Now Available: Maudsley Deprescribing Guidelines

[[Li...]]

 

Oops!  There is an error in The Maudsley Deprescribing Guidelines under the “Dilutions” subheading in the diazepam section (p. 405).

The text states:

In the USA, the manufacturer recommends that the 5mg/mL (Intensol) solution should be mixed with water or other diluents to make a less concentrated solution for use. 

The official US FDA label from the manufacturer states: 

Diazepam Intensol Oral Solution is a concentrated oral solution as compared to standard oral liquid medications. It is recommended that Diazepam Intensol Oral Solution be mixed with liquid or semi-solid food such as water, juices, soda or soda-like beverages, applesauce and puddings.

Use only the calibrated oral syringe provided with this product. Draw into the oral syringe the amount prescribed for a single dose. Then empty the oral syringe contents into a liquid or semi-solid food. Stir the liquid or food gently for a few seconds. The Diazepam Intensol Oral Solution formulation blends quickly and completely. The entire amount of the mixture, of drug and liquid or drug and food, should be consumed immediately. Do not store for future use.

Why does this matter?

Mixing the diazepam Intensol with water to make a less concentrated solution from which the required dose would be measured is not the same thing as mixing the already measured dose of the concentrated liquid with water or another liquid to enhance palatability.  

Some prescribers and pharmacists are uncomfortable with drug manipulation*.  If yours fall into this camp, you would be wise to avoid making the incorrect claim that the manufacturer recommends dilution of the Intensol for the purpose of obtaining smaller doses.

*Drug manipulation is the physical alteration of a dosage form for the purpose of extracting a proportion of the drug amount. 

 

[[Ma...]]

How do you get a free copy?

[[Li...]]

35 minutes ago, [[M...] said:

How do you get a free copy?

@[Ma...] You could contact your local library to ask if they can get it via inter-library loan or would be willing to purchase a copy for general circulation.

[[Ma...]]

Thank you. Did I read somewhere that someone had a PDF? I can’t find it & hopes they may share…assuming that is legal.

I want to forward it to my provider who got me into this mess 2 years ago this month 🤨.

[[Li...]]

You’re welcome. The publisher has made selected pages of the book available via Google Books at:

The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines ... - Mark Horowitz, David M. Taylor - Google Books
https://books.google.com/books/about/The_Maudsley_Deprescribing_Guidelines.html?id=BnnsEAAAQBAJ

 

[[je...]]

14 minutes ago, [[D...] said:

Hi, i am currently planning my taper from 3mg diazepam and i am worried about how much i can taper when getting to low doses. Can you tell me more about gaba-a occupancy or help me get more info?

Thanks

Hi @[Do...]. I believe this is what you were looking for. Just start reading this thread from page 1. 

[[Do...]]

1 minute ago, [[j...] said:

Hi @[Do...]. I believe this is what you were looking for. Just start reading this thread from page 1. 

Thanks so much