Compounding rx liquid Klonopin - which suspension to use?

Anyone have experience with compounded rx liquid Klonopin? 

 

My pharmacist said we could do propylene glycol / water combo or an oil-based suspension such as MCT oil or olive oil.

 

Would one be recommended over the other?

 

Anyone have experience with compounded rx liquid Klonopin? 

 

My pharmacist said we could do propylene glycol / water combo or an oil-based suspension such as MCT oil or olive oil.

 

Would one be recommended over the other?

 

The PG based solution will be a true, uniformly-distributed, stable solution.  And it will be fully dilutable if you want to change the concentration (mgs per ml), or make it more palatable.

 

The oil-based will be a suspension, no assurance of uniformity, and not readily dilutable.

 

Pg solution is definitely the best option,

Thanks builder for your input. 

 

My pharmacist said the PG-based solution would only have a two week fridge life, so I would need to fill the script twice a month and that the oil-based suspension would last many months.  I don't recall if that had to stay in the fridge or not. 

 

So when you talk about the GP-based solution being more stable, you mean that from a uniformly-distributed standpoint and not necessarily from a "shelf life" / expiration standpoint, correct? 

Thanks builder for your input. 

 

My pharmacist said the PG-based solution would only have a two week fridge life, so I would need to fill the script twice a month and that the oil-based suspension would last many months.  I don't recall if that had to stay in the fridge or not. 

 

So when you talk about the GP-based solution being more stable, you mean that from a uniformly-distributed standpoint and not necessarily from a "shelf life" / expiration standpoint, correct?

 

I really mean both. 

 

With all due respect, your pharmacist is wrong.  There are currently 4 Rx PG based liquid benzos available that have anywhere from 90 day to 3 year shelf lives. My PG based liquid V has a 3 year shelf life. There are thousands of PG liquid meds, both OTC and Rx that have 1-3 year shelf lives.  And it does NOT need to be refrigerated. 

 

The benzo is not perishable, and the PG is not perishable.  What ingredient is he going to add that would make the solution perishable?

 

And even if the 14 day figure was correct, so what? 

 

A suspension will probably work, a solution is much better.

 

BTW, in Canada, and much of the rest of the world, there is an PG + clonazepam  Rx liquid with a mfgr's recommended shelf life of 120 days.

Oh wow, I had no idea.

 

Is your PG based liquid V from a compounding pharmacy?  If so, could you share the name of the pharmacy or could I private message you to get it.  I would rather work with a pharmacist who knows what they are talking about, especially when it comes to benzo tapering.

 

The 4 Rx PG based liquid benzos with long shelf lives - are they compounded or from manufacturers.

 

I'm new to all of this and really appreciate your insight.

My liquid is an Rx liquid V, (Roxane Diazepam Oral Solution).  The Rx liquid K available in other countries is Roche Rivotril Oral Liquid.

 

All of the liquid benzos I referenced are mfg'd products.  But whether they are mass produced or locally compounded, the same combination of ingredients will give the same results.

 

And BTW, since there is no Rx liquid K available in the US, that isn't an option for you, but I would have more confidence in a mfgr that was a long time producer of a product under FDA supervision than a local pharmacy.  Rx manufactured liquid is the "gold standard" of liquid benzos.  Although most pharmacies are conscientious and diligent, there have been a number of issues reported here on BB with locally compounded benzo liquids.

 

And you know, you can easily dissolve your tablets in PG or vodka and make your own liquid K.

Thanks builder again for your help!

 

I have pancreatitis and just a few drops of alcohol exacerbates it.  I'm not sure if you're familar with pancreatitis, but it can put you in the hospital pretty quickly and has a high mortality rate, so using vodka is not an option for me.  I'm not even sure if PG is.  I was going to ask my pharmacist what % of alcohol that is compared to vodka.

 

Do you feel a dry cut taper would be better over an oil-based suspension?

PG is NOT alcohol.  It is actually the most commonly used pharma solvent world wide.  Extremely common food additive.  Its in your toothpaste.  Its in that bottle of cough/cold remedy in your medicine cabinet.  Its in about half of the sauces, salad dressings, etc in your pantry.

 

I'm not trying to discourage you.  Any system that allows you to make small, gradual dose reductions will allow you to taper off of benzos with with little or no discomfort.

Dry-cutting with scales will work.  Rx liquids will work.  "Homebrew" liquids with alcohol or PG will work. Milk solutions will work. Compounded suspensions will work.  There are real advantages to a true, uniformly distributed solution, but if circumstances mean that isn't a real option for you there are definitely other ways to taper off of benzos.

