heip with a plan

hi first time I have been able to even try posting anything ( it will take awhile to get this correct), Iam currently on .25mg lorazepam 3x day.  I think I would like to do a water taper to taper more slowly have read so much I just get more confused. If I want to space my doses from 3 x day to 4 and keep the same amount .75 daily would it make me  have interdose WDs by splitting the .75 4 times a day versus 3 as I would be below my initial dose .25 3x day and what dose is it at 4 x day have not really started anything yet just splitting .5 mg tablets but cutting for 4 doses will throw  the splitting out the window any help going to 4 doses a day. and will I get interdose wds with this more than iam now sorry for over explaining feel like I have severe brain damage cant put my thoughts down very well . any simple explanations so welcome

hi first time I have been able to even try posting anything ( it will take awhile to get this correct), Iam currently on .25mg lorazepam 3x day.  I think I would like to do a water taper to taper more slowly have read so much I just get more confused. If I want to space my doses from 3 x day to 4 and keep the same amount .75 daily would it make me  have interdose WDs by splitting the .75 4 times a day versus 3 as I would be below my initial dose .25 3x day and what dose is it at 4 x day have not really started anything yet just splitting .5 mg tablets but cutting for 4 doses will throw  the splitting out the window any help going to 4 doses a day. and will I get interdose wds with this more than iam now sorry for over explaining feel like I have severe brain damage cant put my thoughts down very well . any simple explanations so welcome

 

You definitely can do a liquid taper ,  but you really can't do a water taper.  Your benzo is NOT water soluble.

 

But you can dissolve it in a tiny amount of solvent (vodka or propylene glycol) then dilute it with water.

Hello!

Just wanted to say I'm sorry you're having trouble right now. I don't have much in the way of answers either.

Correct me if I'm wrong, but I think I'm hearing:

1. You want to go from .25mg 3x daily to 4x daily.

2. Splitting this pill further doesn't give accurate doses.

3. You would like to mix your pill in a liquid to take more accurate doses

4. You are worried that taking smaller doses spaced out will cause interdose withdrawal symptoms.

 

I do not know how you will react to taking a smaller dose 4 times a day. Have you ever split up the dose into smaller doses before? That would be the best way to guess how you may feel splitting up this dose now. But, just my guess, you will not experience too much discomfort between doses if you aren't experiencing much right now. And the control of a slow, controlled taper will far outweigh initial discomfort.

 

You could start by taking your first one or two .25mg doses in pill form and the rest as a suspension (crushed up pills in liquid)?

 

For example (I AM STILL FIGURING THIS OUT AND NOT RECEIVING MUCH HELP SO THIS COULD BE WRONG!):

1. Split one .5mg pill in half and take that .25mg in pill form. (Put the other half in the pill bottle for tomorrow.)

2. Take a whole .5mg pill and finely crush it into some sort of measuring cup or graduated cylinder.

3. Fill the cup with water up to an amount that's easily divisible by 3. (75mL for example)

4. Let it sit until you're ready for your next dose.

5. Shake, don't stir, immediately before removing 25mL and drinking that 25mL.

6. Repeat, drinking 25mL at each dose time.

 

I hope another member or a pharmacist can help you figure this out.

 

Much luck to you!

Ari

 

For example (I AM STILL FIGURING THIS OUT AND NOT RECEIVING MUCH HELP SO THIS COULD BE WRONG!):

1. Split one .5mg pill in half and take that .25mg in pill form. (Put the other half in the pill bottle for tomorrow.)

2. Take a whole .5mg pill and finely crush it into some sort of measuring cup or graduated cylinder.

3. Fill the cup with water up to an amount that's easily divisible by 3. (75mL for example)

4. Let it sit until you're ready for your next dose.

5. Shake, don't stir, immediately before removing 25mL and drinking that 25mL.

6. Repeat, drinking 25mL at each dose time.

 

I hope another member or a pharmacist can help you figure this out.

 

Much luck to you!

Ari

 

I really don't mean to be argumentative, but it doesn't matter how much you crush, grind, mix, shake, stir, etc, the benzo is NOT water-soluble

 

 

Several common benzos (diazepam, lorazepam, alprozalam) are available in Rx liquid.  All of the Rx liquid formulations are either an alcohol or PG solvent, diluted with water.  They are made that way, because the benzos (except Librium and midzolam) are NOT water-soluble

Yes.

 

That is why I used words like crush, shake, etc. To denote that I mean the the pill is being crushed into smaller parts. The word "suspension" also denotes this meaning. Note how I did not use the word "dissolve." That would be because I do not wish to give the impression the pill dissolves in water!

 

Water may be the least effective suspension. That might be a useful thing to point out or remind someone about? But I tend to lean toward listening to people and helping them in the way they ask.

 

This person said they'd done a lot of reading. I did a lot of reading as well. I trusted that they read the sticky threads in this forum that explain suspensions work better with higher viscosity fluids like whole milk. But many people have used water just fine.

