Taper going great...want to know how to adjust it with 1 less pill

Hi everyone, I could really appreciate your advice. I have downloaded the excel taper sheet and started with (4 1mg xanax tabs) 4mgs daily total in 800 ML of water. Every day I remove 2ML from the total ( which is 800ML water with 4 1mg tabs crushed in) I then pour what is left after my 2ML cut into 4 jars. For example I am now pulling and tossing 140ml and dividing whats left into 4 jars.

 

This has been working for me so far, but I am getting close to only needing to put 3 1mg tabs in...and then do my 2ml pull and divide into 4 jars.

 

I'm not sure how to make the adjustment. I want to continue as I am but don't want to waste a pill that I won't be needing. So I need to make a new chart with 3 pills instead of 4. Another reason I want to do this is because I am realizing the more time that goes by the greater the percentage every 2 weeks. Right now my drop every 2 weeks is 4.07% and I'd like to keep it around that amount as so far I am able to continue to work.

 

It's probably simple to do, but I can't figure out how to make a new schedule. If I just put 3 pills in 800ml instead of the 4 would that be correct? I don't think so 

 

I'd really appreciate some guidance on this one. Thanks in advance!!!!!

 

PS I'm not sure how to send an attachment or a photo of my schedule if that would help.

You are right that the same amount of liquid with a different number of pills and removing the same amount would not keep your removed amount consistent. But here is the thing: right now you are throwing away almost a whole pill worth of liquid every day? Why not switch it around, make around bigger batch, draw out your daily doses into the little jars, and keep what's left for the next day? Why throw your medicine away? Wouldn't you rather have a backup stash of all the pills you didn't use in case you ever has an issue getting a refill during your taper?

When you get to pulling 200 mL total from your solution (i.e. drinking 600 per day), switch to making 800 mL but only using 3 1 mg pills. And go back up to taking the full 800 mL, and start removing 2 mL a day again. Your cut will be lower, but keeping the percentage cut the same.

 

I hope that makes sense.

 

 

Don’t use water, you’re leaving yourself open to massive dose variance since benzodiazepines are not soluble in water. You’re also using way too much solution.

 

Use the titration calculator at http://benzo.alwaysdata.net and it will give you the proper math to make a solution and then you want to get either alcohol (80 proof/40% or higher) or propylene glycol and add 2mL of which you choose per milligram of benzo and then add water to get to the desired concentration. You’ll then use 1mL and 10mL syringes to measure out your doses. This makes a true solution. Water can’t even make a suspension.

Actually, based on the solubility numbers I have seen, she is using enough water to make a solution. Xanax is either "slightly" or "sparingly" soluble in water (I don't remember which), which does exempt it from being made into a liquid medication using water that could feasibly be given in hospitals or stocked by pharmacies (that would be a lot of giant bottles), BUT is feasible for her to do at home.

Solubility numbers are in a perfect world. Why use a massive amount of water and hope that it’s going into solution when we know for a fact that a minor amount of alcohol or propylene glycol and water will absolutely make a solution?

She is using 8 times the amount of water needed in a lab environment. It should be sufficient. I'm not saying that it is ideal or what I would choose to do. But if she has been doing it this way for over 2 months and is having zero symptoms, I wasn't going to push a change, aside from the one that would help rectify the problem she is having.

 

And the lab tests for solubility in water are no more or less questionable than the ones for ethanol and water or propylene glycol and water, those numbers are also "in a perfect world", not to mention the fact that no one has been able to point to a study where they run tests on a successful stable solution that has THEN been further diluted with water.

 

I really didn't intend to start a debate, I just don't want someone to be pressured to change something that is working for them.

Alprazolam is a white crystalline powder, which is soluble in methanol or ethanol but which

has no appreciable solubility in water at physiological pH.

 

Source:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018276s045lbl.pdf

Alprazolam is a white crystalline powder, which is soluble in methanol or ethanol but which

has no appreciable solubility in water at physiological pH.