Thank you again for further clarification.  It sounds like my best route is the PG route.  I see a few recommended compounding pharmacies on this board, so I'll start calling more tomorrow to determine who would be the best to go with.

Thank you again for further clarification.  It sounds like my best route is the PG route.  I see a few recommended compounding pharmacies on this board, so I'll start calling more tomorrow to determine who would be the best to go with.

 

:thumbsup:

Hi Builder!  (Hoping you're on the boards this week & see this)

 

So I called two pharmacies, one of which was recommeded here on the boards and so far I'm 0 for 2 in terms of finding a PG based solution.  The one recommended was from awhile back and they have since moved away from benzo compounding.  I guess CA is really strict about a ton of things.  The other is in Boston and they use either a non-PG based, proprietary water-based suspension that has been third party tested for a shelf life of 60 days at room temp. 

 

I'm calling three more pharmacies today that are all PCAB / PCCA accredited and will report back. 

 

In the meantime, I do have a question for you.  The local pharmacist I had originally started with suggested a dose of 0.5mg / 1 ml, but my doctor didn't think that made sense and wrote the script as 0.5mg / 5 ml.  If I go back to the doctor and ask for the 1ml dosage, he would most likely allow it and write a new script.

 

So which is better in your opinion?  I'm usually good with numbers, but am having a hard time conceptualizing the taper down using the different syringes.  I measured it out and determined that a daily dose of 0.5mg at 5 ml is approx 1/2 Tbsp whereas the same dose with 1 ml is 1/4 tsp.  & once I'm towards the end of the taper, it would seem that the 1 ml would allow for smaller and smaller cuts.  So I'm leaning towards the 1 ml, but thought I would check in with the experts first.

 

Any and all advise is appreciated!

Hi Builder!  (Hoping you're on the boards this week & see this)

 

So I called two pharmacies, one of which was recommeded here on the boards and so far I'm 0 for 2 in terms of finding a PG based solution.  The one recommended was from awhile back and they have since moved away from benzo compounding.  I guess CA is really strict about a ton of things.  The other is in Boston and they use either a non-PG based, proprietary water-based suspension that has been third party tested for a shelf life of 60 days at room temp. 

 

I'm calling three more pharmacies today that are all PCAB / PCCA accredited and will report back. 

 

In the meantime, I do have a question for you.  The local pharmacist I had originally started with suggested a dose of 0.5mg / 1 ml, but my doctor didn't think that made sense and wrote the script as 0.5mg / 5 ml.  If I go back to the doctor and ask for the 1ml dosage, he would most likely allow it and write a new script.

 

So which is better in your opinion?  I'm usually good with numbers, but am having a hard time conceptualizing the taper down using the different syringes.  I measured it out and determined that a daily dose of 0.5mg at 5 ml is approx 1/2 Tbsp whereas the same dose with 1 ml is 1/4 tsp.  & once I'm towards the end of the taper, it would seem that the 1 ml would allow for smaller and smaller cuts.  So I'm leaning towards the 1 ml, but thought I would check in with the experts first.

 

Any and all advise is appreciated!

 

1)  A solution is better than a suspension!  But...a suspension is usually "good enough".  If a suspension is properly prepared by a trustworthy pharmacy, and it is .1mg per ml, it will be OK.

 

2)  .5mg = 5ml is the same as .1mg=1ml...that's the ratio I always recommend.  It's dilute enough to measure small dose units, and is easiest to calculate/plan.  No math, just move the decimal.

 

3)  If you can't get a compounded PG solution, make your own.  Its simple.

Thanks builder!

 

So if 0.5mg = 5ml and my first dose cut is 5%, so now my new dose for the week is 0.475, do I take up 4ml using a 5ml syringe and the remaining dosage from a 1ml syringe going up to the midway mark between 0.7 and 0.8?

Thanks builder!

 

So if 0.5mg = 5ml and my first dose cut is 5%, so now my new dose for the week is 0.475, do I take up 4ml using a 5ml syringe and the remaining dosage from a 1ml syringe going up to the midway mark between 0.7 and 0.8?

 

Yes, the new dose (5% cut) will be .475mg.  That will be 4.75ml of liquid.

 

Yes, 4ml with the 5ml syringe, and .75ml (between .7 and .8 ) on your 1ml syringe.

THANK YOU!

Thanks builder for your input. 

 

My pharmacist said the PG-based solution would only have a two week fridge life, so I would need to fill the script twice a month and that the oil-based suspension would last many months.  I don't recall if that had to stay in the fridge or not. 

 

So when you talk about the GP-based solution being more stable, you mean that from a uniformly-distributed standpoint and not necessarily from a "shelf life" / expiration standpoint, correct?

