Switching from pill to liquid diazepam: advice?

Hello,

I just completed a crossover from 1 mg Ativan to 9 mg Valium after approx. 3 months on benzos for insomnia and seizures following discontinuation of birth control. My doctor prescribed the Roxane liquid diazepam suspension to assist with a micro-titration, but I'm wondering how to switch over from pill to liquid form.

I've seen quite a bit on this site related to homemade suspensions, but not much on the commercially prepared stuff (it's an alcohol suspension). Has anyone used it? Is the transition from pill to liquid something that needs to be done slowly?

Any advice/guidance would be greatly appreciated. 

Facingmountains

That's a fairly popular product.  I used it and many others too.  It's great because it is a solution and can be easily diluted with water while remaining a solution.  I don't think it has any alcohol in it unless it is the Intensol (5mg/ml).

When going from pills to liquid a lot of people choose to only liquify one or two mg at a time and keep the rest pills.  But you can also liquify it all.  There is often symptoms which arise from the switch.

Hello,

 

I just completed a crossover from 1 mg Ativan to 9 mg Valium after approx. 3 months on benzos for insomnia and seizures following discontinuation of birth control. My doctor prescribed the Roxane liquid diazepam suspension to assist with a micro-titration, but I'm wondering how to switch over from pill to liquid form.

 

I've seen quite a bit on this site related to homemade suspensions, but not much on the commercially prepared stuff (it's an alcohol suspension). Has anyone used it? Is the transition from pill to liquid something that needs to be done slowly?

 

Any advice/guidance would be greatly appreciated. 

 

Facingmountains

1)  The pharma=grade liquid Vs are solutions, not suspensions.

2)  ...and as SG has advised, there is an  alcohol-based product (Diazepam Intensol), but this is not commonly used for tapers.  Intensol is a concentrate, (5mg=1ml) which is really counter to the concept of microtapering.  The more commonly used liquid V is Diazepam Oral Solution (5mg=5ml).  Both the Intensol and the Oral Solution can be diluted.

3)  People rarely "switch" from pills to liquid, they just take the "cut" portion of their dose as liquid (typically 1ml and less).  I started my liquid microtaper at 9mg total dose, and took 8mg in pills, and the balance by liquid.  You should not experience any difficulties making that small transition, but just as a precaution, you might want to add the 1mg of liquid with no reduction for 10 days-2 weeks.

Great, thanks so much for the advice. Sounds like pills + liquid (I checked - it is the solution) may be the way to go.

In terms of timing, still trying to get a sense of a reasonable guideline for a titration timeline. I've only been on this stuff for three months and don't want to prolong the exposure, but also don't want to trigger severe withdrawal symptoms and end up having to backtrack. The Ativan/Valium crossover took just over a month and went fairly smoothly, but I'm a bit in the dark about where and when to start the cuts.

Facingmountains,

The key to starting your taper is, how do you feel?  It sounds like you are doing good with the liquid V so you could start tapering now.  As you said, you don't want to be on this stuff longer than you need to be.  If I were you, with somewhat short term use.  I would start with 1% a day for a week and if that isn't an issue.  Increase to 2% which would bring you to 0% in 2 months.  Again go with how you feel.

Stay strong!

sharkey

Great, thanks so much for the advice. Sounds like pills + liquid (I checked - it is the solution) may be the way to go.

 

In terms of timing, still trying to get a sense of a reasonable guideline for a titration timeline. I've only been on this stuff for three months and don't want to prolong the exposure, but also don't want to trigger severe withdrawal symptoms and end up having to backtrack. The Ativan/Valium crossover took just over a month and went fairly smoothly, but I'm a bit in the dark about where and when to start the cuts.

Speaking very generally, I would not expect to be off for at least six months and maybe more like a year, although some go even longer.  But it would be good to forget time if you can and just keep it open-ended and go solely by how you feel.

As for a starting point, at your dose I'd begin by removing .03mg per day and see how you react for a few weeks.  If all is good, nudge it up to .04mg and re-test.  Keep doing this until you find a cut that brings on symptom increase, then back off.

Thanks for the guidance, Sharkey and SG57.

I was able to crossover from 1 mg A directly to 9 mg V with few problems, so perhaps that's a good sign? However, since I had such a severe reaction to coming off the progestin birth control in Dec (symptoms similar to benzo w/d, perhaps not surprising since they both affect GABA receptors), I think it makes sense to start slow with the daily titrations and go from there.

FM