 

Source:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018276s045lbl.pdf

 

Yeah, I get that it's poorly water soluble. But if you take the time to read further than the first Google result, you can find actual solubility numbers, at different temperatures and different pH levels. At ph 7, which is the pH of pure water and very close to the average for tap water,  and at or near room temperature, alprazolam has been tested in various studies to have a water solubility of 0.0324 mg/ml, which is 3.24 mg / 100 ml, or 40 mg/l, which is 4 mg / 100 ml.

 

Again, I am not saying that it is ideal. It's kind of a lot of water. You can't make and store a large batch, etc. I am just saying that if you use a ton of water, like faith is, it should work fine. There is just as much evidence for that working fine as there is for an alcohol/water or pg/water solution, if not more, because of the lack of studies regarding further water dilution of a stable solution.

The first Google search? Not likely.

 

All that's been created is an unreliable Xanax and water suspension at best, and I use that term loosely.

 

If this is how they choose to make a liquid, I'd rather they dose 3 mgs in pill form, the other in a more reliable solution.

 

I never have and never will support on unreliable method, period.

 

Waves, I wish you a good end to your taper. To the OP, I wish you well also.

 

I'll stick to what I've learned from Jana, not the shit methods I see all too often here.

 

It is time to for me to say bye bye to BB.

 

Benzo-off,

 

My intention is not to offend, or create discord. I just want to be sure that others are receiving accurate information. If you have sources that contradict what I have read, please will you provide them? My only goal here is to share what I have learned, and to continue to learn, myself.

https://www.pharmatutor.org/articles/enhancement-solubility-characteristics-of-alprazolam

 

The main problem associated with alprazolam is its poor water solubility. Hence the present work aims at preparing efficient water soluble complexes of alprazolam, HP-β-Cyclodextrins and PEG6000 to improve bioavailability.

 

MATERIALS AND METHOD

 

Materials

Alprazolam was obtained as a gift of Cipra Pharmaceutical, Pune. Hydroxy propyl β cyclodextrin(HP-β-CD)was obtained from Gangwal Chemicals, Mumbai. Polyethylene glycol(PEG6000) was obtained from S-d Fine Chemicals, Mumbai. All the rest chemicals used were of analytical grade.

 

Methods

Preparation of complexes1,2

a) Physical Mixture

Alprazolam with HP-ß CD and PEG6000 in ratios 1:1, 1:2, 1:3 were mixed in a mortar for about one hour with constant trituration. The mixture was passed through sieve no. 80 and stored in dessicator over fused calcium chloride.

 

b) Kneading Method

Alprazolam with HP-ß CD and PEG6000 in ratios 1:1, 1:2, 1:3 were taken. Hydroxy propyl β cyclodextrin is added to the mortar and triturated with small quantity of 50% ethanol to prepare a slurry. Slowly the drug is incorporated into the slurry with constant trituration. The prepared slurry is then air dried at room temperature for 48hrs. The resultant product is pulverised and passed through sieve no. 80 and stored in dessicator over fused calcium chloride.

 

Evaluation

 

Phase solubility analysis3

Phase solubility studies for alprazolam complexes were performed to determinethe stoichiometry of drug. Complexes containing 10mg of the drug weretaken and added to 20ml proportions of distilled water in volumetric flasks, each containing variable amount of hydroxypropylb-cyclodextrin (HP-b-CD) such as 3, 6, 9, 12 and 15x10-3 moles/liter. The abovesolutions were shaken for 72hrs on a rotary shaker. Then the solutions werefiltered and absorbance’s were recorded at 226nm.The solubility of alprazolamin every solutions were calculated.

 

Drug content estimation4

50mg of complex was accurately weighed and transferred to 50 ml volumetricflask and volume was made up to the mark with methanol. Form this 1ml wastaken in 10ml volumetric flask and the volume is adjusted up to the markwith same solvent. The absorbance of the solution was measured at 226 nmusing appropriate blank.

