Titration Questions - Combining benzos and dosage equivalence.

Hello,

 

Need some advice, please, to make sure I don't mess up.  I started titration tapering of Lorazepam and was having interdose w/d so I am crossing over to valium.  I think my system metabolizes the Lorazepam too fast even though I dose 4 times a day.  The change to water / Everclear titration went pretty well.

 

Q.  With the Ashton equivalency of 1 mg Ativan (Lorazepam) to 10 mg valium, is it correct that if I dissolve a 10 mg valium tablet in 100 ml water it would be the equivalent to dissolving 1 mg Lorazepam in 100 ml and then each .5 ml reduction would then be equivalent going forwards?  In other words, I can cut the valium by the exact same amount of liquid as my Ativan and have the correct dose?  Then, afterwards, the .5 ml Lorazepam in 100 ml = .5 ml valium.

 

Q.  I am still on two benzos, Lorazepam and valium.  During a crossover taper, which I know is another forum, from Lorazepam to Valium, can I combine the valium/lorazepam liquid into a single-dose cocktail?  Or should I keep the individual doses separate? 

 

I am just afraid that there will be some kind of reaction between the two benzos.  But it seems silly since I am drinking them both at the same time to keep them separate.  Plus, it's kind of complicated having separate little bottles of my benzos and keeping track which is which.  I just want to be safe and not introduce problems.  I am not suggesting storing the valium/lorazepam liquid together but only combining the two together when I am drawing out my 4 doses for the day.

 

Any help/advice would be appreciated.  I want to make sure that I have my titration dose equivalency correct from lorazepam to valium and that by mixing the two solutions together before dosing that I will not be creating some kind of toxic cocktail that could cause issues.

 

Then once fully crossed over to the valium I will resume a daily micro  taper.

 

Thank you!

 

 

 

 

Q.  With the Ashton equivalency of 1 mg Ativan (Lorazepam) to 10 mg valium, is it correct that if I dissolve a 10 mg valium tablet in 100 ml water it would be the equivalent to dissolving 1 mg Lorazepam in 100 ml and then each .5 ml reduction would then be equivalent going forwards?  In other words, I can cut the valium by the exact same amount of liquid as my Ativan and have the correct dose?  Then, afterwards, the .5 ml Lorazepam in 100 ml = .5 ml valium.

 

100ml water will not keep 10mg V dissolved since solubility of V in water is .04mg/ml.  You'd need to use a bare minimum of 250ml water.  I'd use smaller V pills if it were me.  Also, what is the proof/ABV?  And how much Everclear are you using?  10mg V is a lot to dissolve.

 

Q.  I am still on two benzos, Lorazepam and valium.  During a crossover taper, which I know is another forum, from Lorazepam to Valium, can I combine the valium/lorazepam liquid into a single-dose cocktail?  Or should I keep the individual doses separate?

 

I think it would be fine to combine them.  Not a problem.  hey should be dosed on their own schedules, but if the dose times happen to line up that's great.

 

I am just afraid that there will be some kind of reaction between the two benzos.  But it seems silly since I am drinking them both at the same time to keep them separate.  Plus, it's kind of complicated having separate little bottles of my benzos and keeping track which is which.  I just want to be safe and not introduce problems.  I am not suggesting storing the valium/lorazepam liquid together but only combining the two together when I am drawing out my 4 doses for the day.

 

I'd be careful about combining liquids into one liquid though.

<100ml water will not keep 10mg V dissolved since solubility of V in water is .04mg/ml.  You'd need to use a bare minimum of 250ml water.  I'd use smaller V pills if it were me. >

 

My primary care doctor will only prescribe 2 mg tablets but I need 4 per day to successfully crossover from Lorazepam per Ashton table.  My doctor does not agree to prescribe any more than that.  Found another doctor to prescribe the 10 mg tabs.  I cannot afford to change the second prescription to 2 mg tabs right now because insurance does not cover that doctor and also can't afford to throw any solution out.  (I am only working part-time due to this so money is very tight for us.) 

 

What I am doing is taking the 2 mg tablet split twice per day.  Then the 10 mg tablet is what I am using for the water titration to make up the difference which I save in a jar  I hope to use the water solution to make the reductions after my crossover is complete until I get down to less than 2 mg per day.

 

<Also, what is the proof/ABV?>

 

The Everclear is 150 proof. 

