Liquid Diazepam

[[sl...]]

Now we are wondering if it has something to do with the liquid diazepine.  Dissolving the tablets seems very wasteful and tedious.

Not sure where to go from here.

 

Dissolving tablets is only wasteful if you do a daily liquid discard method. If your wife is sensitive to the liquid you're using, an alcohol and water mixture might be more tolerable and it can be made concentrated enough to keep for months. I was afraid of taking any ethanol because I have a sensitive stomach and I never drink, but this turned out to not be a problem at all for me.

 

I make a 30+ day supply in just 30ml of liquid clonazepam; I'm at much higher doses than your wife (over 10X the benzo equivalent to her), so I take the rest of my doses in tablets. But if you want to keep things simple, you could try dosing just liquid as described below and the ethanol content will still be less than half a ml per day. For comparison that's about 1/10th of a teaspoon of ethanol.

 

I was just playing around with the research numbers and it looks like if you can source 100 proof alcohol (or even 90 proof), I think you'd be able to easily dissolve 2mg into each 1ml of solution. 100 proof is 50% ethanol, and the maximum dissolution of diazepam in 50% ethanol has been demonstrated to be around 4.76mg/ml (per reference below), giving you a good margin of error.

 

The approach I would use requires sourcing a couple graduated cylinders (a chemistry tube with measurements on the side for precise liquid measuring), a glass stir rod, and a dropper. All of these can be bought on Amazon in a kit for $20 or so. I can post a link to the exact product I own if you can't find it.

 

To make a test batch, I would add 20mg in tablets (10 x 2mg if that's what you have) to the bottom of a 10ml graduated cylinder, and then carefully add 90-100 proof alcohol with the dropper up to the 10ml line (remember to measure by sighting the bottom of the dip in the surface of the liquid). I'd wait for the tablets to dissolve, stir with a glass stir rod, then transfer to a clean medicine bottle with a lid (ideally with an oral syringe adapter). Then I'd give it about a day or two to sit and soak; you could shake it from time to time for good luck. Finally I'd transfer it to the fridge just to be safe, but it's 40-50% ethanol, so it's VERY well preserved.

 

The resulting 2mg/ml solution could be shaken and then dosed with a 1ml syringe with 100 gradations (available at pharmacy or maybe you already have a couple; also there's Amazon "1ml oral syringes"). Your smallest measurement would be 0.02mg; you could dose by 2mg, 1.98mg, 1.96mg, 1.94mg, etc, by simply extracting 1ml, 0.99ml, 0.98ml, 0.97ml, etc from your liquid medicine bottle with the 1ml syringe. Simple math; just multiply the ml drawn by 2 to get your dose, or divide your intended dose by 2 to get the ml to pull.

 

If the test batch is well tolerated, then a 30ml batch could be made just as easily in a 50ml cylinder with 60mg of diazepam.

 

I hope I haven't overwhelmed you. This is just one way to dose liquid, and it saves the hassle of daily mixing and throwing away medicine. I've been doing a similar approach myself, and I had my clonazepam approach considered and repeated by a compounding pharmacist and confirmed by my own tapering experiences.

 

Would you consider giving a homemade liquid diazepam formula a try? Or, alternatively, would you have a compounding pharmacist willing to mix you a 45% ethanol, 2mg/ml solution?

Let me know how I can help! 

 

---

Solubility of Lamotrigine, Diazepam, and Clonazepam in Ethanol + Water Mixtures at 298.15 K. Journal of Chemical and Engineering Data, 2008, Washington D.C.: American Chemical Society, pp. 1107-1109. Accessed online at:

https://digital.library.unt.edu/ark:/67531/metadc674044/m2/1/high_res_d/Acree%20Pub-479.pdf

 

[[He...]]

All these suggestions are greatly appreciated.  We haven't changed anything since the last post.  She is still at 1.7 mg, with half liquid for the morning dose, all tablets for the evening.  She has had 4 tolerable days in a row, so we think perhaps she just needed more time to adjust.  Soon she will try half liquid for her night dose and see how it goes.  She wants to get to all liquid, but needs to be patient.

Thank you for all your support, and we'll keep you posted.

[[sl...]]

I'm so glad to hear your wife is stabilizing on her current liquid portion. Such patience is required of us in this process; sometimes it's just "the slower the better".

I hope you continue to see improvements! 

[[Li...]]