 

I really mean both. 

 

With all due respect, your pharmacist is wrong.  There are currently 4 Rx PG based liquid benzos available that have anywhere from 90 day to 3 year shelf lives. My PG based liquid V has a 3 year shelf life. There are thousands of PG liquid meds, both OTC and Rx that have 1-3 year shelf lives.  And it does NOT need to be refrigerated. 

 

The benzo is not perishable, and the PG is not perishable.  What ingredient is he going to add that would make the solution perishable?

 

And even if the 14 day figure was correct, so what? 

 

A suspension will probably work, a solution is much better.

 

BTW, in Canada, and much of the rest of the world, there is an PG + clonazepam  Rx liquid with a mfgr's recommended shelf life of 120 days.

 

Hey builder, do you know the name of the manufacturer that makes the PG + clonazepam Rx liquid that is used in Canada & elsewhere?  After speaking with several compounding pharmacists, I found one who was willing to put some research in to see if he could make me a solution instead of a suspension.  I told him it was available outside the US and he asked if I knew who the manufacturer was so he had an idea of what was being done.  So wanted to check with you to see if you know who specifically offers that 120 day shelf life clonazepam solution you speak of.

Thanks builder for your input. 

 

My pharmacist said the PG-based solution would only have a two week fridge life, so I would need to fill the script twice a month and that the oil-based suspension would last many months.  I don't recall if that had to stay in the fridge or not. 

 

So when you talk about the GP-based solution being more stable, you mean that from a uniformly-distributed standpoint and not necessarily from a "shelf life" / expiration standpoint, correct?

 

I really mean both. 

 

With all due respect, your pharmacist is wrong.  There are currently 4 Rx PG based liquid benzos available that have anywhere from 90 day to 3 year shelf lives. My PG based liquid V has a 3 year shelf life. There are thousands of PG liquid meds, both OTC and Rx that have 1-3 year shelf lives.  And it does NOT need to be refrigerated. 

 

The benzo is not perishable, and the PG is not perishable.  What ingredient is he going to add that would make the solution perishable?

 

And even if the 14 day figure was correct, so what? 

 

A suspension will probably work, a solution is much better.

 

BTW, in Canada, and much of the rest of the world, there is an PG + clonazepam  Rx liquid with a mfgr's recommended shelf life of 120 days.

 

Hey builder, do you know the name of the manufacturer that makes the PG + clonazepam Rx liquid that is used in Canada & elsewhere?  After speaking with several compounding pharmacists, I found one who was willing to put some research in to see if he could make me a solution instead of a suspension.  I told him it was available outside the US and he asked if I knew who the manufacturer was so he had an idea of what was being done.  So wanted to check with you to see if you know who specifically offers that 120 day shelf life clonazepam solution you speak of.

 

You can make your own emulsion with full fat milk. It's reliable, easy to make and only necessities are a trip to a grocery store.

Wish I could.  The casein in milk causes me chronic sinus inflammation.

Hey builder, do you know the name of the manufacturer that makes the PG + clonazepam Rx liquid that is used in Canada & elsewhere?  After speaking with several compounding pharmacists, I found one who was willing to put some research in to see if he could make me a solution instead of a suspension.  I told him it was available outside the US and he asked if I knew who the manufacturer was so he had an idea of what was being done.  So wanted to check with you to see if you know who specifically offers that 120 day shelf life clonazepam solution you speak of.

 

Here’s a link to a New Zealand Consumer Medicine Information leaflet from May 2017 on Rivotril® 2.5 mg/mL oral solution (drops):

 

https://medsafe.govt.nz/Consumers/cmi/r/rivotril.pdf

 

Manufacturer is Roche Products (New Zealand) Limited.

 

Inactive ingredients are:

 

saccharin sodium (954), propylene glycol (1520), glacial acetic acid (260), peach flavour PHL-014725 and brilliant blue FCF (E133, CI42090)

 

Please let us know if the compounding pharmacist is able to make a solution for you!

 

 

 

 

Hey builder, do you know the name of the manufacturer that makes the PG + clonazepam Rx liquid that is used in Canada & elsewhere?  After speaking with several compounding pharmacists, I found one who was willing to put some research in to see if he could make me a solution instead of a suspension.  I told him it was available outside the US and he asked if I knew who the manufacturer was so he had an idea of what was being done.  So wanted to check with you to see if you know who specifically offers that 120 day shelf life clonazepam solution you speak of.

 

In Canada, clonazepam is Rivotril, the the liquid is made by Roche.

 

And any pharmacist (or you yourself) can make a liquid clonazepam solution using propylene glycol.

Thank you