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Water, milk, baby food or ice cream (!) for titrating


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Hi, have heard many conflicting things about what the correct medium is for titrating. Have read that no benzo is soluble in any medium other than something with a very high Ph that cannot be consumed. Anyone have any thoughts or information on this?

 

Jean

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Jean,

 

For me, milk is the ideal solution.  I use two percent milk and I have had a relatively smooth taper so far.  It is thought that the benzo binds with the fat in the milk to create a pretty good suspension.  I have tried water in the past, and I found that worked ok too, you can actually see the particles floating around in the water.

 

As far as ice cream and baby food?  I am not sure about that....I have never heard of anyone using either....there was one member on here that used diluted applesauce and he was able to successfully taper off of Ativan....

 

Hopefully, someone else can comment on the baby food (I believe this may be similar to applesauce in consistency) and the ice cream.

 

The majority of people I have seen have used milk or water, but I have seen other variants that have worked well too. 

 

TC

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Jean,

 

I will reply properly later, but just a quick note to say that "solubility" is not the issue. Doctors prescribe liquid benzos all the time, and they work perfectly well (no high Ph value). The liquid benzo is not in solution, it is in suspension!

 

Water is a poor suspension medium for benzos, milk is a little better - that is all. There are a number of things we can do to improve the situation, but I'll write about them when I return in an hour or two.

 

Baby food should work well (as will anything with high viscosity). Ice cream will be either too stiff, and maybe a little too runny (when melted) to be ideal, but I'm sure it would work better than water (and perhaps milk). Though, it is full of sugar too, so this is not a great solution.

 

I'll be back soon.

 

Edit: typos.

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Hi again,

 

First of all, I'd like to volunteer that I am no chemist, so if anyone would like to follow-up with better explanations or more strict interpretations, I'd certainly welcome it.

 

As I explained in my previous post, we are not trying to create a solution. As I understand it, solutions are where two (or more) elements or compounds mix together to form a homogeneous substance (mostly, liquids), but do not interact with each other. Instead, we are adding benzodiazepine (probably, more accurately, ground up particles of benzodiazepine bound to binding agent) to form a suspension. Suspensions always will settle over time (unlike solutions). However, some suspensions are better than others. We can use water to suspend our benzo-powder, but homogenised full-fat (4%) milk should work better. For one, milk is of greater viscosity, and this will slow the process of settlement. Secondly, most (but not all) benzodiazepines appear to have an affinity for fat, so they will have a tendency to bind with the fat in the milk. Homogenised milk has gone through a process to ensure that the fat is evenly distributed throughout the milk (older members will remember how the fat used to collect at the top of bottles of milk and we would shake it before opening - I certainly remember this).

 

Irrespective of the suspension medium (water, milk, juice, etc.), we can improve the suspension. Firstly, grind up your benzodiazepine into as fine a powder as possible. The finer the powder, the slower it will settle. Secondly, use more viscose liquids (full-fat milk rather than water, a smoothie rather than juice, for example). Thirdly, agitate the liquid immediately before you remove any liquid.

 

You should also consider how you agitate the liquid: you should shake it, or if this is not possible, make lots of up and down movements with a spoon or stirring rod (avoid actual stirring).

 

Stirring the liquid will create a vortex. Even if you shake the liquid, be sure to not add a rotational action, as this will induce a vortex. The reason why you should avoid a vortex is that this will create a concentration gradient radiating from the centre to the edge of the liquid. If the particles are denser than the liquid (this appears to be the case with benzos, as the powder tends to settle, not float in water or milk), then the particles will tend to be more concentrated towards the outside of the vortex. It appears that another force (I've just read about it, it is called diffusion flux) results in particles tending to move in the opposite direction (towards the centre) to until they reach a state of equilibrium. I assume this just means that the concentration of particles follows a curve, as all the particles do not gather at the very edge. Anyway, the concentration of particles is not even throughout the liquid - that's the point!

 

Because of the relatively low viscosity of water, and because the fat in homogenised milk appears to have an affinity for the benzo particles, I would recommend full-fat (4%) homogenised milk over water. However, whichever liquid you use, agitate the liquid - do not stir it. Use more viscose (thicker) liquids for a better suspension medium. Grind up the particles as small as possible (they will settle more slowly).

 

It is also possible to obtain suspension agents from the pharmacist. We've had posts about this (I thought we had one stickied) - if anyone finds a post, please reply with a link. These suspension agents should work very well, of course, so these would be my top recommendation.

 

I have never studied chemistry, so, someone - anyone, please feel free to tidy up my explanation.

 

Typos and small corrections.

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Thank you Colin and TC for your responses. Colin, I've heard that milk foams when whirled up with mini blender. Do you just draw out thru the bubbles?  ;D  I know all of this is not an exact science but just trying to get as close as possible.

 

Thanks,

Jean

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Hi,

 

If the milk is agitated (rather than whizzed up by a blender) I would expect less foaming. I would not recommend a hand blender: it is not necessary; it will not make the benzo-particles any finer; it will create a lot of foam; and it will create a strong vortex!

 

I would not worry about any foam that might be created. Ignore the foam, place the tip of the syringe deep into the liquid, and draw up what you require. Be sure that the liquid is agitated immediately before you draw off any liquid.

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  • 5 months later...

I'm not sure about that method. The benzo powder would settle while jello (jelly, to us Brits*) while it sets. It would not be distributed evenly through the jello. Maybe if it was stirred up every so often while setting, it would be OK.

