Instruments to aid in withdrawal?

[[Be...]]

Hi there,

 

I am looking into two things I recently heard about:

 

1) A Pill-Cutter

 

2) A Weighing Balance

 

The situation: My mother is trying to withdraw from lorazepam (currently on 0.425 mg/day...down from 1.50mg, but it is VERY tough for her right now)- I am going to ask her to cut down her reduction rates to about a maximum of 10% her previous dose (previously she was doing .125mg/10 days). Therefore, she would need to cut by .0425 mg.

 

The problem: She is currently overseas, and the only denomination tablet of ativan that she gets is 1.00 mg (nothing lower than that). I want to provide her with a pill cutter and a weighing balance to help her get the cuts accurate. Does anyone have any ideas on which products I can purchase for her?

 

Thank you!

[[Tr...]]

Benzofighter,

 

I read your question regarding a pill cutter and scale.  However, would she be able to get her medication in liquid form?  That way she wouldn't have the stress of weighing and cutting.  I don't know if that would be an option to consider.

 

 

TRY

 

 

[[Be...]]

Hey there,

 

That's a good idea- I didn't think of that. So are you saying get a liquid form and then dilute it with water?

 

I'll ask her about this.

 

Meantime, I'd still welcome suggestions on the equipment in case the liquid solution is not available.

[[be...]]

Benzofighter,

 

I read your question regarding a pill cutter and scale.  However, would she be able to get her medication in liquid form?  That way she wouldn't have the stress of weighing and cutting.  I don't know if that would be an option to consider.

 

 

TRY

 

Great idea Try! I wonder if an elderly person can handle a scale. Or an accurate cut from a pill cutter. Hands might shake.

[[Be...]]

Hehe my mother is not elderly (i'm in college if that's any indication)

 

Anyways, I did a lot of research into this and it looks promising! I've found a commercially available oral solution of Ativan (2mg/mL).

 

Now i'm just trying to figure out whether to dilute it or whether to use a micropipette to get the amount of medicine necessary (0-0.50mg). I want to make a system that is easy for her to follow on the days that I am not home to prepare the medicine for her.

 

Any ideas?

 

BTW- Thank you for the encouragement guys!

[[...]]

I think liquid lorazepam is the way to go.  There are several ways to do it.  Many make their own with the pills using alcohol to dissolve it.  Or you can go to a compounding pharmacy and have them make it.  I'm not sure if they need a special script to do that, but you could call and ask if you brought them pills if they would convert to liquid.

 

You really need it diluted to about .1mg/ml or lower.  .01m/ml would be even better.  More dilution is good as she will be using syringes.

[[Be...]]

Hi there,

 

So far, I am thinking about what another poster (badsocref) said in the following post:

 

http://www.benzobuddies.org/forum/index.php?topic=116563.0

 

I am leaning towards obtaining a micropipette to extract the small quantities of the drug (we're talking less than 0.25mg per dose, 2 times a day), and then dissolving it in water and drinking it.

 

Am I mistaken that Lorazepam Intensol cannot be taken orally? Does it HAVE to be injected?

[[...]]

Excellent!  Micro pipettes are perfect for this if you are willing to spend a few bucks.  They are basically "super syringes."  Very accurate.

 

I didn't taper lorazepam, but have some experience through helping a friend.  You need to choose the right pipette for the concentration and dose.  The P1000 seems to be able to divide 1ml into about 1000 doses accurately.  So if you wanted to do a daily microtaper 2mg/ml might still be too concentrated even for a P1000 pipette as that requires cuts on the order of .001mg daily.

 

I don't think it is for injecting.  I think it is an oral med.

 

http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=5615

 

And I wouldn't want to swear to this, but just looking at the ingredients and solvents it is a lot like the diazepam oral solution which can be diluted with water.  So it might be dilutable with water.  A pharmacist might know.

[[Be...]]

Thank you for responding! Absolutely, the right micropipette is needed. And we're willing to spend whatever is necessary to do this right.

 

Based on my calculations, a 20-200 microliter pipette (I found this one on Amazon) should be perfect for the job, even if the solution is not diluted and still 2mg/mL.

 

Suppose, for example, that my mother wants to take 0.23mg.

 

Well, using dimensional analysis,

0.23 mg * 1 mL/2mg * 1000 microliters/1mL = 115 microliters Lorazepam Solution.

 

This would easily be measured out in a 20-200 microliter pipette, without even being diluted from the original concentration!

 

At the low end, suppose she wants 0.10 mg:

0.10 mg * 1mL/2mg * 1000 microliters/1mL = 50 microliters.

 

That also fits inside the 20-200 microliter pipette.

 

[[...]]

Looks like you are on your way.  I've never actually used a pipette, but I've read where the low end of the volume is not as accurate.  I guess that would be below 20 microliters on the P200.  But it may be accurate enough for what is needed.

 

Also, if you plan to do a daily microtaper cut of .001mg would probably work fine for the P200.  I think your mom would need a daily cut this small eventually.