Ambien/Ambien CR Equivalent Dose -- Anybody Know?

[[la...]]

I recently switched from Ambien CR 6.25 mg to a compounded rx which suspends 5 mg of Ambien in a continuous release liquid.

 

Any insights on why I'd be feeling crummy?  Headaches, extreme grogginess in the morning, eye twitching, flareup of tendinitis symptoms.

 

Does anybody know for relative certain if Ambien 5 mg is roughly equivalent to Ambien CR 6.25 mg?

 

If this is merely dose cut discomfort, no worries.  I just hope that:

• 
  I haven't accidentally increased my zolpidem dose.
   
  
• The CR liquid is not resulting in too slow of a release and extending my morning hangover.
  

 

I will contact the compounding pharmacist about this tomorrow or Wednesday; just trying to gather a little data first.

[[Be...]]

The only thing I know about ambien cr vs plain ambien is that the CR is time released or longer acting.  I think they are supposed to be the same strength of total benzo.  Asking your pharmacist is all that comes to mind and you already figured that out. Of course, I'll be interested in what you find out.

[[Co...]]

5mg Ambien per what volume? Is it that there is 5mg of Ambien per teaspoon (5ml), or some other measurement? If so, how much liquid (volume) do you take?

[[la...]]

Hi, all.  It's 1 mg Ambien per 1 ml liquid.  I take 5 ml (5 mg).

 

By the way, I am much improved today and now suspect it was just drug-swap turbulence.

 

After so many years of exposure to Zolpidem, I have (unfortunately) a very refined "palette."  I can detect differences in the drug when procured through different pharmacy chains.

 

And now, switching from commercial Ambien CR to crushed-up Ambien mixed in bubble-gum flavored CR fluid....  Perhaps some turbulence is to be expected?

 

We'll see how this shakes out in the next few days.

[[Co...]]

Hi,

 

Ah, that explains it. Since you take 5ml @ 1mg per ml, you take a dose of 5mg. Since your previous dose was 6.25mg, your dose has dropped by 20%. Our general advice is to keep cuts to no more than about 10%. When you get a new prescription, maybe ask your doctor for 0.9mg per ml. This would work out 4.5mg for a dose of 5ml, and equates to a 10% drop. In all probability, you will be able to manage such drops every 1-2 weeks without too many ill-effects.

 

For how long is your present prescription intended to last?

[[la...]]

Well, if you think about it, my starting dose was actually 12.5, so my drop is around 10% from the initial dose.

 

The pharmacist was kind enough to provide an all-purpose prescription to help control cost:  at 1 mg/1ml, it's easy to speed up or slow down the reduction.  If you want to cut by a modest amount, you take a little less fluid; if you want to be more aggressive, take much less fluid.  It allows you to be as aggressive or conservative as you wish, without having to purchase a different prescription.

 

The current prescription supplies enough medication to see me through a 1 mg reduction every two weeks, until the drug is eliminated (10 weeks, estimated).

 

I'm feeling quite well today, and wonder if I've simply weathered the drug change storm.  I note that Sylvia, who participates on my buddie blog, reports that her switch from Ambien CR 6.25 to Ambien 5mg also produced some turbulence after a few days.  The two do not appear to have a convenient direct equivalence.  That's good info for anyone else who may plan to taper from Ambien CR.

[[Co...]]

Hi,

 

I don't understand. When describing doses, mg is the active ingredient. So, you were taking 6.25mg Ativan CR, and switched to daily dose of 5ml (@ 1ml per 1ml), you have cut your dose by 20%. Is there something I'm missing?

 

Yes, you should be able reduse your dose by taking less liquid. How easy/difficult do you find this?

[[la...]]

Hiya, Colin.  My starting dose in late April was 12.5 mg.

 

From my starting dose in April (12.5), my reduction is 10%.  A 1.25 mg reduction (from 6.25 to 5) is 10%.

 

From my most recent dose (6.25), the reduction is closer to 20%.  So, I guess it depends on whether we reckon these things from the original dose, or from the most recent dose.

 

The liquid dosing is proving pretty easy.  They provided a 1 mg:1 ml fluid, and a syringe where I can easily measure the fluid out to as little as .10 ml.

[[Co...]]

Hi,

 

Sorry to keep drilling this home, but a 1.25mg reductions from 6.25mg is a cut of 10%. 1.25/6.25 = 0.2 (20%).

[[la...]]

Just wanted to update this storyline to report that the compounded rx seems to be working quite well.  After a brief adjustment, I am quite comfortable with this substitution and am now in the titrating phase.  So it makes sense to switch venues and continue the discussion over in http://www.benzobuddies.org/forum/index.php?topic=12936.0, on the Titrating board.

 

In case anyone should come across this post looking for ideas for tapering off Ambien CR, my prescription reads as follows:  "ZOLPIDEM SR FIXED OIL 1 MG/ML SUPENSION, Take up to 10 ml at bedtime per taper protocol."  It was dispensed by Pharmacy Innovations in Jamestown NY.  The cost was considerably less than normal Ambien.

[[sy...]]

Less? I paid $6.60 for 30 Ambien (5mg) at our local Costco Pharmacy. Or did you mean Ambien CR?

 

Sylvia

[[la...]]

My insurance doesn't cover Ambien or Ambien CR.  The compounded prescription from a small, reasonably-priced pharmacy costs me about 1/6 as much as Ambien CR out-of-pocket.

[[Co...]]

Hi,

 

It should be kept in mind that a compounding pharmacy will use cheap generic Ambien (not the CR type) to make up the liquid. So, it should not be altogether surprising that a compounded Controlled Release liquid might work out less expensive than the Ambien CR capsules. However, it is surprising to me that so few doctors will use a compounding pharmacy. If they do not trust their own abilities to make such a prescription, it kind of begs the question if they are up to being a doctor. It is not rocket science after all.

[[sy...]]

We have a $3000 deductible on our health insurance so I pay everything out of pocket until we reach that amount. 30 Ambien CR (12.5mg) cost $137.

 

Sylvia

[[la...]]

Colin, you're 100% correct about the recipe:  regular Ambien in a CR liquid, so it is more affordable.

 

However, it is surprising to me that so few doctors will use a compounding pharmacy. If they do not trust their own abilities to make such a prescription, it kind of begs the question if they are up to being a doctor. It is not rocket science after all.

 

How strongly I agree with this statement!  It is among the most highly-compensated and highly-regarded professions and, silly me, I would expect it to require significant skill.  The irony of their concern about drug safety...  Words simply fail me.

 

And I further note that the "magic CR" formula (which adds $3-$4 to the price of each Sanofi-Aventis tablet) can be at least closely approximated at no cost by a pharmacist, in a flavor of your choice, from bubblegum to salmon.

 

I might be irritated by all this, except that my irritation receptors were burnt off years ago from overuse syndrome.

 

But in any case, I am pleased to have found my path forward.  Hopefully, someone else may discover this thread and be spared the same expense and delays I endured.