 

* for you American's, over here, "jelly" is not "jam"! This is clear as mud! ::)

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  • 5 months later...
I've been using 2% milk for titrating but the bubbles, foam thing is confusing. On the titrating video, he says after stirring up the milk and adding the crushed benzo to let it sit till the bubbles are gone. Then draw out what you need. Does this mean the benzo has separated from the milk and I didn't get the right amount drawn out all this time. I'm down to 75ml from 100 ml.  :wacko:
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I used milk at one point during my taper with the brand name K tablets and did not have any problems. I didn't do much with it. The one thing I found that helped a lot was to let the tablet sit in the milk for 15 minutes or so. Then a quick stir and I would have an even looking suspension that worked well enough for me. There is also talk of using Miralax solution since the cellulose binds to the benzo and creates an even suspension. I did not try this method though, because by the time I heard of it, I was using the K wafers. NOTHING worked for me to suspend those things!
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  • 4 months later...
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I am down to a quarter of a Temazepam tablet thinking about crushing this up and taking off a line with a credit card and putting the rest  :'(on a spoon with milk and drinking it. I want to cut 10% of my quarter tablet dose at night.
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  • 3 weeks later...
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[9f...]
Has anyone used Ora-plus, or xantham gum as a suspension fluid?

 

I have never heard of anyone using it.. I know what Xanthum Gum is, I bet that would work. I never really thought about that.

 

 

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Hi Sigma,

 

I bought the ora-plus and am using it now for my titration suspension fluid.  I like it a lot, but only a week in.

 

It contains xantham gum - so I gave up trying to create my own suspension.

 

As for the other ingredients, they are not as close to the food chain, but there is no bad taste, and I need less than a ml per dose.

 

Best thing about it is that it lasts for a month or more, if refrigerated.  I could carry a freezer bag if I needed to go somewhere. 

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[9f...]

Hi Sigma,

 

I bought the ora-plus and am using it now for my titration suspension fluid.  I like it a lot, but only a week in.

 

It contains xantham gum - so I gave up trying to create my own suspension.

 

As for the other ingredients, they are not as close to the food chain, but there is no bad taste, and I need less than a ml per dose.

 

Best thing about it is that it lasts for a month or more, if refrigerated.  I could carry a freezer bag if I needed to go somewhere. 

 

I am glad it is working for you.

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Thanks Sigma,

 

It is a relief to have figured out a way to taper on 1mg clonazepam.  (no more refills as the doc does not believe in tapering)  So I have enough left and a good way to do it.  HAPPY!

 

I hope everyone finds what works for them too.

 

healthybodyandmind

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  • 3 months later...

Baby food should work well (as will anything with high viscosity). Ice cream will be either too stiff, and maybe a little too runny (when melted) to be ideal, but I'm sure it would work better than water (and perhaps milk). Though, it is full of sugar too, so this is not a great solution.

 

I'll be back soon.

 

Edit: typos.

 

What a higher fat milk product like whole milk, half and half or cream, like ice cream without the sugar, if benzo a binds better to fat?  I can see that because its closer to a petrochemical I think so not water soluable..that's what I think.  I think most drugs are a derivative of petro chemicals, the petroleum industry started the pharmacy industry I think is the history. 

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Just FYI and for another point of view, I've been successfully using plain water for two years now titrating four different meds, and it's been working just fine.  I don't grind or blend, I just allow the pill to dissolve in the water, and then stir it up well.  I keep stirring it as I measure it out so that it stays in suspension. 

 

Since I dose multiple times per day and have to carry the meds around with me in little bottles, water is ideal--no worries about refrigeration.

 

Personally I would not want to use something besides water because I wouldn't be able to tell by looking at it whether or not it was evenly suspended when I was measuring it out.

 

As Colin points out, the important thing is that the drug is suspended--it's not going to truly dissolve in anything you can safely drink.  But I find that the pills themselves (the binders and fillers) dissolve quite nicely in water if you just let them sit for five or ten minutes. 

 

Personally I think the less you manipulate the pill and the fewer surfaces you expose it to, the more consistent your measurements are going to be from one day to the next, because microscopic amounts of the drug are going to stick to any surface it's exposed to.  That's why I avoid the whole grinding and blending business. 

 

So, just for another POV, this is what has been working for me.

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I'm not sure about that method. The benzo powder would settle while jello (jelly, to us Brits*) while it sets. It would not be distributed evenly through the jello. Maybe if it was stirred up every so often while setting, it would be OK.

 

I agree with this and was thinking the same.  I think it would work fine if you stirred it continuously until it started to set up.  How long that would take though?  and I just have to use this emoticon:  :idiot: but not regarding the jello.  I just want to see it in my post!

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I'm not sure about that method. The benzo powder would settle while jello (jelly, to us Brits*) while it sets. It would not be distributed evenly through the jello. Maybe if it was stirred up every so often while setting, it would be OK.

 

I agree with this and was thinking the same.  I think it would work fine if you stirred it continuously until it started to set up.  How long that would take though?  and I just have to use this emoticon:  :idiot: but not regarding the jello.  I just want to see it in my post!

 

You might refrigerate the jello so that it is chilled (but not set), and then set up a  double-chill bowl (like a double-boil arrangement), with ice between the two bowls and stir until it starts to set. Then transfer back to the fridge. I'm sure there will be a number of ways of doing this. Maybe removing it from the fridge every 10 minutes for a stir is all that is required.

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I titrated years ago with water but I didn't throw the medicine I didn't use away.  I think I kept it but I don't remember how now.  I might have marked the quantity and combined it somehow.  It made it harder I remember.  If you are using 'half' of a solution.  Couldn't you keep the other half for the next day? I would think one day wouldn't be too much to hold on to it. 
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