than that of solid dosage forms due to lower stability (e.g. liquid dosage forms are more susceptible to chemical degradation).  Also liquids that do not contain a preservative are prone to microbial contamination.

 

Libertas do you have a citation for that info?  not being confrontative here but curious....

Curiosity is a good thing.  I suggest you conduct your own search on the stability of different dosage forms, but here’s one to get you started:

 

Stability of Pharmaceutical Products | SpringerLink

https://link.springer.com/chapter/10.1007/978-981-15-6426-0_10

Curiosity is a good thing.  I suggest you conduct your own search on the stability of different dosage forms, but here’s one to get you started:

 

Stability of Pharmaceutical Products | SpringerLink

https://link.springer.com/chapter/10.1007/978-981-15-6426-0_10

 

No I had done my own research on this and found evidence that the solutions I was making were good for about a year.

I was wondering where you got your research.

I'm not able to get a subscription to this link, so yes I need to use good old google 

 

 

No I had done my own research on this and found evidence that the solutions I was making were good for about a year.

 

 

Wow!  A year? I’d be interested in seeing that evidence, SufferingSixty! As far as we know, none of the do-it-yourself liquids for any of the benzodiazepines discussed in this forum has been tested for strength/stability over time.  We’ve searched the literature plus checked for stability-indicating formulations in sources such as Allen’s Compounded Formulations, Nahata and Hipple’s Paediatric Drug Formulations, and Trissel’s Stability of Compounded Formulations.

 

The stability-indicating studies we’ve found for professionally compounded benzodiazepine liquids indicate drug concentration decreases over time, even when the formulations include excipients to improve stability/shelf-life.

 

For example, below is a table from a stability study for a professionally compounded clonazepam liquid (citation below). It shows the percent of the initial concentration of clonazepam (0.1mg/mL) remaining after 60 days:

 

Day % remaining

1   99.5%

14 98.8%

28 98.6%

60 98.1%

 

An almost 2% decrease in drug concentration over two months may not seem like much.  However, as I’m sure you know, it can make a big difference to individuals who are sensitive to small changes in dose, especially when they are tapering a potent benzodiazepine such as clonazepam.

 

Another study (citation below) found that the concentration of lorazepam in a professionally compounded liquid decreased to 88.9% of the initial concentration after three months.

 

Citations:

 

Clonazepam: Allen LV Jr., Erickson MA. Stability of acetazolamide, allopurinol, azathioprine, clonazepam, and flucytosine in extemporaneously compounded oral liquids. Am J Health-Syst Pharm. 1996;53(16):pp1944-1949.

 

Wan-Man Ellaria Lee, Ralph A. Lugo, William J. Rusho, Mark MacKay, and John Sweeley. Chemical Stability of Extemporaneously Prepared Lorazepam Suspension at Two Temperatures. The Journal of Pediatric Pharmacology and Therapeutics: October 2004, Vol. 9, No. 4, pp. 254-258.

 

No I had done my own research on this and found evidence that the solutions I was making were good for about a year.

 

 

Wow!  A year? I’d be interested in seeing that evidence, SufferingSixty! As far as we know, none of the do-it-yourself liquids for any of the benzodiazepines discussed in this forum has been tested for strength/stability over time.  We’ve searched the literature plus checked for stability-indicating formulations in sources such as Allen’s Compounded Formulations, Nahata and Hipple’s Paediatric Drug Formulations, and Trissel’s Stability of Compounded Formulations.

 

The stability-indicating studies we’ve found for professionally compounded benzodiazepine liquids indicate drug concentration decreases over time, even when the formulations include excipients to improve stability/shelf-life.

 

For example, below is a table from a stability study for a professionally compounded clonazepam liquid (citation below). It shows the percent of the initial concentration of clonazepam (0.1mg/mL) remaining after 60 days:

 

Day % remaining

1   99.5%

14 98.8%

28 98.6%

60 98.1%

 

An almost 2% decrease in drug concentration over two months may not seem like much.  However, as I’m sure you know, it can make a big difference to individuals who are sensitive to small changes in dose, especially when they are tapering a potent benzodiazepine such as clonazepam.

 

Another study (citation below) found that the concentration of lorazepam in a professionally compounded liquid decreased to 88.9% of the initial concentration after three months.

 

Citations:

 

Clonazepam: Allen LV Jr., Erickson MA. Stability of acetazolamide, allopurinol, azathioprine, clonazepam, and flucytosine in extemporaneously compounded oral liquids. Am J Health-Syst Pharm. 1996;53(16):pp1944-1949.

 

Wan-Man Ellaria Lee, Ralph A. Lugo, William J. Rusho, Mark MacKay, and John Sweeley. Chemical Stability of Extemporaneously Prepared Lorazepam Suspension at Two Temperatures. The Journal of Pediatric Pharmacology and Therapeutics: October 2004, Vol. 9, No. 4, pp. 254-258.

 

Ok Ok these citations are excellent.  I'll keep that in mind and mind my own business