How to use Rx 1 ml:5 mg liquid diazepam? Help please.

I am currently tapering diazepam using both pills and homemade liquid solution from pills using a solvent and water. I liquid taper 1 mg at a time along with taking my pills at a reduction rate of .02 mg a day.  I have thought about using Rx liquid for my taper portion just because of the convenience and accuracy.

My pharmacist said he could get concentrated liquid diazepam, but only in 1 ml:5 mg solution. If I decide to go this route, how do I use it to taper one mg at a time since 1 ml = 5 mg?  My current taper rate is .02 mg a day using a 1 mg:100 ml ratio. I dose 2 x daily with the liquid in the evening.

I know this probably seems very simple to most of you, but I have had benzo brain the last couple of weeks.

Thanks to anyone who can help with using concentrate Rx diazepam.

JoJo

Hello, jojodancer.  It’s good to “see” you!

Am I understanding you correctly that your pharmacist told you s/he could get the 25mg/5mL Intensol but not the 5 mg/5 mL oral solution of diazepam?

If so, it would be both interesting and helpful to members of the community to learn his/her reasons for this.  (You also might want to consider looking for an alternative pharmacy — different pharmacies use different suppliers that stock different drugs.)

Might I encourage you to ask your pharmacist if it is OK to dilute the Intensol to achieve a lower concentration?  And, if I so, what procedure would s/he suggest?

I am neither a pharmacist nor a pharmaceutical scientist.  However, as a layperson, I would want to ask a suitably qualified professional the above questions in light of the following instructions from the drug information sheet at DailyMed:

Proper Use of an Intensol™

An Intensol is a concentrated oral solution as compared to standard oral liquid medications. It is recommended that an Intensol be mixed with liquid or semi-solid food such as water, juices, soda or soda-like beverages, applesauce and puddings.

 

Use only the calibrated dropper provided with this product. Draw into the dropper the amount prescribed for a single dose. Then squeeze the dropper contents into a liquid or semi-solid food. Stir the liquid or food gently for a few seconds. The Intensol formulation blends quickly and completely. The entire amount of the mixture, of drug and liquid or drug and food, should be consumed immediately. Do not store for future use.

I was told that I could get 5mg/1ml concentrate or 5mg/5ml non-concentrate. I was never told I could get 25mg/5ml concentrate.  And I am not sure what brand it is, maybe Roxane.

So if I need to make a 1 mg solution out the 5mg/1mil Rx liquid concentrate diazepam to taper, I am not sure of the process. I do not need 5 mgs of solution a day when I take the majority of my daily dose in pill form, unless I can make a 5 day batch from the 5mg/1ml liquid prescription.  That would give me 1 mg a day for 5 days, but I don't know if Rx liquid diazepam can be made in larger future batches instead of having to make it daily so it stays fresh.

Sorry if I am being confusing.  Maybe I should just stay with what I know and keep making my liquid out of my pills.

Thanks for the reply and help.

JoJo

1mg/1mL is equivalent to 5mg/5mL (5 divided by 5 = 1).

5mg/1mL is equivalent to 25mg/5mL (25 divided by 5 = 5).

Make sense? 

In case you’re wondering, the reason I gave the concentrations as 5mg/5mL and 25mg/5mL  is because those are the figures used in the drug information pamphlets on DailyMed. My apologies if doing this confused you.

For tapering purposes, the lower concentration is preferable.  My impression is we have multiple members who have used/are using the 5mg/5mL (1mg/1mL) oral solution of diazepam.  Do you know how to locate the Valium/Diazepam Support Group?  That might be a good place to find info/ask questions.

Do you know how to locate the Valium/Diazepam Support Group?  That might be a good place to find info/ask questions.

Valium Support Group  It's a thread so if you have questions just jump in and ask, no need to start a new topic.

I was told that I could get 5mg/1ml concentrate or 5mg/5ml non-concentrate. I was never told I could get 25mg/5ml concentrate.  And I am not sure what brand it is, maybe Roxane.

In my experience it is easier to use the 5mg/5ml non-concentrate since it allows you to taper by smaller amounts.  1 ml of this is equal to 1 mg of Valium. 

