Really need help on titration for ativan as going to get a liquid solution!!

[[Sh...]]

How long can liquid ativan solutions made up by a pharmacy stay fresh if they are in the fridge? Also if it is a good compounding pharmacy, do they make up acceptable solutions and is this the best way to taper (titrate) off of ativan since I am now on  my last push and it is brutal? What do you suggest in terms of what the taper formula should be as I am now at .35mg of ativan as you can see by my story below. What should I tell the pharmacist to make up?

 

Thanks so much,

 

Sean

[[po...]]

Hi Sean

 

I use compounded ativan and organized with the pharmacist to have it made up to .1ml Ativan =1ml of the compound liquid.  My total bottle was 300ml.  I find this works well and accurately for me.

 

You probably need to sort out the shelf life with the pharmacist, as I guess it will depend on what they use.  After a couple of months I notice mine gets a bit of white crust around the edges of the bottle.

 

Do make sure you give the bottle a good shake each time before drawing, as sometimes sediment does gather on the bottom.

 

oh and for me not nearly as brutal as the first two thirds, its getting easier

 

best of luck

poppins

[[...]]

Hi Shift:

 

I encourage you to discuss all your questions regarding compounded ativan with your pharmacist as well as with your doctor who will be writing the prescription.

They will be able to tell you how long the suspension remains stable, and the various concentrations they can compound to help you taper off the remaining .35 mg.

 

I can't say if this is the best way to taper off ativan as everyone is different.  You need to find the method that works best for you.  Some people prefer to make their own suspension, some crossover to valium due to the longer half-life, some use compounded liquids or capsules.

 

Hope this helps.  Take care.

 

mmgc

 

[[Be...]]

I'm afraid I don't know how the liquid compounding works, Shift400.    I imagine you could ask the pharmacist how long the liquid ativan is good for.  They put expiration dates on everything else so why not this?  I think you will just have to settle on how fast - or slow - you want to taper off and let the pharmacist translate that into a liquid mix with instructions.  Most people seem to start liquid tapering by removing 1% the 1st day, 2% the second day and so on.  Hope this helps.

[[...]]

Hi mmgc,

 

I am tapering off Ativan using Intensol liquid which is a 2mg/ml solution that is manufactured, not compounded.  I use a diabetic syringe (Becton Dickinson was only syringe brand that worked well for small, precise amounts) from which I remove needle and then just withdraw Intensol dose, and empty dose into some water, and drink water.  I add more water to glass and drink it, and repeat again.

 

Here is an example as to how I calculate how much Intensol to withdraw:  I am down to .16 mgs of Ativan twice daily, for a total dose of .32 mgs per day.  I withdraw .08 mgs of the 2mg/ml solution (the solution is double concentration, that is instead of 1 mg/ml it is 2mg/ml so I need to withdraw half the amount of my dose for it to be equivalent.  This method allows you to get very small doses.  One  I am tapering slowly, very slowly and doing well.  If you have any questions you can contact me.  Good luck.

 

Yael

[[Sh...]]

Thanks I appreciate that. What do you mean by 1 percent the first day and 2 percent the second day?

[[Sh...]]

Thanks, you all are so helpful!! How do you carry your solution around if you go out during the day?

[[...]]

Thanks, you all are so helpful!! How do you carry your solution around if you go out during the day?

 

You could put each dose in a small container with a secure lid and place it in a lunchbox with a few ice packs to keep it cool.

[[...]]

Thanks I appreciate that. What do you mean by 1 percent the first day and 2 percent the second day?

 

I think when Beeper says to remove 1% the first day and so on, she is referring to a titrated suspension made at home.  Most people using this method use a 100 ml cylinder to suspend their crushed tablets in and discard 1 ml the first day leaving them with 99 ml and so on.  Most people use milk or water to titrate at home without the use of preservatives.

If you get a compounded liquid from the pharmacy you probably don't need to discard any of it just use a syringe to take what you need.  The compounded liquid generally contains preservatives.  The pharmacist will be able to explain to you the best way to administer your doses once you discuss your taper schedule with him/her.

[[po...]]

in terms of carrying around, I found some perfect little glass bottles that each hold 10mls - they were part of a bath oil sample set I was given - dr Haushka.  They've been perfect, small enough to carry.  However once I'm off, I may never be able to buy that particular bath oil again!

[[Sh...]]

All great ideas and good information.

[[pr...]]

Since this is going to be a pharmaceutical preparation, your pharmacist should be able to tell you how long it will last and whether or not it needs to be refrigerated.  They'll know that stuff.