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Apple Cider Vinegar....possible medium for titrating Xanax?


[ci...]

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Good morning fellow Benzo Buddies and Warriors..:)

 

Need your sage feedback on the viability of using ACV (above) for titrating a 1 mg xanax pill..am at that level of cutting that cutting a Xanax pill is close to impossible!..am planning on using 98 ml of water plus 2 ml of ACV as the dissolving agent for the Xanax...then titrating down every day/week(?) 1 ml...the total volume of liquid in the graduated cylinder would equal to 100 ml.

FWIW, I have "dissolved" a Xanax pill in ACV and it dissolved perfectly in about half and hour...just mixed it around with a toothpick and it becomes totally dissolved..

Question I have is, has anyone used ACV as their dissolving agent...?..Many folks use vodka. Not an option here for a recovering alcoholic..:/..Have heard of OraPlus/propylene glycol..as well..

Am wondering if the acidity of ACV will destroy the medicinal properties of the Xanax?..I got a bottle of the stuff in my pantry, hence why not use it?:):)..

 

Background:  Misused X for approx 2 years(5-6 mg/day) until 3/20. Started cutting .25/.125 from 3 mg/day.  Currently at .75 mg/day. Been "holding" at this amount since mid-July.

 

Cinna

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Hi, Cinnabar!

 

Been awhile since we chatted!  You've made good progress on your taper--congrats!

 

I'm not a chemist so can't advise you on the ACV.  But if it were my taper, dissolving/suspending a benzo in anything that isn't documented as pharmacologically compatible would be a last resort.  Not saying it couldn't work--but I'd hate to see you run into problems this close to the finish line.     

 

What do you think about compounding your own 1 mg/mL Xanax suspension?  Here's the "recipe":

file:///C:/Users/user/Downloads/Alprazolam%20Oral%20(1).pdf

OOPS--that's not right!

Sorry, I don't know how to link the pdf, so you will have to google:  Nationwide Children's alprazolam suspension

 

You could get by without buying a mortar and pestle--BB members have ground tablets to a fine powder using just a bowl and spoon.  A graduated cylinder would be handy though.  You'd also need an amber glass bottle in which to store the suspension, a 1 mL syringe for dosing, and maybe a syringe adaptor that fits in the mouth of the bottle.  One 16-oz bottle of Ora-blend suspension vehicle (or the cheaper knock-off called Flavor-blend) would last you through the end of your taper.

 

The suspension has the advantage of being stable for 60 days in the fridge.  There's no need to prepare it fresh daily, saving time and tablets.  If desired, you could adapt the recipe to make a lower concentration or a smaller batch.  The only potential disadvantage I can think of is if you're sensitive to any ingredients in the suspension vehicle.   

 

Anyway, it's another option for you to consider.   

 

Hang in there, you're almost through!

 

Koko Lee  :smitten:

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Hello Koko Lee, thank you for posting this, I agree 100%, I tried the liquid titration with water, and milk, I believe it does not work, I think it changes the whole chemical structure of the medicine, four days after I started that, I did not feel right, so I went back to dry cutting.When you have a minute, could you help me make the solution? How would I mix it if I am taking a total of a half .25 a day? Would I make a 30 days worth ? Or 15 days worth, and how much would I take each day, and remove?

Thank you

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Hi Mike!

 

Absolutely, I'll do what I can to facilitate.  Please let me know your tablet strength and how many times a day you prefer to dose, and I'll get back to you asap. 

 

I want to add that, if you're in the US and have a cooperative prescriber and access to a compounding pharmacy, you can have the compounding pharmacy professionally prepare your xanax suspension for you.   

 

Another possibility is to ask your doctor to prescribe Alprazolam Intensol oral solution.  It's a 1 mg/mL concentrate and can be diluted with water to whatever concentration you need in order to most conveniently and accurately draw your target dose.  I can explain in more detail how to go about doing that if you're interested. 

 

Either of those options might be more straightforward than buying the ingredients and equipment to make your own suspension.  The only reason I am suggesting home-made suspension to Cinnabar is that she is not taking Xanax by prescription--so she is having to improvise her taper.         

 

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Hi Koko:

 

Indeed..hope u r doing well.:)..Much warm Thank You's to you for the info above!!..re: making a liquid Alprazolam solution..So basically my understanding is that that recipe on that aforementioned website makes a SUSPENSION of a 60 days worth of 2 mg alprazolam concentration?(120ml)--REFRIGERATE bottle:)

 

So, if a person, such as myself, were only on .75mg/day, would I use a 1 ml. syringe and just "pull up" .75ml of that suspension fluid then divide it into my daily doses, let's say twice/3 times a day?...the next day, I would REPEAT the same process above?...The integrity of the Xanax in that bottle of suspension(refrigerated) does NOT change..It is still a 2mg/Alp suspension only just LESS is in the bottle?..so in one day the bottle will have lessened to 119.25?

 

I THINK I understand that recipe(wonderful website) and and your explanation of using that Liquid Alp.in my taper plan downwards...

 

Fingers crossed that: "By jove, I think I've got it" :):)

 

Have a wonderful week, Koko!..Ur a luv! :smitten:

 

 

 

 

 

 

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Hi Cinnabar,

 

Finally figured out how to post that link!

https://www.nationwidechildrens.org/-/media/nch/specialties/pharmacy/compounding-formulas/alprazolam-oral.ashx

 

Ta daaaah!  :D

 

Yes, it's a suspension--but, very importantly, it's 1 mg/mL concentration (not 2 mg/mL as you indicate) ! 