Thank you for sharing this good news with us, Helping Husband.  I know your wife is concerned about accuracy (i.e. ensuring that what she measures is what she gets in terms of the amount of benzodiazepine she is ingesting).  The commercially manufactured oral solution of diazepam is the preferred option to achieve accuracy in dose. (It also has been proven to be safe, effective, and stable when used/stored in accordance with the manufacturer’s instructions.)

[[He...]]

Things are moving along.  Still having some bad wave days.  Haven't changed anything for the last 2 weeks and have been at 1.7 mg Valium.  We have looked thru other support groups as per your suggestion (it's a bit mind-boggling because there are so many).  Jimmy T referenced a Benzo Brain video for dissolving a tablet and micro tapering.  We are having a mental block trying to convert her quantities to ours (1.7 mg in 2 doses).

It would be great if we could find a schedule for this.  I thought I ran across one on BB once, but can't find it now.

[[sl...]]

Taper schedules depend on taper rates, starting dosage, number of doses, and mg/ml (if liquid). This is why it's not usually possible to just find one around the forum that works perfectly for you.

 

If you want to make a daily water suspension of diazepam, such as in the video I think you're referring to, you can just follow the video instructions with your full daily dose in tablet form, download her spreadsheet and adjust the dosage to your total daily dosage and the dates to your dates. You'd then follow the spreadsheet to determine how many ml of liquid to remove from the combined daily suspension, then you divide the remaining amount into two doses. The spreadsheet is for a linear reduction, so it may have increasing WD symptoms.

 

I think percent-based reductions are generally better tolerated, but you would need a different resource to create a taper plan than the spreadsheet provided above. I would use this form: http://benzo.alwaysdata.net/titration/titrationForm.php

 

I also don't personally recommend a pure water suspension of diazepam. It's so easy to add a tiny amount of solvent to dissolve the diazepam and wait a little while before diluting the tablets and solvent with water; this is much more likely to create a solution of some if not all of the diazepam, and make your reductions and dosing more accurate.

 

I suspect that 1-2ml of 180 proof alcohol would serve this purpose for you, and I doubt your wife would be able to taste it in 300ml of water. With this alcohol stage I think it's important to have very strong alcohol and to wait 20-30 minutes for the tablets to saturate in the alcohol alone and dissolve.

 

I hope this helps.

Are you planning to give up on the liquid form you've been trialing?

[[He...]]

Hello ALL,

Helping Husband checking in with an update.  It's been a while, but there hasn't been much to report.  My wife reduced to 1.6 mg (all tablets) about 8 days ago, down from 1.7 mg, which she was on for several weeks.  She takes 1/2 dose in the mornung and 1/2 dose in the evening.  Waves have been tolerable, but they usually hit hard at around 10 days after a cut.  We will see what happens over the next few days.  At some point she will have to try one of your suggestions for making liquid because it is getting too difficult to measure the tablets at these low doses.

Thank you all for your kindness, patience, and help.

[[Li...]]

Hello Helping Husband.  Thank you for the update.  Kudos to you and your wife for identifying two key pieces of information for a successful taper — what constitutes a “small enough” (tolerable) reduction in dose and withdrawal pattern (i.e. “waves usually hit hard at around 10 days after a cut”).

 

Re: next steps ...

 

Have you considered finding a compounding pharmacist who could prepare custom capsules containing the smaller dose sizes your wife needs to complete her taper?  You could also ask a compounding pharmacist about the possibility of preparing a custom liquid that does not contain ingredients that cause her issues. Compounding pharmacists can also assist with developing and (more importantly) adjusting taper schedules in response to symptoms and circumstances.

[[He...]]

Just looking ahead, is 0.5 mg a place to consider stopping the Diazepam if she feels "decent"?  Or do most need to go lower?

[[He...]]

Also, she is wondering if she should try switching back to one dose per day instead of two.  That would make the tablets easier to cut down and weigh.

[[sl...]]

Just looking ahead, is 0.5 mg a place to consider stopping the Diazepam if she feels "decent"?  Or do most need to go lower?

 

It's a personal decision. I think if your having trouble cutting, and your wife is feeling well, it might be worth the gamble. You can certainly go as low as you can accurately measure, or anywhere in between.

 

Also, she is wondering if she should try switching back to one dose per day instead of two.  That would make the tablets easier to cut down and weigh.

 

I'm curious, how exactly would this make the tablets easier to weight? Could you not simply weight two doses at once, and then roughly split them in half?

 

If I'm missing something, then yes, I think you could try one dose a day, but I suggest making the adjustment when stable and not cutting and waiting two weeks for any withdrawal from the schedule adjustment.

 

I hope this helps! I celebrate your continued journey towards freedom. 