I am using this in combination with with diazepam pills.  I use the liquid to taper.  I am now down to 1.9 mg of valium/diazepam a day.

I mix it with water at a ratio of 1 ml of liquid diazepam to 9 ml of water.  I make a large batch that I later draw my doses from because it is much easier than trying to mix one dose at a time when I need it.  I got these instructions, information and rationale from the poster Builder.

Mixing the liquid diazepam with water in a ratio of 1 ml of liquid diazepam to 9 ml of water makes the math easier while tapering and provides you a solution with a lower concentration of diazepam, which allows you taper daily by a smaller amount.  This creates for an easier taper.

I use a 10 ML syringe that I bought in a batch from Amazon:[nobbc]https://www.amazon.com/gp/product/B01JJYMOP6/ref=oh_aui_search_detailpage?ie=UTF8&psc=1[/nobbc].  This syringe allows me to measure as low as .2 ml or 2/10ths of an ml.  This allows you to make reductions by .02mg of valium after the liquid valium is diluted with 1 part liquid diazepam to 9 parts water.

Use a jar that is clean and can seal tightly.  I bought several the jars in case I break one.

I use the 10 ML syringe to measure out 10 ML liquid Diazepam/valium and spray it into the jar.

I then use the same syringe to draw 10 ml of water and spray it into the jar.  I repeat this 9 times so that the jar now has a total of 90 ml of water and 10 ml of liquid diazepam in it.  I use these numbers as an example.  You can certainly make a larger batch if you like.

By drawing the water into the same syringe after I used it to draw the liquid diazepam and spraying it into the jar, I make sure to wash out any of the liquid Diazepam that might have stuck in the syringe--although none is visible to me.

I now have a jar with 100 ml of solution with the water at a 9-1 ratio with the liquid diazepam.  At this point I close and shake the jar.  I also shake it every day before drawing my daily dose.

Another thing that I do is pour a bunch of the liquid diazepam out of its container into a glass jar and use that to draw from to make my mixture.

I do this for two reasons:

1. It is very hard and awkward to draw the liquid diazepam out of its container while it is much easier to do so out of a jar since the jar has a wider top to get the syringe into and is smaller and easier to work with.

2. I am afraid that I might wind up dropping or spilling the liquid diazepam container if I am trying to tilt it to draw liquid out of it with a syringe.

When taking my dose, I shake the jar with the mixture, open it, and use the 10 ml syringe to draw out however much of the diluted liquid valium that I need and then I spray it down my throat.

Edit: Deactivated commercial link

Greetings, confuseduser. 

I agree with you that the FDA-approved 5mg/5mL oral solution of diazepam is preferable for tapering and hope that jojodancer will be able to find a pharmacist who could obtain this for him if he pursues this option.

Thank you ever so much for sharing how you dilute the 5mg/5mL solution to create a liquid with a concentration of 0.1mg/1mL.  You don’t sound like a “confused user” —  the description of the procedure you use is both clear and helpful.

PS If you are interested in learning about a device that makes it easy to measure liquids directly from a bottle using an oral syringe, here’s a video for you:

Proper Use of Adapter Cap and Oral Syringe

Thanks Confuseduser for the information.

I can get 5mg/5ml non-concentrate, but I was not sure if I could mix a non-concentrate with water.  My pharmacist wasn't clear about the dosage directions.  I think he was having a hard time understanding how I was using the liquid to taper. I don't blame him, because my benzo brain probably was not making much since to him. 

This is great information and makes the math a whole lot easier.  I have been using a 1 mg:100 ml ratio with my homemade liquid just because it is easier for me to see the 2 ml mark on the syringe instead of the .2 ml marking.  I dissolve 1 mg diazepam pill into 2 ml of vodka and 98 ml of water. Does it make a difference if I use a 1:100 ratio instead of a 1:10 ratio like you do with Rx liquid?

Thanks for the help confused user and you too Libertas,

JoJo

I will defer to others who have experience with using the 5mg/5mL solution. (For what it’s worth  ... based on what I’ve read, if I were in your shoes, I would use either the undiluted 5mg/5mL solution or the 1:9 dilution that confuseduser uses).

