PLEASE HELP! Need instructions! How do I mix OraPlus with Mirtazapine?

Could someone help me? I need step by step instructions on how to liquify Mirtazapine with Oraplus. I was told that Mirt is not soluble with just water and I need a suspension liquid to mix with it but all the instructions are very vague and not helpful. I have spent hours online looking for answers only to come up with nothing. Please anyone can you help me? 

From what I read, this is what I'd do...

 

Figure out the desired concentration (how many mg per ml) and how much (how many days supply) you want to make.

Calculate how much Mirt and how much OraPlus you'll need to make that solution

Accurately weigh out or measure the pills and OraPlus

Crush the pills into a fine powder.

Add ~25 ml OraPlus to the powder and mix well into a smooth slurry.

Add the rest of the OraPlus (and/or OraSweet if you want a flavoring) to bring up the volume to the amount you need.

Mix well.

Probably safest to store in the refrigerator and to mix well before each use.

 

I can probably help you with calculations if you wish.

 

I saw a lot of minor variances to the above.  Probably most would work OK. 

From what I read, this is what I'd do...

 

Figure out the desired concentration (how many mg per ml) and how much (how many days supply) you want to make.

Calculate how much Mirt and how much OraPlus you'll need to make that solution

Accurately weigh out or measure the pills and OraPlus

Crush the pills into a fine powder.

Add ~25 ml OraPlus to the powder and mix well into a smooth slurry.

Add the rest of the OraPlus (and/or OraSweet if you want a flavoring) to bring up the volume to the amount you need.

Mix well.

Probably safest to store in the refrigerator and to mix well before each use.

 

I can probably help you with calculations if you wish.

 

I saw a lot of minor variances to the above.  Probably most would work OK.

 

Weigh out or measure the pills? If one pill is 15 mg... then 4 pills is 60 mg.  So then if I crush those pills and add my Oraplus and water etc. to the crushed pills and fill to the 60 ml line... I have 60 mg = 60 ml right? So then if I want to take 7 mg of Mirtazapine I would withdraw 7 ml's right?  That's the simplest way I can think of doing it.  Would that work? No need to weigh the pills if I do it that way... right? 

Yes.  That should work.

 

Make sure you initially mix into a small amount of the OraPlus.  It's easier to get a nice even slurry with a small amount - kind of like making gravy in a pan.

 

One source I read was from a pharmaceutical compounding group.  They advised to add a little extra medicine when making liquid formulations - up to 20%.  It apparently compensates for some reduction in absorption or availability.  I've seen several people in the forum make similar adjustments when switching to liquids.  So if you find that 7 ml doesn't quite feel like it should, you might need 8 ml to compensate for the switch to liquid.

 

Good luck!

Yes.  That should work.

 

Make sure you initially mix into a small amount of the OraPlus.  It's easier to get a nice even slurry with a small amount - kind of like making gravy in a pan.

 

One source I read was from a pharmaceutical compounding group.  They advised to add a little extra medicine when making liquid formulations - up to 20%.  It apparently compensates for some reduction in absorption or availability.  I've seen several people in the forum make similar adjustments when switching to liquids.  So if you find that 7 ml doesn't quite feel like it should, you might need 8 ml to compensate for the switch to liquid.

 

Good luck!

 

The only way I could figure that out is by weighing the powder and that's not going to happen. I don't want to up dose or guess so I'll just keep it at 60 mg's = 60 ml's.  If I have problems I will buy a scale for $25 and weigh the tabs.  Thank you!! I just finished a Clonazepam taper with water and I used the same system... it worked great.  I have been Benzo free for 6-months!!!

Hello, RaquelRocks.  I’ve included an article below that describes a method developed by compounding pharmacists to prepare an extemporaneous oral suspension of lorazepam using regular tablets as the drug source.  Although the drug used is different than yours, the method itself might be of interest (it’s described in the Preparation of Lorazepam Suspensions section). The pharmacists did not weigh or crush the pills (they dispersed/disintegrated them in water before adding the suspending vehicle).  Another plus of this method is that it minimizes drug loss due to surface transfer (the pharmacists prepared the suspension in the same bottle they used to dispense it). 

 

Based on what I’ve read and my own experience, when switching to a liquid formulation, some people experience a difference in effect whereas others don’t (I did not). In the former cases, there were often other factors that may have contributed to the perceived difference (e.g. drug loss due to the preparation method the individual used, making a reduction in dose at the same time as switching to the liquid formulation, high anxiety about making the switch).  When I switched to a professionally compounded oral suspension, I did not updose. Instead, I took the same dose and held it constant.  I then monitored myself for any changes in symptoms.  After I was confident I had adjusted to the new formulation, I began to make reductions. 

 

Reference:

 

Wan-Man Ellaria Lee, Ralph A. Lugo, William J. Rusho, Mark MacKay, and John Sweeley. (2004). Chemical Stability of Extemporaneously Prepared Lorazepam Suspension at Two Temperatures. The Journal of Pediatric Pharmacology and Therapeutics: October 2004, Vol. 9, No. 4, pp. 254-258. Accessed online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469120/pdf/i1551-6776-9-4-254.pdf

 

Hello, RaquelRocks.  I’ve included an article below that describes a method developed by compounding pharmacists to prepare an extemporaneous oral suspension of lorazepam using regular tablets as the drug source.  Although the drug used is different than yours, the method itself might be of interest (it’s described in the Preparation of Lorazepam Suspensions section). The pharmacists did not weigh or crush the pills (they dispersed/disintegrated them in water before adding the suspending vehicle).  Another plus of this method is that it minimizes drug loss due to surface transfer (the pharmacists prepared the suspension in the same bottle they used to dispense it). 

 

Based on what I’ve read and my own experience, when switching to a liquid formulation, some people experience a difference in effect whereas others don’t (I did not). In the former cases, there were often other factors that may have contributed to the perceived difference (e.g. drug loss due to the preparation method the individual used, making a reduction in dose at the same time as switching to the liquid formulation, high anxiety about making the switch).  When I switched to a professionally compounded oral suspension, I did not updose. Instead, I took the same dose and held it constant.  I then monitored myself for any changes in symptoms.  After I was confident I had adjusted to the new formulation, I began to make reductions. 

 

Reference:

 

Wan-Man Ellaria Lee, Ralph A. Lugo, William J. Rusho, Mark MacKay, and John Sweeley. (2004). Chemical Stability of Extemporaneously Prepared Lorazepam Suspension at Two Temperatures. The Journal of Pediatric Pharmacology and Therapeutics: October 2004, Vol. 9, No. 4, pp. 254-258. Accessed online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469120/pdf/i1551-6776-9-4-254.pdf

 

 

Thank you.  I prepared my solution yesterday and will be taking it tonight.  When I switched to Liquid from tablet during my Clonazepam taper I started the taper from day one with no issues.  I am going to take my regular dose of Mirt in the suspension for a few days and see what happens then I will start to taper.  I just pray I don't have issues with this taper.  I just want to be done with meds... so tired of all this.  :'(