 

 

[[Mo...]]

I personally cannot imagine stopping at .5mg a day and wouldn't recommend it for most people, though some do just fine like that.  I know someone who crushed their pills and put it on a piece of wax paper and then they would weigh out the tiny amounts on a scale.

[[He...]]

Thanks, Slownsteady.  It just seems that when she gets down below 1mg/day, it is very difficult to split it into 2 EQUAL parts.  Maybe it doesn't really if they are equal or not.  We're not sure.  Plus, there is usually some residue lost when the tablet is split.

We are probably over thinking this.

[[sl...]]

Thanks, Slownsteady.  It just seems that when she gets down below 1mg/day, it is very difficult to split it into 2 EQUAL parts.  Maybe it doesn't really if they are equal or not.  We're not sure.  Plus, there is usually some residue lost when the tablet is split.

We are probably over thinking this.

 

I've found it's hard to know the line between thinking and overthinking when doing something for the first time. I'm glad you're planning ahead, but you may be splitting hairs.

 

I'm assuming you're working with 2mg tablets, so 1mg or less is half a tablet, is that correct?

[[He...]]

Yes.  She tried Liquid Diazepam from Roxanne Labs, but it was problematic.  So we've been shaving 2 mg tablets.  It's okay for now, but when she gets down to, say 0.7 or less in two doses it will be very difficult to divide in half.  We may have to try a solution at that point.

[[sl...]]

Yes.  She tried Liquid Diazepam from Roxanne Labs, but it was problematic.  So we've been shaving 2 mg tablets.  It's okay for now, but when she gets down to, say 0.7 or less in two doses it will be very difficult to divide in half.  We may have to try a solution at that point.

 

Thanks for this clarity. My suggestion for the stage of your taper that is sub 1mg would be to start with a 2mg tablet and split it in half. Then I suggest shaving the flat side of this half tablet with your file or razor to get to your total daily dose pill weight. The goal would be to keep this cut side flat and even across while doing the shaving; I haven't done this, but I think it's very doable.

 

The results would be your total daily dose in a pill sliver with a flat side. Then I suggest using an aluminum pill splitter from Amazon, like the EqualSplit, and placing this flat side face-down in the splitter, eye the tablet sliver middle between the blades and you should get a near perfect even split! I suggest using a bright light and a magnifier if your eye sight is a problem. This is basically a modification of how I cut perfect tablet 1/4s... the method is illustrated in this video:

 

I hope this makes sense and is some value in considering. 

[[He...]]

Thank you.  That is pretty much the system we are using.  We have a similar pill cutter and cut the 2 mg tablet in half.  Then we file down each half to 0.7 mg.  Twice a day makes 1.4 mg, which is where she is at right now.  She usually has to wait 14 to 21 days or more for the waves from the lower dose get tolerable.  It is just a slow process and she gets depressed because it is all taking so long.  But we realize that it must be this way.

Thank you for your help.

[[Ta...]]

I moved to a water taper and it's a game changer.  Go to Benzo Brains on you tube and she has a video explaining it.  You can use your pill and disolve it in water.  This will take away the side effects of using a different brand (using compound liquid). 

[Guest [...]]

If you try the liquid taper again, either water or compounded, it’s always better to move one dose at a time and wait a few weeks.

That will lessen some of the wd’s.

I didn’t do this back in Jan, but I should have.

 

Good luck, she’s getting so close.

 

Winnie

[[He...]]

Update:  It's been several months since we posted last.  My wonderful wife has been tapering with her tablets at a rate of 5% each time.  She is down to 1.14 mg of Diazepam, but the time between cuts is getting longer.  Symptoms and waves are getting worse.  Every morning brings anxiety, cramps, diarrhea, back pain, and intense waves.  Evenings bring cramps, bloating, and often more waves.  Can barely get 2 or 3 hours of sleep at night.

She is becoming very depressed and pessimistic about her situation.  I feel helpless to help her in any way, and that is frustrating me.  I tell her it is only temporary and she will improve, but a lot of Buddies tell her that and she is getting worse.  Her spirits are very low and I am worried.  Cold weather is coming and that doesn't help either.  Is there anything I can do to help her?

Thank you.

[[Li...]]

I’m sorry your wife is suffering, Helping Husband.  Regrettably, it is not uncommon for individuals to struggle when they reach low doses.  We have several active members at low doses of Valium/diazepam who may be able to offer suggestions based on their experience. You can connect with them by posting to one or both of the following support groups:

 

Valium/Diazepam Support Group

http://www.benzobuddies.org/forum/index.php?topic=96753.msg1238323#msg1238323

 

3,2,1: Under 3 mg Valium people

http://www.benzobuddies.org/forum/index.php?topic=151673.msg2035496#msg2035496

 

To post to the above groups, click the Reply button found at the top right or bottom right of the page.