 

Note that, under "Ingredients", you're instructed to use sixty 2 mg tablets (for a total of 120 mg of active drug substance) and suspend in 120 mL of suspension vehicle. That yields 120 mg/120 mL, which is equal to 1 mg/mL.  Does that make sense?  If not, let me know and I'll try to explain it better. 

 

Please, please be soooooo very careful with your calculations.  When in doubt, ask for help here on BB.  Even if you're pretty sure of what you're doing, it never hurts to have a 2nd pair of eyes to check your work. 

 

Now for your dosing.  If you're aiming for a total daily amount of 0.75 mg consisting of three separate doses (like morning, noon and night), you first shake the bottle well (a crucial step whenever using a suspension) and just draw up 0.25 mL per dose.  No need to draw up 0.75 and divide into three parts.  Oui?

 

Don't hesitate to ask questions if you need help with anything--equipment suggestions or suspension preparation or dosing or whatever. 

 

Koko Lee 

 

PS--If your tablet strength is something besides 2 mg, or if you would like the concentration of your suspension to be lower than 1 mg/mL, I'll be happy to work through the necessary changes with you.   

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Ok, one more question Koko...:)

 

I thought I would post it out here in the public forum as some folks may wonder if it makes any difference....Do u think it would be OK to use a washed/rinsed out(very well) old amber vitamin bottle for that liquid alp suspension?..some supplements come in dark green, dark blue colored bottles..and do u believe it should be GLASS vs. PLASTIC?..I think I know the answer to this one but I thought I would run it by you.... 8)

 

Oops..yes, I stand corrected in my last post..I meant 1 mg/1ml of suspension..instead of the 2 mg/ml I wrote..

 

I think the heat here in S. Cal is really getting to me..:(

 

Cinna:) 8)

 

 

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Hello cinnabar58 and Koko Lee.

 

I just checked out the Nationwide formulation for the alprazolam suspension for the first time. Yowza! That’s a high concentration (1 mg/mL) for a potent benzodiazepine.  It also uses a lot of tablets (60 2-mg) in not much liquid (120 mL of the suspending vehicle).

 

I wonder if cinnabar58 might want to consider ...

 

... making a less concentrated suspension? (see Note below)

 

... using a combination of tablets and liquid until she reaches a point where she needs to switch to all liquid? (There are advantages to doing this including minimizing possible issues related to a change in drug delivery from tablet to liquid and minimizing out-of-pocket costs for the suspending vehicle.)

 

Note:

 

As I’m sure you both know, according to Ashton, alprazolam and clonazepam have about the same potency (0.5mg of either is equivalent to 10mg of diazepam).  The stability study provided with the alprazolam formulation from Nationwide tells us the active drug substance in regular alprazolam tablets remains stable for up to 60 days when combined with the suspending vehicle.

 

Given the above, I wonder if cinnabar58 might want to consider using the Nationwide formulation for the 0.1mg/mL oral suspension of clonazepam at:

 

https://www.nationwidechildrens.org/-/media/nch/specialties/pharmacy/compounding-formulas/clonazepam-oral.ashx

 

The above formulation uses six 2-mg tablets in 120 mL of the suspension vehicle.

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Wow!!..

 

Hi Libertas!!..I thank u (and anyone else's) for ur input into this topic!!:)

 

Hmm, I was looking at the Alp. recipe a bit more closely and I am also wondering if the 60-2mg Alp for the ALP recipe was typed out incorrectly by the publisher of said article??..It does seem like a lot..Those 2mg Alps are the bars, if I'm not mistaken...and I'm thinking 60 of those bars plus ONLY 120 ml of the Ora-Plus..hmm, very "pasty"ish...or so it seems?

 

I've never had experience with this whole titration stuffs...Now, the "recipe" you linked re:the Clonazepam sounds like it would result in a more like a liquid-like consistency versus a thick-like consistency for the Alprazolam one?

 

I wonder if that is a typo?..any other conjecturers out there?

 

Oy vay!!:/

 

Cinna :crazy:

 

 

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Not a typo.  ;) The 1 mg/mL concentration agrees with the 120 mg/120mL proportions and with the concentration used in the stability study cited at the bottom of the method. 

 

Libertas, you're correct that, as written, it's a high concentration--certainly higher than Cinnabar needs--and you're also right that the alprazolam method can be adapted to lower concentrations.  For the sake of both accuracy and precision, it would be better to take 2.5 mL of a 0.1 mg/mL suspension than to take 0.25 mL of a 1 mg/mL suspension.  And that would be even more true as the dose gets smaller. 

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Ok, one more question Koko...:)

 

I thought I would post it out here in the public forum as some folks may wonder if it makes any difference....Do u think it would be OK to use a washed/rinsed out(very well) old amber vitamin bottle for that liquid alp suspension?..some supplements come in dark green, dark blue colored bottles..and do u believe it should be GLASS vs. PLASTIC?..I think I know the answer to this one but I thought I would run it by you.... 8)

 

Oops..yes, I stand corrected in my last post..I meant 1 mg/1ml of suspension..instead of the 2 mg/ml I wrote..

 

I think the heat here in S. Cal is really getting to me..:(

 

Cinna:) 8)

 

I'd go with glass.  Amber is recommended, but you can probably slide on that since it'll be stored in a dark refrigerator 99% of the time and expires in just 60 days anyway.

 

I'd be more concerned with the materials in the lid because the suspension will have to be shaken/inverted before each dose.  If the lid is lined with cardboard that will get soggy over time, maybe you could cut a circular piece of #1 plastic out of a milk jug to use as a liner.  (I know I said to avoid plastic, but sometimes there's just no substitute.  :( )

 

I've been reading about the fires and heat wave there.  Stay hydrated, and be safe! 

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