I hear you about the challenges of reading the syringe lines, especially on a 1mL syringe with 100 graduations!  Here’s a post I wrote on a “solution” that works for me:

Difficulty reading syringe lines when measuring liquids?

http://www.benzobuddies.org/forum/index.php?topic=236287.msg3030011#msg3030011

Thanks Confuseduser for the information.

 

I can get 5mg/5ml non-concentrate, but I was not sure if I could mix a non-concentrate with water.  My pharmacist wasn't clear about the dosage directions.  I think he was having a hard time understanding how I was using the liquid to taper. I don't blame him, because my benzo brain probably was not making much since to him. 

 

This is great information and makes the math a whole lot easier.  I have been using a 1 mg:100 ml ratio with my homemade liquid just because it is easier for me to see the 2 ml mark on the syringe instead of the .2 ml marking.  I dissolve 1 mg diazepam pill into 2 ml of vodka and 98 ml of water. Does it make a difference if I use a 1:100 ratio instead of a 1:10 ratio like you do with Rx liquid?

 

Thanks for the help confused user and you too Libertas,

JoJo

IMO it is best to use the 5mg/5ml as is, directly from the pharmacy. The reason being is that there is less chance for error in dosage, uniformity, spoilage etc. Also with Valium there is no need to dilute because unlike klonopin and Xanax, Valium is not as concentrated.  (1mg of X & K = 20mg V.)

Thanks Confuseduser for the information.

 

I can get 5mg/5ml non-concentrate, but I was not sure if I could mix a non-concentrate with water.  My pharmacist wasn't clear about the dosage directions.  I think he was having a hard time understanding how I was using the liquid to taper. I don't blame him, because my benzo brain probably was not making much since to him.

Liquid Valium is not common and most pharmacists and doctors have little to no experience with it.  So I am not surprised that your pharmacist wasn't clear about the dosage directions.

This is great information and makes the math a whole lot easier.  I have been using a 1 mg:100 ml ratio with my homemade liquid just because it is easier for me to see the 2 ml mark on the syringe instead of the .2 ml marking.  I dissolve 1 mg diazepam pill into 2 ml of vodka and 98 ml of water. Does it make a difference if I use a 1:100 ratio instead of a 1:10 ratio like you do with Rx liquid?

Honestly the 1:100 dilution ratio that you mentioned is uncharted territory for me.  I think it might be over diluting the liquid valium.  I can understand having trouble reading the .2 ml marks on a 10 ml syringe.  Maybe try 19 parts water to 1 part liquid valium.

 

Thank you ever so much for sharing how you dilute the 5mg/5mL solution to create a liquid with a concentration of 0.1mg/1mL.  You don’t sound like a “confused user” —  the description of the procedure you use is both clear and helpful.

I chose a this username randomly, and at the time I was new to all of this and very overwhelmed.  I am not confused any more and I am certainly not a user.  I hate taking the Benzos, but I obviously have to taper gradually.

In November 2018 I wanted to change my username, but was told that due to the limitations of the messsageboard I would have to open a new account and have this account closed.  I thought it better to stay with the username and account where I have a history of posts and people know me.  So COnfuseduser I am.

PS If you are interested in learning about a device that makes it easy to measure liquids directly from a bottle using an oral syringe, here’s a video for you:

 

Proper Use of Adapter Cap and Oral Syringe

That is a useful link to a very cool device.  Thanks for posting it. 

 

IMO it is best to use the 5mg/5ml as is, directly from the pharmacy. The reason being is that there is less chance for error in dosage, uniformity, spoilage etc. Also with Valium there is no need to dilute because unlike klonopin and Xanax, Valium is not as concentrated.  (1mg of X & K = 20mg V.)

You raise a valid point, Gudruna.

But the instructions on the bottle of liquid Diazepam specifically state to dilute to increase palatability.  Without diluting it, the liquid diazepam is very harsh tasting to the point that it would be very, very difficult to take.  Once diluted with a 9 to 1 ratio of water to liquid diazepam it tastes like very mild cough syrup.

Also, the liquid valium is quite sticky and if you take it directly a small amount might stick in the syringe. 

