Miss Piggy needs advice

[[Mi...]]

Hi Pamster

The doctor. I have said no to the liquid as already struggled with a different brand of tablets plus I think I can get down lower okay on tablets.

Phoned 3 pharmacies about the liquid and none could guarantee same brand as tablets.

They are also saying do the crossover in one go instead of two so a direct swap 10mg tem for 5mg dia. I have concerns about that x

Hi

Had another phone call. They want me to change over to liquid to reduce. This was not discussed at the meeting and I am apprehensive about moving brands. Already had problems with tablets earlier. Any advise appreciated. UK based x

Thank you Pamster

All help, support and care very much appreciated x

 

Who are they and what is the liquid?

[[Mi...]]

Getting help from nhs as they were the ones who put me on them. Please do not go too fast. Best to pace yourself. I see you were getting similar advice from others on another thread. Take care.

hi piggy I'm gonna do a daily taper but i may push myself to the limits as i want rid of this shite out of me sorry for the language but as others have shown its each to there own i just think a daily taper is better for me then i feel like I'm actually getting somewhere than cut and hold but as i said everyones different i think its what you think ya self would be best and just go with it wishing you all the luck xx EDIT i see your UK based i cant get any help off my GP with benzo withdrawal have you gone to a private doctor as I'm amazed they are even helping i get a no they don't wanna know its better get on Heroin then they will give me Methadone the worlds all screwed with the pharmacy giants they don't care if your on a drug that cost pittance so they wont help me but i go the H route they help me cos they make money its a crazy world we live in money money money I'm not condoning the use of Heroin just to make that perfectly clear xxx thanks

[[Li...]]

Hi Pamster

The doctor. I have said no to the liquid as already struggled with a different brand of tablets plus I think I can get down lower okay on tablets.

Phoned 3 pharmacies about the liquid and none could guarantee same brand as tablets.

They are also saying do the crossover in one go instead of two so a direct swap 10mg tem for 5mg dia. I have concerns about that x

Hi

Had another phone call. They want me to change over to liquid to reduce. This was not discussed at the meeting and I am apprehensive about moving brands. Already had problems with tablets earlier. Any advise appreciated. UK based x

Thank you Pamster

All help, support and care very much appreciated x

 

Who are they and what is the liquid?

 

Are you certain the liquid uses regular tablets as the drug source?  According to the UK electronic medicines compendium (link below), two formulations of liquid diazepam are available in the UK — both of them use the the pure active drug substance (aka Active or Active Pharmaceutical Ingredient) as the drug source, not regular tablets.

 

Your concern about switching entirely to liquid is understandable. Have you considered using a combination of your regular tablets and the liquid?  You would take most of your dose in tablet form and only use the liquid to make reductions in dose.  Many of our members have used this combination approach to taper diazepam.

 

 

Link:

electronic medicines compendium (emc)

https://www.medicines.org.uk/emc/

 

 

[[Mi...]]

Thank you Libertas

I just assumed the liquid made by the same brand as my tablets would have the same ingreds. Sounds pretty naive now I think about it

Your idea of the tablets and the liquid is good. The doctor here is suggesting moving all over to liquid. I am not up for that! And it certainly was not discussed in our meeting....Thank you again.

Hi Pamster

The doctor. I have said no to the liquid as already struggled with a different brand of tablets plus I think I can get down lower okay on tablets.

Phoned 3 pharmacies about the liquid and none could guarantee same brand as tablets.

They are also saying do the crossover in one go instead of two so a direct swap 10mg tem for 5mg dia. I have concerns about that x

Hi

Had another phone call. They want me to change over to liquid to reduce. This was not discussed at the meeting and I am apprehensive about moving brands. Already had problems with tablets earlier. Any advise appreciated. UK based x

Thank you Pamster

All help, support and care very much appreciated x

 

Who are they and what is the liquid?

 

Are you certain the liquid uses regular tablets as the drug source?  According to the UK electronic medicines compendium (link below), two formulations of liquid diazepam are available in the UK — both of them use the the pure active drug substance (aka Active or Active Pharmaceutical Ingredient) as the drug source, not regular tablets.

