Problems with Liquid Mirtazapine??

I’m tapering off Mirtazapine. I’m now at 1.2mg. The only way to be able to measure a dose this small is by making a liquid form of the medication in a 1:1 ratio. 1ml = 1mg. I use OraPlus suspension liquid with H2O to make my solution. 1/2 OraPlus, 1/2 H2O. Mirtazapine will not dissolve into homogeneous solution but will go into a suspension. The manufacturer indicates a50/50 preparation  of it is appropriate. I’m wondering though at such a low dose if I’m always getting an accurate dose. Some days I feel awful other days fine and can’t account for the discrepancy. I’m just wondering if there’s anyone here getting off mirtazapine via a liquid form that has had similar trouble at a low dose range while using it in liquid form.

I’m tapering off Mirtazapine. I’m now at 1.2mg. The only way to be able to measure a dose this small is by making a liquid form of the medication in a 1:1 ratio. 1ml = 1mg. I use OraPlus suspension liquid with H2O to make my solution. 1/2 OraPlus, 1/2 H2O. Mirtazapine will not dissolve into homogeneous solution but will go into a suspension. The manufacturer indicates a50/50 preparation  of it is appropriate. I’m wondering though at such a low dose if I’m always getting an accurate dose. Some days I feel awful other days fine and can’t account for the discrepancy. I’m just wondering if there’s anyone here getting off mirtazapine via a liquid form that has had similar trouble at a low dose range while using it in liquid form.

 

I used a liquiid from a compounding pharmacy and got off at about 0.0024.  I was tapering another drug at the same time so I did not notice the up and down. But I am experiencing the same up and down pattern during benzo withdrawal and I understand why you are questioning things.  You are really getting low so all I can say is hang in there.  You will be getting off soon.

Ok thank you for your post

I’m tapering off Mirtazapine. I’m now at 1.2mg. The only way to be able to measure a dose this small is by making a liquid form of the medication in a 1:1 ratio. 1ml = 1mg. I use OraPlus suspension liquid with H2O to make my solution. 1/2 OraPlus, 1/2 H2O. Mirtazapine will not dissolve into homogeneous solution but will go into a suspension. The manufacturer indicates a50/50 preparation  of it is appropriate. I’m wondering though at such a low dose if I’m always getting an accurate dose. Some days I feel awful other days fine and can’t account for the discrepancy. I’m just wondering if there’s anyone here getting off mirtazapine via a liquid form that has had similar trouble at a low dose range while using it in liquid form.

 

Hi Pokey... if you are still here could you help me with that solution that you are talking about.  I successfully tapered off Clonazepam using alcohol and water but I'm not sure how Oraplus works.  Do you mean 50% water and 50% Oraplus? How many milligrams do you mix?  Do you put it the entire pill and then pull with a syringe? I can't find any videos or instructions on how to do it.  Hopefully you are done with your taper by now since this is an older post. 

Raquel:  I make a 1:1 suspension of mirtazapine using OraPlus. You will need a mortar and pestle to grind the pills up. You can buy small ones on Amazon. You can buy OraPlus on Amazon as well. Depending on what dose you are at now will determine how many tablets of mirtazapine you will need to grind up. I will use what I’m doing now as an example. I grind up 4- 7.5mg tablets. That’s 30mg of mirtazapine. To that I add 20ml of OraPlus and 10ml of H2O so that I end up with a suspension of 1mg/1ml.  I use a coffee frother to mix the mixture well. Mirtazapine tends to clump when added to the OraPlus. So you want to make sure it’s mixed well and be sure to shake bottle well each time you draw a dose.  Right now I’m at a dose of 1mg ( I reinstated) . So I draw up in the syringe 1ml. You can also use OraPlus only, you don’t have to add any water. I do because I think it makes the suspension a little thinner causing less bubbles in the suspension which can be problematic when drawing small doses. You should use a graduated cylinder ( also can buy on Amazon) to measure out the OraPlus and water. Hope this helps. Let me know if you have other questions.

 

Raquel:  I make a 1:1 suspension of mirtazapine using OraPlus. You will need a mortar and pestle to grind the pills up. You can buy small ones on Amazon. You can buy OraPlus on Amazon as well. Depending on what dose you are at now will determine how many tablets of mirtazapine you will need to grind up. I will use what I’m doing now as an example. I grind up 4- 7.5mg tablets. That’s 30mg of mirtazapine. To that I add 20ml of OraPlus and 10ml of H2O so that I end up with a suspension of 1mg/1ml.  I use a coffee frother to mix the mixture well. Mirtazapine tends to clump when added to the OraPlus. So you want to make sure it’s mixed well and be sure to shake bottle well each time you draw a dose.  Right now I’m at a dose of 1mg ( I reinstated) . So I draw up in the syringe 1ml. You can also use OraPlus only, you don’t have to add any water. I do because I think it makes the suspension a little thinner causing less bubbles in the suspension which can be problematic when drawing small doses. You should use a graduated cylinder ( also can buy on Amazon) to measure out the OraPlus and water. Hope this helps. Let me know if you have other questions.

 

Thanks Pokey,

 

I'm confused with the grinding of so many pills like that and I'm not at all good with math.  I basically want to take 5% off the pill every month.  So I'm thinking of taking 7mg the first week 6.5 the second 6 the third etc. so how would I do that?  I was originally thinking of just getting a precision mg scale and weighing it... removing the 0.5  mg that way and putting the rest in a capsule but I don't know if that works either.  I just want to be done with this crap and it looks so much more complicated than the Clonazepam taper.  I used alcohol for that but have been told that alcohol and Mirt don't go well together.  I'm just lost.  Im on a Facebook forum for Mirt and nobody is helping me there either.

I think perhaps it might work best for you to ask your doctor to ask a compounding pharmacy to make up liquid Mirtazapine for you if you are not chemistry or math kind of person. For one thing a scale that will weigh such small amounts you are talking about would need to be a laboratory grade balance and they are very $$$$$$. Also as you go down in dose if you are going make 5% cuts the amount you cut gets smaller and smaller as you go. For example to go down 5% from 7mg you’d cut it by .35mg, not .5 which means your dose would be 6.7mg(rounded up). Also making a cut every week is pretty fast. I think it would be easier for you to have a liquid form compounded for you by a compounding Rx and make 10% cuts every 3-4 weeks.

I’m tapering off Mirtazapine. I’m now at 1.2mg. The only way to be able to measure a dose this small is by making a liquid form of the medication in a 1:1 ratio. 1ml = 1mg. I use OraPlus suspension liquid with H2O to make my solution. 1/2 OraPlus, 1/2 H2O. Mirtazapine will not dissolve into homogeneous solution but will go into a suspension. The manufacturer indicates a50/50 preparation  of it is appropriate. I’m wondering though at such a low dose if I’m always getting an accurate dose. Some days I feel awful other days fine and can’t account for the discrepancy. I’m just wondering if there’s anyone here getting off mirtazapine via a liquid form that has had similar trouble at a low dose range while using it in liquid form.

 

All the research out there indicates that it takes about 3-4 months of being completely off the drug BEFORE you start to feel better.  I would try and jump off soon and then let your body heal.  That is what I plan on doing.  I wish I was as far along as you... good job!!