 

Many people choose easily accessible fluids for suspension because they feel more comfortable not adding another chemical solution to the mix. Also, water juice and milk are cheaper and easier to get. Some people have adverse reactions to ingredients in pharmaceutical suspensions or ethanol or propylene glycol.

 

Some people do not wish to make a solution.

 

There were several other questions and concerns this person expressed in their post. You might seem less argumentative if you offer advice and suggestions for the concerns people have stated that are unrelated to whether or not a solution or suspension is better.

If you cannot do that, maybe you should try offering help to people making solutions!

 

I imagine it would be much less frustrating for you and you could help a lot more people that way.

hi first time I have been able to even try posting anything ( it will take awhile to get this correct), Iam currently on .25mg lorazepam 3x day.  I think I would like to do a water taper to taper more slowly have read so much I just get more confused. If I want to space my doses from 3 x day to 4 and keep the same amount .75 daily would it make me  have interdose WDs by splitting the .75 4 times a day versus 3 as I would be below my initial dose .25 3x day and what dose is it at 4 x day have not really started anything yet just splitting .5 mg tablets but cutting for 4 doses will throw  the splitting out the window any help going to 4 doses a day. and will I get interdose wds with this more than iam now sorry for over explaining feel like I have severe brain damage cant put my thoughts down very well . any simple explanations so welcome

Hi cassy

 

I'm happy you decided to post and must say that you managed to put all right your ideas on it. I try to give you my viewpoint.

 

The liquid taper (someone improperly calls it water taper) allows you to reduce very small and precise amount of benzo from your dose. From an accuracy point of view it is the most precise taper method. When you put a benzo tablet in a cup of water, after a while the tablet disintegrates. What remain visible from the tablet are a few particles at the bottom. Because you can't no longer see the tablet, you are misled to think it is completely dissolved in water. It is not. If we use a microscope we will find benzo ingredients and the excipients (binder, coating, filler, etc...) deposited at the bottom due to gravity. When you shake the solution these ingredients and excipients will get into a swirl resulting in aleatory distribution of them within the solution. If you draw the liquid up with a syringe, you might be getting nothing or something. One thing is certain, you won't get the right dose. What shall we do then?

 

There are 2 ways:

- Directly use medication drops or use alcohol (insignificant quantity) to dissolve the tablet. Water is then added to make up the right volume. This method for those who accept alcohol is the most indicated one. For information the benzo liquid drops sold by pharmacy contains up to 20% of alcohol. There are buddies who for other reasons (can't bear alcohol, religious belief,...) don't even want to hear about alcohol regardless of the irrelevant volume being used. It is in fact not a matter of 1/4 nor 1/8 of a  glass of wine. In most cases it's about 4 or 5 ml of alcohol and when diluted with water results undetectable by taste. Nevertheless for those buddies, alcohol may be replaced by fatty milk or equivalent (Eg: Almond milk,...) whose fat can dissolve benzo.

 

- A different way is based on suspended solution instead of the previous dissolved solution. In this case commercial suspension liquid (Ora-Plus, SyrSpend,...) with its viscous property is used to keep benzo ingredients suspended all over the solution rather than floated on the surface or dropped to the bottom. The problem with this kind of solution, prepared by pharmacist or by yourself, is that there might be a drop in effects. This drop might be felt as small (5%-10%) or severe like a cold turkey depending on the person's metabolism.

 

Let's talk now about your intention to re-distribute your .75 mg of lorazepam to 4 times instead of 3. If intended to reduce the inter-dose withdrawal then I don't think you will need to. The elimination half-life of lorazepam is actually between 12 and 18 hours. That means the time required for the concentration of lorazepam to decrease by half in the body of an average person is minimum 12 hours. When you take 3 doses, the average time between 2 consecutive doses is about 8 hours and the inter-dose symptoms must be mild if any. The problem might be different when it comes to taper only 2 doses a day. Have you ever thought to taper the 3 doses altogether so they can extinguish altogether?

 

Wish you a good start and smooth journey towards a full recovery.

 

 

 

 

"For information the benzo liquid drops sold by pharmacy contains up to 20% of alcohol. "

 

For clarification in the US, there are 3 Rx liquid benzos, diazepam, lorazepam, and alprozalam.  Liquid diazepam is available in 2 formulations. 

 

The Diazepam Intensol is a 5mg per ml concentrate with a 19% alcohol content.  It is a concentrate, specifically formulated to be further diluted before use.  For example, if it were diluted down to a .1mg/ml solution as is commonly used for a taper, the alcohol content is reduced to .38%. For all intents and purposes, that's essentially zero.

 

The Diazepam Oral Solution is a propylene glycol based product with no alcohol.

 

Both the Lorazepam Intensol, and the Alprozalam Intensol are also PG based solutions and do not contain alcohol.