 

<And how much Everclear are you using?>

.3 or .4 ml, just enough until it looks like a paste in the mortar and pestle.

 

Then I have been mixing it in 100 ml of water.  Have only done this for one week which is the beginning of my crossover.  I am on day 8 now. 

 

Thank you so much for your help.  My doctor is clueless and the one that started me down this whole path and seems very uncomfortable to even talk about this but will keep giving me the 2 mg tabs at least for now.  Pdoc is threatening to practically c/t me with such a rapid recommended taper which I think means loss of job and home I live in with the family of 5 that I support.  I am thinking of not going back to her for fear she will do something drastic.

 

What I really need is to figure my way through this mess and do a gradual micro taper that will keep me functional enough to maintain my profession and support my family.

 

Thank you for responding to my message.

<100ml water will not keep 10mg V dissolved since solubility of V in water is .04mg/ml.  You'd need to use a bare minimum of 250ml water.  I'd use smaller V pills if it were me. >

 

My primary care doctor will only prescribe 2 mg tablets but I need 4 per day to successfully crossover from Lorazepam per Ashton table.  My doctor does not agree to prescribe any more than that.  Found another doctor to prescribe the 10 mg tabs.  I cannot afford to change the second prescription to 2 mg tabs right now because insurance does not cover that doctor and also can't afford to throw any solution out.  (I am only working part-time due to this so money is very tight for us.) 

 

What I am doing is taking the 2 mg tablet split twice per day.  Then the 10 mg tablet is what I am using for the water titration to make up the difference which I save in a jar  I hope to use the water solution to make the reductions after my crossover is complete until I get down to less than 2 mg per day.

 

<Also, what is the proof/ABV?>

 

The Everclear is 150 proof. 

 

<And how much Everclear are you using?>

.3 or .4 ml, just enough until it looks like a paste in the mortar and pestle.

 

Then I have been mixing it in 100 ml of water.  Have only done this for one week which is the beginning of my crossover.  I am on day 8 now. 

 

Thank you so much for your help.  My doctor is clueless and the one that started me down this whole path and seems very uncomfortable to even talk about this but will keep giving me the 2 mg tabs at least for now.  Pdoc is threatening to practically c/t me with such a rapid recommended taper which I think means loss of job and home I live in with the family of 5 that I support.  I am thinking of not going back to her for fear she will do something drastic.

 

What I really need is to figure my way through this mess and do a gradual micro taper that will keep me functional enough to maintain my profession and support my family.

 

Thank you for responding to my message.

 

That proof Everclear can dissolve a lot, but why are you using so little?  You want to make a liquid, not a paste.  I'd use 3ml and try just dropping the pill into it.  If it doesn't break up, drop it into 1ml water first to break it up, then add 3ml Everclear.  Mortar & pestle usually is not required.

 

Here is what I would try with your 10mg V pill.  Put it in an empty jar and tip the jar.  Add 1ml of water (to break up the pill).  Let it sit until it is disintegrated.  Add 3ml Everclear 150 and mix and let sit to dissolve.  Add 496ml water.  The result will be .02mg/ml liquid V.  If you want to make .01mg/ml for easier math add 996ml water instead.

 

Why so much water?  Water can only keep .04mg/ml V dissolved.  You need a lot to keep 10mg dissolved.

This is awesome.  I will try this today and let you know how it goes.  The math needs to be as easy to follow as possible so I will go with the 496ml water.  Guess I will also get my water quota for the day filled too.  <g>

 

This will be mixed with distilled water and refrigerated unless there is a reason to use tap water with the chlorine in it to kill any harmful bacteria and just leave it in the jar in the cupboard. 

 

This is awesome.  I will try this today and let you know how it goes.  The math needs to be as easy to follow as possible so I will go with the 496ml water.  Guess I will also get my water quota for the day filled too.  <g>

 

This will be mixed with distilled water and refrigerated unless there is a reason to use tap water with the chlorine in it to kill any harmful bacteria and just leave it in the jar in the cupboard. 

 

 

I think either tap or distilled will work.  Refrigeration might be okay, but I would just keep it at room temperature.  Temperature can change solubility and coldness makes liquids less soluble.  Also, store it in a dark place.

Hopefully this improved method will help me to stabilize into the titration better.  Thank you.