Liquid Tapering question

Does liquid solution go through your system quicker than a dry tablet?  I am giving myself the suggested 2-3 week minimum to let my body adjust from full dose in tablet form 2 mg. Xanax, to the same dose in liquid solution. I was beginning to cut the dose without waiting for my body to adjust from table to liquid.  Is it normal to feel noticeable side effects during the transition even though I'm holding the dose at 2mg?  I don't want to keep jumping from tablet to liquid back and forth, which so far I haven't except for the initial change. I'm terrified of "kindling".

There is so much to this process that frustrates me and makes me not want to even try.  I'm on Lamictal and gabapentin as well.  Been on those two for about 5 years, and on the Xanax for 26 years. 

Does liquid solution go through your system quicker than a dry tablet?  I am giving myself the suggested 2-3 week minimum to let my body adjust from full dose in tablet form 2 mg. Xanax, to the same dose in liquid solution. I was beginning to cut the dose without waiting for my body to adjust from table to liquid.  Is it normal to feel noticeable side effects during the transition even though I'm holding the dose at 2mg?  I don't want to keep jumping from tablet to liquid back and forth, which so far I haven't except for the initial change. I'm terrified of "kindling".

There is so much to this process that frustrates me and makes me not want to even try.  I'm on Lamictal and gabapentin as well.  Been on those two for about 5 years, and on the Xanax for 26 years.

 

You may want to consider a tablet liquid combo, it’s much easier and less of a shock to your system. Here’s a link to explain how to do this. http://www.benzobuddies.org/forum/index.php?topic=254653.2#post_hybrid

 

Slownsteady has to extensive notes on the entire process.

 

 

Hi Imnot crazy,

Yes, it is normal to feel symptoms while adjusting to a liquid, especially when replacing your entire dose with liquid as I believe you are doing. There are two major variables I consider when trialing a liquid. The first variable is the biocompatability of the liquid medicine, which basically means does it feel like the medicine form I was taking before and if not how long will it take to adjust to this change. And the second variable is tolerance of the liquid ingredients, which means, what if anything in the liquid could cause an internal reaction, or is causing a reaction, when I dose.

 

These two variables are seemingly impossible to anticipate before trialing the liquid. It's nice when a liquid medicine is made of a common source, like alcohol and water or Ora-Plus, because these substances can be trialed independent of the active drug ingredient, thereby finding out if any of the ingredients are intolerable before taking the next step and using the liquid ingredients to dose medicine. Unfortunately I believe you are trialing the commercially manufactured form of alprazolam which has the benefit of being a true solution, but I don't know any way to test the inactive ingredients separately from the alprazolam.

 

So in your case, I suggest the liquid trial is perhaps more risky but also rather simple as the two variables I mention are rolled into one. I suggest 10 days minimum of regular dosing to see if you can stabilize. If your symptoms are significantly increasing in severity over several days and without other obvious causes, I suggest returning to tablets immediately; I think the nebulous risk of kindling is not as severe an issue as trying to take a liquid with ingredients that your body cannot tolerate. However, ideally, 10+ days of steady dosing on liquid and your body will have had a chance to either adapt to any variables, or it will be raising doubts that this is going to work on the long-term.

 

Also, as TMH is suggesting, if you can get a prescription for both tablets and liquid a liquid/tablet hybrid can significantly reduce the risk of both trialing and dosing a liquid, reduce the cost, and reduce the consumption of solvents and other liquid ingredients. It isn't the best option in all cases (specifically low daily doses or many daily doses that require concurrent reductions) but it might be worth considering if your doctor is amenable to supplying a script for tablets as well, at least for an initial transition to liquid with less discomfort.

 

Probably by now you're in for a penny, in for a pound, with all liquid. No worries. I suggest sticking with your trial, practicing patience, and making room for a mystery to unfold. You're learning symptom-monitoring, which is the backbone of patient-led symptom-based tapering. It's normal to feel extra anxiety about tapering and withdrawal after so many years of regular dosing.

 

You're doing great! 

What type of liquid are you using?  A homebrew liquid you make yourself or a commercially manufactured oral solution? 