Most importantly, diluting the liquid Diazepam gives you a solution with a lower concentration of Diazepam. This allows you taper daily by a smaller amount.

I use a 10 ML syringe that has markings down to .2ml and a 1 ML syringe that allows me to easily make cuts of .1ml.  .1 ML of the solution is equivalent to .01 mg of Diazepam, that is 1/100 of a milligram.  If the liquid valium was undiluted I could not make these smaller cuts  This works better  for a daily liquid micro taper.

I will defer to others who have experience with using the 5mg/5mL solution. (For what it’s worth  ... based on what I’ve read, if I were in your shoes, I would use either the undiluted 5mg/5mL solution or the 1:9 dilution that confuseduser uses).

 

I hear you about the challenges of reading the syringe lines, especially on a 1mL syringe with 100 graduations!  Here’s a post I wrote on a “solution” that works for me:

 

Difficulty reading syringe lines when measuring liquids?

http://www.benzobuddies.org/forum/index.php?topic=236287.msg3030011#msg3030011

I want to thank everyone who help me with their post on this topic!!!

I have much more knowledge now and I think I am on the right track o what information I was looking for.

JoJo

Your post lifts my spirits, jojodancer!  I wish more of our members would do what you have done — recognize and thank those who have offered input and assistance.  I am delighted that you received the information you were looking for and that it has helped you. Libertas

 

IMO it is best to use the 5mg/5ml as is, directly from the pharmacy. The reason being is that there is less chance for error in dosage, uniformity, spoilage etc. Also with Valium there is no need to dilute because unlike klonopin and Xanax, Valium is not as concentrated.  (1mg of X & K = 20mg V.)

 

You raise a valid point, Gudruna.

 

But the instructions on the bottle of liquid Diazepam specifically state to dilute to increase palatability.  Without diluting it, the liquid diazepam is very harsh tasting to the point that it would be very, very difficult to take.  Once diluted with a 9 to 1 ratio of water to liquid diazepam it tastes like very mild cough syrup.

 

Also, the liquid valium is quite sticky and if you take it directly a small amount might stick in the syringe. 

 

Most importantly, diluting the liquid Diazepam gives you a solution with a lower concentration of Diazepam. This allows you taper daily by a smaller amount.

I use a 10 ML syringe that has markings down to .2ml and a 1 ML syringe that allows me to easily make cuts of .1ml.  .1 ML of the solution is equivalent to .01 mg of Diazepam, that is 1/100 of a milligram.  If the liquid valium was undiluted I could not make these smaller cuts  This works better  for a daily liquid micro taper.

Hey confuseduser!

Yes the instructions do suggest dilution for palatability. The instructions also says use diluted solution promptly. With Valium in particular, a 1ml/1mg solution measuring out miniscule amounts is easy if using a 1ml 100 increment syringe. Each line on this type of syringe equals .01ml when using a 1ml/1mg solution.

btw, I successfully did a daily micro taper using a 1ml=1mg solution. No dilution was necessary prior to measuring dose. I would suggest for those tapering Valium using a pharmaceutical solution to measure out undiluted dose and then dilute it as necessary using immediately.  Klonopin and Ativan should be diluted to 1ml/.10mg because they are more concentrated than Valium (1mg K/A =20mg/10mg=V)

Thank you for clarifying the meaning of “Dilute for palatability,” Gudruna!  I’ve read posts from members indicating they use the undiluted 5mg/5mL oral diazepam solution but don’t care for the taste.  So, they measure their dose using an oral syringe, add it to a more palatable liquid (e.g. soda, tea, juice — just not grapefruit per link below), and then drink the mixture immediately. 

I’ve also read it’s a good idea to “flush” any remaining solution from the syringe by filling it several times with water, squirting the water into the glass, and then drinking the rinse water.  Did you do this?

Grapefruit and medication: A cautionary note - Harvard Health

https://www.health.harvard.edu/staying-healthy/grapefruit-and-medication-a-cautionary-note

Confuseduser, this is a part of one of your previous post that was very helpful and easy to understand.

"I use the 10 ML syringe to measure out 10 ML liquid Diazepam/valium and spray it into the jar.