 

You also might find it helpful to read through past posts to the above groups.  To do so, click the Page numbers found at the top left or bottom left of the page.

[[sl...]]

Update:  It's been several months since we posted last.  My wonderful wife has been tapering with her tablets at a rate of 5% each time.  She is down to 1.14 mg of Diazepam, but the time between cuts is getting longer.  Symptoms and waves are getting worse.  Every morning brings anxiety, cramps, diarrhea, back pain, and intense waves.  Evenings bring cramps, bloating, and often more waves.  Can barely get 2 or 3 hours of sleep at night.

She is becoming very depressed and pessimistic about her situation.  I feel helpless to help her in any way, and that is frustrating me.  I tell her it is only temporary and she will improve, but a lot of Buddies tell her that and she is getting worse.  Her spirits are very low and I am worried.  Cold weather is coming and that doesn't help either.  Is there anything I can do to help her?

Thank you.

 

Hi Helping Husband,

I am sorry to hear that things have been so difficult, but I am grateful that you're keeping an eye on her symptomatic trends and looking for supports.

 

Has your wife considered trauma-informed psychotherapy? In my experience, reductions of benzo dosage and holding are not always sufficient for ongoing recovery. Some taperers, like myself, need to employ skill-building opportunities to keep up with reductions and to learn non-medicated methods for down-regulating our nervous systems. When taperers are struggling with low doses or very small reductions, my mind goes to mental health skill-building as an opportunity with great promise for supporting further neurological recovery.

 

My initial thoughts on the topic of skill-building are summarized in this post:

http://www.benzobuddies.org/forum/index.php?topic=259937.msg3287164#msg3287164

 

I hope you and your wife can find opportunities to move into this winter with greater ease.

Let us know if there's anything we can do to help. 

[[ho...]]

Update:  It's been several months since we posted last.  My wonderful wife has been tapering with her tablets at a rate of 5% each time.  She is down to 1.14 mg of Diazepam, but the time between cuts is getting longer.  Symptoms and waves are getting worse.  Every morning brings anxiety, cramps, diarrhea, back pain, and intense waves.  Evenings bring cramps, bloating, and often more waves.  Can barely get 2 or 3 hours of sleep at night.

She is becoming very depressed and pessimistic about her situation.  I feel helpless to help her in any way, and that is frustrating me.  I tell her it is only temporary and she will improve, but a lot of Buddies tell her that and she is getting worse.  Her spirits are very low and I am worried.  Cold weather is coming and that doesn't help either.  Is there anything I can do to help her?

Thank you.

 

Hi-

The 5% cut’s may be too much at one time.  Perhaps doing a doing a daily micro taper would be better at this point and very slow and symptom based.  I know she had problems with the liquid ( I have lurked and a seen your posting) but you might want to try to have it compounded and one that is held under the tongue.  I had problems with my first liquid too, and then I had a pharmacist that found the recipe that I am currently using and it is working great.  I do a combination of pills and liquid and a daily micro taper. 

 

It is something to consider again.  If not, consider dry micro tapering so she isn’t hit so hard by the 5%.  I know that doesn’t sound like much, but it sure can be.  For myself, even at a micro taper 10% a month is too much and it just gets harder the lower the doses it seems.  So when we can micro taper/daily, that gives us so much more control. 

 

I hope she is feeling better and that you both can find a solution or that you already have.  She (both of you) is so close!  How exciting 

 

Marie

[[He...]]

Hi Everyone.  Helping husband here.  My wife has been going along with her taper of valium, dropping 5% abiut every three to four weeks.  She still gets waves and has trouble sleeping, but that is expected.  She has been taking the valium in two doses each day, a total of 0.87mg.

Last night she missed her evening dose and is worried about what she should do.  She continued her regular routine this morning, but is still worried about missing one

dose.  She asked me to see what BB thought she should do.

Any suggestions or thoughts?

Thank you.

 

[[...]]

Hi

I missed a dose One night and the advice I received here was that due to Valium’s long half life it most likely wud not be noticeable. I think I was on about 1 mg 3 times a day at that time. I just kept to my doses and didn’t notice any difference. Most of the feedback was the same

Hope this helps

Curious I read your old posts is she on all liquid now?

Joeb