Thanks for all your replies, it feels great to get support.  I'm using a home brew of only water and the X tablet fully dissolved in the water.  300ml h20, the I divide it into four doses.  When starting this taper a few weeks ago, I went on the 4 doses to relieve interdose w/d which I was experiencing when taking only 2 doses, an am and a pm. I'm probably adjusting to that physiologically as well.

I'm glad to know I'm not imagining these symptoms being so strong during the start of this liquid taper, switching over from dry tabs.

 

Thanks for all your replies, it feels great to get support.  I'm using a home brew of only water and the X tablet fully dissolved in the water.  300ml h20, the I divide it into four doses.  When starting this taper a few weeks ago, I went on the 4 doses to relieve interdose w/d which I was experiencing when taking only 2 doses, an am and a pm. I'm probably adjusting to that physiologically as well.

I'm glad to know I'm not imagining these symptoms being so strong during the start of this liquid taper, switching over from dry tabs.

 

Hi Imnot crazy,

I'm glad Libertas asked, because I was thinking from other threads of yours that you had a manufactured liquid. I was wrong!

 

Some information that might be useful to consider: alprazolam does not readily dissolve in water. The tablets deconstruct, but from what I've read, only 0.04mg/ml can be dissolve in water and only under ideal conditions. So what I believe you've created is a water suspension of undissolved alprazolam particles (plus other tablet excipients, some dissolving, some suspending).

 

In my experience a suspension, particularly in a poor suspension vehicle like water, requires careful handling and dosing methods to reduce inaccuracies. The tablet contents that dissolve rapidly into the water might include things like dye, lactose, etc, and these are not the alprazolam. I think the alprazolam is likely to be some of the fine particles that settle quickly to the bottom of the liquid.

 

To dose a water suspension of tablets I suggest strong agitation (vigorous stirring and/or shaking) immediately before drawing a discard or dose (depending on your method) from the middle of the volume of liquid.

 

Lastly, since it sounds like you are doing a daily discard method, I suggest rinsing your primary measuring vessel with a little water and adding this to your divided doses. I suggest repeating this rinse of the dosage jars after you drink each dose and swallowing the rinse water. This last step is intended to minimize the chance that medicine has clung to the sides of your vessels and reduced your dosage; it might be unnecessary but it's easy and I would do this myself if I was doing a water suspension.

 

Water suspensions are unreliable to my understanding, and I am wary of them especially for short-acting benzos like alprazolam. That being said, they are simple to produce and they have worked for many many taperers. I hope the suggestions above help you to improve the reliability of your liquid dosing. 

If water suspensions are unreliable.what are my options for xanax liquid taper?  Will I be hurting myself more by switching over to another solution formula at this point?  Is the reason people use vodka to 100% dissolve tablets like xanax and the fillers they use in manufacturing?  I would never be able to afford a true prescription liquid.  I'm so overwhelmed.

Other BB suggested I have to wait 2-3 weeks for my body to stabilize after switching from a dry taper to a liquid which I'm doing.  Aren't there no guarantees even when shaving off dry pills that one is getting all medication and not more fillers one day and less the next becasue the med isn't fully distributed in the tablet?  This is making me crazy.  I'm freaking out because now I feel like doing a water taper is bad.

I'm sorry to hear how overwhelmed you are. In my last post I highlighted some techniques which I think improve the reliability of a water suspension. I suggest implementing some or all of these techniques if you can.

 

You are right: there are no guarantees in tapering. I think any homemade liquid carries a risk of being unreliable, but also every at-home modification of a pharmaceutical carries a similar risk, from weighing and shaving tablets on a cheap scale to just splitting tablets. By changing the form of the drug by shape, weight, and/or chemically, I think we are taking a nebulous risk, and yet a risk that many of us accept because it appears to be our best option forward in health.

 

I think you are referring to a myth about drug distribution in pressed tablets. It's true that the medicine in a potent benzodiazepine tablet is a very small percentage of the total volume, but to my understanding basic tablet manufacturing consists of very large batches with a very high standard of homogenization. Furthermore I read somewhere that scored tablets meet even higher standards for uniformity since they are intended to be divided at least once. So while I can't cite any research at this time, I'm pretty sure this concern is a myth.