 

Preparation of Alprazolam-HP-β-CD& Alprazolam-PEG6000 complex tablets5

The complexes each separately single polymer (HP-β-CD), second polymer (PEG6000) super disintegrant (crosscarmellose sodium), filler (microcrystallinecellulose), lubricant (magnesiumstearate) and glidant (talc) were blended together by dry mixing in a laboratory mixer (poly bag) for 10 mins. The mixture was then compressed using 8mmstandard concave punch and die set (Pilot Press 12 station) at compressionforce 6 ton. The formulations of the tablets with their code are listed in tableno.2 and 3. Total tabletweight is kept at 300 mg.

 

 

As far as I can tell, this is a study using additives to enhance the water solubility of the drug in tablet form. I have read a number of these studies because it is interesting, and loosely related to the issue of making a liquid solution, via the solubility testing, but we are not trying to make new tablets, here, we are talking about making a reliable liquid from which to dose the medication.

 

I have read studies showing the solubility in water, which is poor, which is why you need to use a lot of it ifor you want to do it that way. I have read studies showing solubility in alcohol/water and alcohol/pg, which show very good solubility so long as the alcohol or pg make up about 85-90% of the solution, and lesser solubility the more dilute it is. I have not seen a study that creates an ideal solution (85-90% ethanol/pg and 10-15% water) or a less ideal solution (40% ethanol or pg and 60% water) and then further dilutes it and then re-tests the consistency of the new solution. I have also seen no studies using milk. Both of these options work, in theory, to be sure, but there is no evidence that I have found to be able to reference.

 

On the other hand, I can reference countless water solubility studies. Yes, they all show that these drugs are poorly water soluble. That means it cannot be used to create a liquid medication that could be dispensed by a pharmacy. In Faith's case, for instance, a 10 day supply would have to be dispensed in a 1 liter bottle. So for the pharmaceutical companies, obviously it is a no-go. But for Faith? And for anyone who wants to do it this way, it's not NOT an option. Right?

HopeToDoThis,

 

Thank you for your reply. This does make sense. I checked the spreadsheet and you are correct when I reach 3 pills I will be pulling exactly 600ml out of my 800ml. The only difference I do see is that instead of my end date being Jan 6, 2020 it will now be April 14, 2020 (if I don't change it again when I reach 2 pills). I see this dragging out longer and longer, but I understand that I must do this if I don't want my % every 2 weeks to get too high. The way my sheet looks now...when I am down to just half a pill (.5) I will be dropping at a whopping 21.88%/2weeks yikes!

 

So if I am understanding you correctly...when I get to the day (March 12) that I'm pulling 600ml out and am taking 3 pills, I start all over with 800ml of water with 3 pills dissolved in it and start fresh again at taking out 2ml per day?? If this is accurate the way I understand it, it is actually a good thing because I was getting concerned that when I got to a very low amount of liquid, I wasn't sure how i would divide that into 4 doses.

 

A note to all who were so kind to offer advice...Although I appreciate the advice I do not want to change my method right now. I may have to at some point and I understand that water may not offer the perfect solution...but it appears to be working for me. I don't want to try something new, to be honest I am scared to. For now, this is working for me. I am not saying it's a breeze, but I am grateful that I am still able to work. I do have bad days, sometimes bad weeks, but so far I have been able to manage. Dare I say, I have a general sense that I actually feel better the more I drop (which shocked me)!!

 

I have symptoms but I am also doing everything in my power to help this process. I meditate, get enough sleep, handle stress better than I used to, do very light exercise and stretching, most of all I eat super clean. I drink lots of water and only water. I aim to finish my 3L bottle of Poland Spring every day in addition to my liquid doses. I mean, I do not stray with my diet AT ALL. I eat Keto and avoid all things high in glutamate. No sugar or sugar substitutes. No gluten, no dairy. I watch what I put in my body and on my body. No more vitamins, supplements, nothing. I have noticed my brain feels sharper when I have more healthy fats the day before. I try to have a whole avocado every day and for a snack I eat my veggies with organic coconut spread. I make sure to have lots of greens. One day I went out to dinner with my daughter and picked all healthy items for my meal...or so I thought. I had oysters.( This was in the beginning of my journey and I thought they were safe) Boy did I pay for it! I felt horrible. I googled and found out they were high in Glutamate. I have learned my lesson and now I eat nothing until all ingredients are checked first. If i do slip and I am sensitive to something my symptoms worsen.