 

Your concern about switching entirely to liquid is understandable. Have you considered using a combination of your regular tablets and the liquid?  You would take most of your dose in tablet form and only use the liquid to make reductions in dose.  Many of our members have used this combination approach to taper diazepam.

 

 

Link:

electronic medicines compendium (emc)

https://www.medicines.org.uk/emc/

[[Mi...]]

Libertas

Just had a look here

https://bnf.nice.org.uk/drugs/diazepam/medicinal-forms/

Appears to be 4 oral suspensions and 6 oral solutions. Will have to google the difference. Also pharmacies I have checked with just get the cheapest one from the wholesaler!

 

Thank you Libertas

I just assumed the liquid made by the same brand as my tablets would have the same ingreds. Sounds pretty naive now I think about it

Your idea of the tablets and the liquid is good. The doctor here is suggesting moving all over to liquid. I am not up for that! And it certainly was not discussed in our meeting....Thank you again.

Hi Pamster

The doctor. I have said no to the liquid as already struggled with a different brand of tablets plus I think I can get down lower okay on tablets.

Phoned 3 pharmacies about the liquid and none could guarantee same brand as tablets.

They are also saying do the crossover in one go instead of two so a direct swap 10mg tem for 5mg dia. I have concerns about that x

Hi

Had another phone call. They want me to change over to liquid to reduce. This was not discussed at the meeting and I am apprehensive about moving brands. Already had problems with tablets earlier. Any advise appreciated. UK based x

Thank you Pamster

All help, support and care very much appreciated x

 

Who are they and what is the liquid?

 

Are you certain the liquid uses regular tablets as the drug source?  According to the UK electronic medicines compendium (link below), two formulations of liquid diazepam are available in the UK — both of them use the the pure active drug substance (aka Active or Active Pharmaceutical Ingredient) as the drug source, not regular tablets.

 

Your concern about switching entirely to liquid is understandable. Have you considered using a combination of your regular tablets and the liquid?  You would take most of your dose in tablet form and only use the liquid to make reductions in dose.  Many of our members have used this combination approach to taper diazepam.

 

 

Link:

electronic medicines compendium (emc)

https://www.medicines.org.uk/emc/

[[Li...]]

Hello again, Miss piggy. 

 

Tip of the hat for researching what dosage forms of diazepam are available in your country!  Regrettably, the NICE British National Formulary (BNF) site is only available to users in the UK so I cannot review the formulations.  That’s amazing that 10 different oral diazepam liquids are available in the UK.  In the US, there are only two.

 

Solutions and suspensions are two forms of liquid mixtures.  A suspension is a heterogeneous preparation of a finely divided, undissolved substance dispersed in a liquid vehicle. A solution is a homogeneous mixture of one or more substances (solutes) dispersed molecularly in a sufficient quantity of dissolving medium (solvent).

 

In terms of dosing accuracy, a solution is preferable to a suspension.  Each and every milliliter of a solution contains exactly the same amount of the active drug substance.

 

My best guess is that the solutions you found in the NICE/bnf database use the active drug substance as the drug source, not regular tablets.

[[ha...]]

Thank Miss Piggy for the reply hope you get clean all the best i don't think i will get that help as i have never been prescribed off the NHS so its looks like the only way forward is the way iam currently on ill keep a eye out on how you are doing wishing you all the best we can do it xx

[[Mi...]]

Thank you Libertas. My reading this afternoon agrees with you that solution would be best. Is it not just amazing that we have to find out all these things for ourselves! Wish I had researched the meds before I accepted them in the first place. Steep learning curve!!

I will try and check if i can see the ingredients.

Hello again, Miss piggy. 

 

Tip of the hat for researching what dosage forms of diazepam are available in your country!  Regrettably, the NICE British National Formulary (BNF) site is only available to users in the UK so I cannot review the formulations.  That’s amazing that 10 different oral diazepam liquids are available in the UK.  In the US, there are only two.

 

Solutions and suspensions are two forms of liquid mixtures.  A suspension is a heterogeneous preparation of a finely divided, undissolved substance dispersed in a liquid vehicle. A solution is a homogeneous mixture of one or more substances (solutes) dispersed molecularly in a sufficient quantity of dissolving medium (solvent).

 

In terms of dosing accuracy, a solution is preferable to a suspension.  Each and every milliliter of a solution contains exactly the same amount of the active drug substance.

