Need help with compounded solution and dosage to start taper please.

Hey guys, I was going to try doing a milk titration by myself, but I found that a pharmacy near me does compounding. I take 0.5 mgs of lorazepam 3 times a day (1.5mg daily dose) does anyone know the solution I should ask for and about how much I should taper per day? I would really appreciate some help on this as my math is HORRIBLE.

Hi,  I would NOT recommend using milk with lorazepam as it does not dissolve it.  There are other much better alternatives and it seems you found one in getting a compound liquid made.

 

The concentration needs to match your measuring equipment.  You want to be able to measure daily cuts from say .001mg to .01mg, so if you are planning on using a 1ml syringe a concentration of around .01mg/ml will mean that each .1ml contains .001mg.

 

As for cut size I'd suggest beginning with .002mg per day and try it for a few weeks to see how it goes.  If good then you can consider edging it up and repeat.  Keep doing this until you find a cut that increases symptoms then back off.

 

Thanks for replying, so how do I know how full a 1 ml syringe needs to be to achieve my starting dose? I'm needing to take 3 doses a day because of lorazepams short half life. should I make a cut to dose 1 on day 1 then a cut to dose 1 and 2 on day 2, etc? Im sorry, im having some real trouble grasping this, my cognitive abilities are shot and I need someone to walk me through it.

We'll get through it don't worry.  I'm surprised three is enough with lorazepam.  Most seem to need four.  But it's a good sign you can get by with three.

 

What I would do is make your cut from the full daily dose then divide that into the individual doses.

Thank you for your patience. How many ML would it take from the solution you mentioned to equal 1.5mg? How would I take .002 from that 1.5mg and then divide it into 3 doses? Im sorry for being ignorant, the meds im on make me really foggy all the time.

There are many ways to do it.  A lot of people minimize liquid by using liquid just for the "cut" portion and take the rest in pills.  Others make the entire dose into liquid.  Some use syringes, others use pipettes.

 

The solution I mentioned was .01mg/ml.  That means each ml contains .01mg.  So that would be 150ml for a dose of 1.5mg if the entire dose was liquid.  You might be able to get away with a .1mg/ml solution (10X more concentrated).  In that case each tick mark on a 1ml syringe would be .001mg and the total dose of 1.5mg would be 15ml.

Im starting to think a vodka/ora plus titrate might be simpler because I just don't know how I would hold up taking .002 from my daily dose which is divided into thirds every day. That's some pretty hard math for my foggy brain to handle. What would you think of me putting the entire daily dose into a 100 ml solution, cutting 1 ml (1%) a day ( holding when needed) and dividing what I don't cut into thirds? Essentially ending the taper in 100 days (I know its fast, is it too fast?)

 

Also, if I do go with the compounded version of tapering, is there some sort of computer managed program to help me with the math?

I've seen vodka used with lorazepam with great success.  It dissolves it.

 

1% per day is too fast.  You will be holding a lot at that rate.  I'd suggest finding the highest cut that you can do every day that does not make you hold.  Then just ride it.  But it is up to you.

 

Don't worry about the math.  Don't let it scare you.  It is easier than you think.  Instead of putting the entire dose into 100ml you could put it into 150ml to keep the math simple.  This would be a .01mg/ml solution.  Then to get a .002mg cut you would remove .2ml.  I like this concentration because only the decimal point moves.  The digits remain the same.

 

I 'm going to bed now so I'll pick it up in the morning.  Good night.