 

I am just curious why everyone thinks I am drinking so much water? Even on day one when I was drinking 798ml of water, when you split that into 4 doses it's only 200ml each dose. Its a small juice glass, it's 3 gulps. I look at it as a positive...it helps to keep me hydrated 

 

Thank you all for being self-less and offering help. I truly appreciate it 

Faith,  it only seems like a lot of water when compared to other liquid medications. But you are right, there certainly is nothing wrong with drinking lots of water.

 

I can understand your fear of change and respect your desire to keep your current method. If you stick to your old way of doing it when going down to 3 mg, as Hope described, your first 2 week cut will be 3.5%. That  is a reasonable rate. However, if you think you would like to keep the pace quicker, there are a few options.

 

1. You could just make the exact same ratio solution by mixing 3 mg with 600ml of water. Your four doses would be 150ml each to start, easy to split up, and your amount removed AND percentage of original dose removed would stay the same.

 

2. You could also just change the amount removed. So you could still put the 3 mg in 800 ml, but remove 3 ml a day instead of 2. Your first 2 week cut doing this would be 5.3%.

 

 

I never have and never will support on unreliable method, period.

 

 

 

I'll stick to what I've learned from Jana, not the shit methods I see all too often here.

 

 

 

:thumbsup:

Don’t use water, you’re leaving yourself open to massive dose variance since benzodiazepines are not soluble in water. You’re also using way too much solution.

 

Use the titration calculator at http://benzo.alwaysdata.net and it will give you the proper math to make a solution and then you want to get either alcohol (80 proof/40% or higher) or propylene glycol and add 2mL of which you choose per milligram of benzo and then add water to get to the desired concentration. You’ll then use 1mL and 10mL syringes to measure out your doses. This makes a true solution. Water can’t even make a suspension.

 

 

:thumbsup:

 

 

Thank you Waves for explaining other options to me! I don't know why I find this so complicated...

 

I do understand that water is not the most accurate method. I have looked at the link with the other calculator at benzoalwaysdata.net but do not know how to fill it out. Is there somewhere that explains how to complete the calculator? For arguments sake I tried this but don't know if it's accurate.

 

Under Medication I put 4mgs

 

Under Liquid Solution number of tablets to dissolve 4

 

Under Daily Dose I put

1mg

1mg

1mg

1mg

 

I hit submit, but don't know if I am filling it out correctly  :'(

I thought you were approaching 3 MG per day, not 4. Are you just running the calculator to see what your schedule would have been? I'm a little confused as to what you are looking for, but if you can help me understand,  I am happy to help.

LOL yes, I am sorry for confusing you. I just put 4 to try to practice since that was my original dose. So sorry 

Also, "correctly" is subjective because it depends on what you want to do with it. Let's say you wanted to taper 5% every 2 weeks, readjusting to the new daily dose every two weeks. I use this as an example because many people are comfortable with this rate. In this case you would choose

 

Tablet strength: 2 MG

Dose 1: 0.75 mg

Dose 2: 0.75 MG

Dose 3: 0.75 MG

Dose 4: 0.75 MG

You would then blank out the "reduction amount" box, and put 5% in the "reduction percentage" box, and 14 days. You would select "across all doses" instead of "first dose first".

Then you would NOT select EITHER "combine with tablets" or "attenuated ending".

 

If you submit it correctly based on this criteria, the graph that accompanies the spreadsheet will have a curved, not a straight, line.

 

Let me know if this is helpful or not.

I am still a bit confused. If the tablet dose is 2mg then how can you be taking .75 4 x a day?

 

In my case I was originally taking a total dose of 4mg...so that would be 1mg 4x a day correct?

 

So with my soon to be 3mg dose, I would put in 3mg and then .75mg 4x a day?

 

I'm so sorry my mind just makes things so much more confusing then they probably are

Yep. 3 ÷ 4 = 0.75

 

So if you wanted to keep your doses equal this is how you would do it.

I apologize for not responding sooner. We had a death in our family. I appreciate you help. Thank you for your kindness and patience.