 

My best guess is that the solutions you found in the NICE/bnf database use the active drug substance as the drug source, not regular tablets.

[[Mi...]]

Libertas...

 

Diazepam 2mg/5ml oral solution sugar free Almus Pharmaceuticals LtdShowCautionary and advisory labels

 

May contain sorbitol, hydroxybenzoates (parabens), propylene glycol, sorbic acid.

 

Active ingredients

 

Diazepam 400 microgram per 1 ml

 

Does that make sense??

 

Thank you Libertas. My reading this afternoon agrees with you that solution would be best. Is it not just amazing that we have to find out all these things for ourselves! Wish I had researched the meds before I accepted them in the first place. Steep learning curve!!

I will try and check if i can see the ingredients.

Hello again, Miss piggy. 

 

Tip of the hat for researching what dosage forms of diazepam are available in your country!  Regrettably, the NICE British National Formulary (BNF) site is only available to users in the UK so I cannot review the formulations.  That’s amazing that 10 different oral diazepam liquids are available in the UK.  In the US, there are only two.

 

Solutions and suspensions are two forms of liquid mixtures.  A suspension is a heterogeneous preparation of a finely divided, undissolved substance dispersed in a liquid vehicle. A solution is a homogeneous mixture of one or more substances (solutes) dispersed molecularly in a sufficient quantity of dissolving medium (solvent).

 

In terms of dosing accuracy, a solution is preferable to a suspension.  Each and every milliliter of a solution contains exactly the same amount of the active drug substance.

 

My best guess is that the solutions you found in the NICE/bnf database use the active drug substance as the drug source, not regular tablets.

[[Li...]]

Yes, a 2mg/5mL oral solution has a concentration of 0.4mg/mL (2 divided by 5). 

 

That’s a lower concentration than the 1mg/1mL oral solution used by many of our US members to taper diazepam. The lower concentration is a plus for tapering because it would allow you to make smaller reductions in dose if needed.

 

Edit: typo

 

 

 

[[Mi...]]

Thank you Libertas. I am so apprehensive about changing the meds then the liquid. I am super sensitive to stuff.

Moan over. Sorry 🙄😉

Yes, a 2mg/5mL oral solution has a concentration of 0.4mg/mL (2 divided by 5). 

 

That’s a lower concentration than the 1mg/1mL oral solution used by many of our US members to taper diazepam. The lower concentration is a plus for tapering because it would allow you to make smaller reductions in dose if needed.

 

Edit: typo

[[Mi...]]

Pamster - what are your thoughts on a direct swap? I really wanted to start tonight. They are delaying as they want a direct swap and I wanted to do it in 2 moves....

[[Pa...]]

Are we talking discontinuing the 10 mgs Temazepam tonight and replacing it with 5 mgs Valium?

[[Mi...]]

Yes Pamster

Do you think it is risky?

I would have preferred a two step process

Are we talking discontinuing the 10 mgs Temazepam tonight and replacing it with 5 mgs Valium?

[[Pa...]]

I feel that since you already have Valium on board you should be okay, if you're uncomfortable just try to calm yourself because its not risky, its just not ideal but you'll be okay. 

[[Mi...]]

Thank you Pamster. I did not do it last night. Seeing the nurse today and just going to tell her I did not agree to a direct swap. This will be the fourth time i have told her then will do as we discussed. It just makes everything so much more stressful. Thank you for your patience and time. Take care.

I feel that since you already have Valium on board you should be okay, if you're uncomfortable just try to calm yourself because its not risky, its just not ideal but you'll be okay. 

[[Mi...]]

Seen the nurse. She has agreed to two step crossover. Assuming 5mg tem=2.5mg dia. How long for before full crossover?? Thank you x

Thank you Pamster. I did not do it last night. Seeing the nurse today and just going to tell her I did not agree to a direct swap. This will be the fourth time i have told her then will do as we discussed. It just makes everything so much more stressful. Thank you for your patience and time. Take care.

I feel that since you already have Valium on board you should be okay, if you're uncomfortable just try to calm yourself because its not risky, its just not ideal but you'll be okay. 

[[Pa...]]