I then use the same syringe to draw 10 ml of water and spray it into the jar.  I repeat this 9 times so that the jar now has a total of 90 ml of water and 10 ml of liquid diazepam in it.  I use these numbers as an example.  You can certainly make a larger batch if you like.

By drawing the water into the same syringe after I used it to draw the liquid diazepam and spraying it into the jar, I make sure to wash out any of the liquid Diazepam that might have stuck in the syringe--although none is visible to me.

I now have a jar with 100 ml of solution with the water at a 9-1 ratio with the liquid diazepam.  At this point I close and shake the jar.  I also shake it every day before drawing my daily dose."

These figures would roughly give me a 10 day supply.  If I only wanted to make a 5 day supply, would I add 5 ml of Rx valium with 45 ml of water to make a total of 50 ml?  If my math is correct, wouldn't this still give me a 1 mg/10 ml solution? I'm just a little concerned about a 10 day batch loosing potency.

Thanks again,

JoJo

These figures would roughly give me a 10 day supply.  If I only wanted to make a 5 day supply, would I add 5 ml of Rx valium with 45 ml of water to make a total of 50 ml?  If my math is correct, wouldn't this still give me a 1 mg/10 ml solution? I'm just a little concerned about a 10 day batch loosing potency.

Thanks again,

JoJo

Your math is correct.  5 ml of Rx valium with 45 ml of water to make a total of 50 ml.  Once you mix it, seal the jar and give it a few shakes.  Each day before I take my dose, I give the jar a shake or two.

I have not had a problem with a batch losing potency over 10 days.  But it is something worth consideration.

Once I have made my batch I store it in a closed jar in a closed cabinet.  Before I started the liquid taper there were a lot of tiny details that worried me. 

Thanks for the reply.

I am currently at 7 mg a day.  I take 3 mg in pill in the morning and 3 mg in pill at night along with liquid tapering 1 mg at a reduction of .02 mg a day, which takes 50 days to taper 1 mg. As I stated before, I dissolve 1 mg valium in 10 ml of vodka and mix with 90 ml of water for a 1 mg:100 ml solution each day.  I then toss 2 ml a day from each 100 ml solution...Ex: Day one I drink 98 ml then day two I drink 96 ml and so on until I am down to zero at day 50. I know tossing is a waste, but it is the only way I know how to taper.

So, if I mix 5 mg of  liquid Valium with 45 ml of water for a total of a 50 ml solution, this would still be a 1 mg:10 ml ratio, correct?  If so, how would I measure my daily doses with a ten ml syringe to keep my reduction at .02 mg a day? And how will I know when I have finished tapering 1 mg?

Sorry for all the questions, but dosing directly from the syringe is a totally new method for me.

Thanks again for the help with this method I am not familiar with.

JoJo :)

So, if I mix 5 mg of  liquid Valium with 45 ml of water for a total of a 50 ml solution, this would still be a 1 mg:10 ml ratio, correct?

That is correct.

If so, how would I measure my daily doses with a ten ml syringe to keep my reduction at .02 mg a day? And how will I know when I have finished tapering 1 mg?

I use the 10 ml syringe to draw from the mix that I prepared using the ratio of 1 ml of liquid valium to 9 ml water.  When I fill the 10 ml syringe up with the mix, the syringe has the equivalent of 1 mg liquid valium, since each ml of the mix is diluted to contain .1 mg of liquid valium.  So 10 mls of the diluted mix is the equivalent to 1 mg of liquid valium.  To keep it simple, remember that 1 ml of this diluted mix equals .1 mg/1 ml of liquid diazepam/valium.

The 10 ml syringe is graduated in increments of .2 mls by hashmarks.  So I just take .2ml less each day.  Because of the way it is diluted, .2 ml equals .02mg of valium/diazepam. 

I stick with the 10 ml syringe for simplicity.  If you have trouble seeing the .2 ml hashmarks on the syringe, you might need a magnifying glass.  It's also helps to keep a note of your daily doses to remember exactly what dose you are at for tapering purposes.