 

I think with care and attention to both your mixing procedure and your symptoms, you could succeed with a water suspension of alprazolam like so many others before you. My point about a water suspension being unreliable was in case you do have trouble with your taper; if you're struggling it may not just be your rate of reductions or the short half-life of your drug. How you suspend your tablets and how you dose the resulting liquid could be an important variable in your taper and something I would want to be aware of if I was tapering in this way.

 

I'm sorry to have concerned you so much. I hope you'll understand my intention was to make you aware of some of the variables I'd be considering with a water suspension, and some of the risks we navigate when making liquid at home. 

widesky,

I am also doing a direct liquid water taper off of 1mg of Xanax.  since it is not soluble in water -- what I do is drop in my 1mg of Xanax into a graduated cylinder, add in 2ml of Tito's vodka, it takes just a few minutes to dissolve, then I add in the remaining 98ml of water -- so, total of 100ml.  I pour this into a large glass jar and then add in 200 more ml of just plain water.  I then shake and pull out what I need from that solution. 

just to continue:  so, let's say I'm on day ten and pulling out ten ml (or 5ml if I am only drawing out .5ml a day) then once have removed that ten ml of "drug water" I add back in the amount to make an even split --- so since you dose four times -- it would be easy to add back in 110ml of water (once you have removed your drug water) and that would make 400ml that you could easily divide into four 100ml doses to drink during the day.  this is how I do it --

Thanks for all your replies, it feels great to get support.  I'm using a home brew of only water and the X tablet fully dissolved in the water.  300ml h20, the I divide it into four doses.  When starting this taper a few weeks ago, I went on the 4 doses to relieve interdose w/d which I was experiencing when taking only 2 doses, an am and a pm. I'm probably adjusting to that physiologically as well.

I'm glad to know I'm not imagining these symptoms being so strong during the start of this liquid taper, switching over from dry tabs.

 

Hi Imnot crazy,

I'm glad Libertas asked, because I was thinking from other threads of yours that you had a manufactured liquid. I was wrong!

 

Some information that might be useful to consider: alprazolam does not readily dissolve in water. The tablets deconstruct, but from what I've read, only 0.04mg/ml can be dissolve in water and only under ideal conditions. So what I believe you've created is a water suspension of undissolved alprazolam particles (plus other tablet excipients, some dissolving, some suspending).

 

In my experience a suspension, particularly in a poor suspension vehicle like water, requires careful handling and dosing methods to reduce inaccuracies. The tablet contents that dissolve rapidly into the water might include things like dye, lactose, etc, and these are not the alprazolam. I think the alprazolam is likely to be some of the fine particles that settle quickly to the bottom of the liquid.

 

To dose a water suspension of tablets I suggest strong agitation (vigorous stirring and/or shaking) immediately before drawing a discard or dose (depending on your method) from the middle of the volume of liquid.

 

Lastly, since it sounds like you are doing a daily discard method, I suggest rinsing your primary measuring vessel with a little water and adding this to your divided doses. I suggest repeating this rinse of the dosage jars after you drink each dose and swallowing the rinse water. This last step is intended to minimize the chance that medicine has clung to the sides of your vessels and reduced your dosage; it might be unnecessary but it's easy and I would do this myself if I was doing a water suspension.

 

Water suspensions are unreliable to my understanding, and I am wary of them especially for short-acting benzos like alprazolam. That being said, they are simple to produce and they have worked for many many taperers. I hope the suggestions above help you to improve the reliability of your liquid dosing. 

Hi widesky, 300 days gave you a very good option; however, if, you, like me cannot tolerate even the tiniest amount of alcohol, you can also use full fat, homogenized milk instead of water. Benzos are soluble in fat; that's how they get trough the blood-brain-barrier.

 

Source: https://www.psychdb.com/meds/benzos/home

 

You have many options to choose from, I hope you are more at ease now.