I'm glad you got your way, good for you!  Professor Ashton suggested 1-2 weeks so I'd follow her recommendation.  https://www.benzo.org.uk/manual/bzsched.htm#s9

[[Mi...]]

Thank you Pamster. I am taking strength from this forum and your knowledge. Appreciate it all x

I'm glad you got your way, good for you!  Professor Ashton suggested 1-2 weeks so I'd follow her recommendation.  https://www.benzo.org.uk/manual/bzsched.htm#s9

[[Mi...]]

Hi Pamster

I have crossed over now to all diazepam.

First week did 5mg T and 2.5mg D at night

2nd week did 5D at night

Apart from feeling more tired at the moment- seems to be okay.

This means I am now on

B 3mg L 3mg T 5mg B 5mg (16mg)

I have said I want to come down slow and they agreed now to cut and hold at 0.25mg a month.

What are your thoughts on this?

Should I take of from tea time one first?

I am apprehensive to go faster but maybe I should but want to try to maintain quality of life...

Also will bring up liquid again - maybe for the reducing part only or get ready for DMT later.

All thoughts appreciated!

Thank you MP x

[[Pa...]]

Is this your current dosing schedule?

 

Breakfast 3 mg

Lunch 3 mg

Teatime 5 mg

Bedtime 5 mg

 

Are your pills 2 or 5 mg?  I don't feel you'll need to worry about liquid Diazepam for awhile yet, you can dry cut your tablets just fine.

 

Reducing .25 mg each month is a very slow taper but if this is what you want then you can certainly use this rate but it might be more advantageous to taper according to your symptoms.  Quality of life can be maintained by doing this.

 

What dose you decide to taper first should be based on where you can afford to cut, if you feel fairly good at teatime then choosing that one for your first cut makes sense.  The next reduction could be made to your lunch dose if you feel you have some wiggle room there.  Its all about how you feel, this is why its so important to keep a good record of your reductions and symptom severity. 

[[Mi...]]

Yes that is the current dosing schedule Pamster.

Since moving completely over I am feeling really tired? Is that common?

Pills are 2mg

Do you think a faster taper like 0.25mg every 2 weeks would be better? It's so hard to tell and I am very scared I go too fast and cannot get back on an even keel.

Thank you

MP

 

Is this your current dosing schedule?

 

Breakfast 3 mg

Lunch 3 mg

Teatime 5 mg

Bedtime 5 mg

 

Are your pills 2 or 5 mg?  I don't feel you'll need to worry about liquid Diazepam for awhile yet, you can dry cut your tablets just fine.

 

Reducing .25 mg each month is a very slow taper but if this is what you want then you can certainly use this rate but it might be more advantageous to taper according to your symptoms.  Quality of life can be maintained by doing this.

 

What dose you decide to taper first should be based on where you can afford to cut, if you feel fairly good at teatime then choosing that one for your first cut makes sense.  The next reduction could be made to your lunch dose if you feel you have some wiggle room there.  Its all about how you feel, this is why its so important to keep a good record of your reductions and symptom severity.

[[Pa...]]

Its common to feel sedation at first but I'm told it goes away as you acclimate to it. 

 

Given your fear, I'd start slow just like you're planning and as long as your doctors are on board I see no reason to go any faster unless you decide you'd like to.  This is your taper your way and maybe once you start it you'll get more comfortable with the process and quit fearing it because its going to lead you to benzo freedom. 

[[Mi...]]

Thank you Pamster

So just to confirm I have gone from 11mg D plus 10mg T to all 16mg D over a two week block

So you think I should start to reduce now? No need to wait for further time for any settlement?

Thank you

MP

Its common to feel sedation at first but I'm told it goes away as you acclimate to it. 

 

Given your fear, I'd start slow just like you're planning and as long as your doctors are on board I see no reason to go any faster unless you decide you'd like to.  This is your taper your way and maybe once you start it you'll get more comfortable with the process and quit fearing it because its going to lead you to benzo freedom. 

[[Pa...]]

The fact you're feeling sedated tells me you've most likely reached full Valium saturation so you can start whenever you feel comfortable doing so but the key word is here is comfortable.  If you have doubts about starting then you can certainly wait awhile longer, this is about your comfort and confidence in this method.