Don't get hung up on the .2ml amount or reducing every day.  Be flexible with yourself.  You don't have to reduce every day.  You could also reduce by a larger amount and wait a few days or even longer between reductions.  You can hold at a dose if you are having major issues.

The key thing with the liquid taper is that it allowed me to easily reduce by smaller amounts than I could with pills and with much less SXS. 

I did fine with dry tapering from 20 mg a day of Valium down to about 7.5mg.  From 10 mg on down I was using a pill cutter to slice 2 mg valium pills into quarters  allow me to make .5 mg cuts.  This was the smallest that I could accurately make with the pill cutter.  As I got lower, the .5mg cut represented a larger percentage of my total dose.  When I cut from 7 mg a day to 6.5mg a day, and then 6.5 mg a day to 6 mg a day, the symptoms became increasingly difficult, and I having to wait a month or more between .5 mg cuts.  Going over to liquid Valium and diluting it with water proved to be a lifesaver for me.  It allowed me to make tiny daily cuts that are smaller and more accurate than I could make using dry cutting.  And it greatly reduced the SXS that I was experiencing. 

Even if I just used the liquid diazepam/valium to make 1 ml cuts which would have been the equivalent of .1 mg of diazepam, it would have been much better than the .5 mg cuts that I was making with the pills.  Of course If I was making 1 ml/.1 mg cuts,  I would not be reducing every day and I would have held longer between reductions.  But I would have been able to make them more frequently and less painfully than the .5 mg cuts that I was making from the pills.

At times I have had to hold my taper for life reasons, health problems, medical procedures, etc.  I wanted to make sure I was minimally symptomatic in order to deal with them.  I have also held because I because my symptoms had ramped up.  In hindsight there were times when I could have held less and tapered at a higher rate.  The important thing is to find what works best for you.

Thanks Confuseduser,

I have been using a liquid micro taper since I started at 15 mg by taking pills and my homemade brew from pills.  I have also had to hold and slow down at different points in my taper due to increased sx, but I do agree that this is a better system than cutting pills to taper.

The reason for my questions is that I have never used prescription liquid Valium and was not sure if the process was different than what I have been doing.  I had also read where others had trouble with their bodies adjusting to prescription liquid after being use to dosing with homemade liquid from dissolving pills.

I'll talk to my Dr. and give it a try, because it seems like a lot less work and more accurate than having to dissolve pills for a homemade liquid. How low in you dose were you when you went to dosing once a day?  And what time of the day did you find dosing worked better for you?  I know we all react differently, but just curious.

Thanks again, you have been a great help with all the information from your own experiences.

JoJo

Thanks Confuseduser,

 

I have been using a liquid micro taper since I started at 15 mg by taking pills and my homemade brew from pills.  I have also had to hold and slow down at different points in my taper due to increased sx, but I do agree that this is a better system than cutting pills to taper.

 

The reason for my questions is that I have never used prescription liquid Valium and was not sure if the process was different than what I have been doing.  I had also read where others had trouble with their bodies adjusting to prescription liquid after being use to dosing with homemade liquid from dissolving pills.

 

I'll talk to my Dr. and give it a try, because it seems like a lot less work and more accurate than having to dissolve pills for a homemade liquid.

I think diluting the liquid diazepam is much easier and more accurate than dissolving pills.  Having said that, many buddies have used the dissolving pills method successfully.

How low in you dose were you when you went to dosing once a day?  And what time of the day did you find dosing worked better for you?  I know we all react differently, but just curious.

I think I was taking 8 or 8.5 mgs of Valium a day when I switched from dosing twice a day to once a day.  I started developing some symptoms, decided to try switching to once a day, and the symptoms went away.  They may have been unrelated to me switching to once a day.  Of course when I got to lower doses of valium I got worse symptoms--especially with those cuts that I mentioned from 7 mg a day to 6.5 mg a day and from 6.5 mg a day to 6 mg a day.  Deciding when to switch from twice a day to once a day with valium is an individual thing and everyone is different.  I've seen people who keep dosing twice a day down to very low levels. 

Thanks again, you have been a great help with all the information from your own experiences.

JoJo

Glad to help.  It is part of paying it back to make it easier for other people who find themselves in my situation.