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Trazodone liquid Form

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  • #16
    To add my thoughts to the discussion...
    Different generics/brands do have slightly different 'dissolution profiles' and you may have been subject to 'dose dumping'.
    This is where the tablet dissolves rapidly and gives a higher peak that might push someone sensitive to the ingredients into mild side effects.
    A different manufacture might dissolve less rapidly and give lower peak.

    Evidence : a patient on one generic of citalopram had this happen when same strength of a different generic was given.
    Not a clinical trial but when original generic was used patient happy again!
    Note the patient is not a picky person and wasn't "name focused".
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    • #17
      Honestly this all sounds very convoluted for what in principle should be a simple exercise.

      If a tablet completely dissolves in liquid I dose volumetrically. Otherwise I cut the tablet to the correct weight.

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      • #18
        Originally posted by Trevor 123 View Post

        Hi I thought I would give an update. Doctor prescribed me 150 mg tablets to split into quarters (37.5mg) to see if there would be less sedation than 50 mg as planned. The doctor was happy for me to split myself and the pharmacist was helpful in supplying a pill cutter. The prescription read:
        Trazodone 150 mg take 1/4 tablet daily and increase if desired.

        I took a quarter at night for a period of 9 nights. I found the splitting relatively easy. However I still found the slightly lower dose caused too much sedation at night like the 50 mg dose In the past.

        I then out of curiousity wondered could I go lower!!? I had found a scientific article that concluded the Cns depression threshold for trazodone is 25mg. So I split the tablet even further in to 1/8 of a tablet equating to 18.75 mg very ish .... ! And I have taken these small quarters for 4 nights and the 5th would be tonight. I have been very surprised. Ive had some nice sleep without feeling over sedated. In the daytime I have still felt an anti anxiety effect. placebo effect ? Who cares if it helps , however there’s clearly still an effect that takes edge off anxiety. I like trazodone even better with the less sedation.

        Am I a medical genuis! Um no I don’t think so, probably a pain the the arse and a nightmare patient to a pharmacist and doctor.

        I will go to my pharmacist and a review with GP soon. But I am very concerned that I might be doing harm to myself by splitting the tablets even smaller and the drug being released too quick for my liver to cope with? Is the drug being released too quick? Maybe it’s even less chance of harm as it’s a tiny dose? The film coating is missing on three sides but still pretty much intact top and bottom and at the back! I have enclosed a photo of the tablet cut down to see what u think there quite a bit of the drug exposed. I’m really worried now it is unsafe to do it. Hopefully my mind can be put at rest.

        I did have a quote for the liquid form 50mg/5ml 120ml for £52 inclusive of delivery. This was from a well known pharmacy that has adverts on tv at moment ( don’t think I’m allowed to name it!) At this low dose that would last me nearly 3 months. And if I got through 3 bottles a year then that could be £200 ish if my Gp did a private prescription. Private seems lower cost than cost to NHS? How does that work ? I’m guessing theres
        a chance this price might sky rocket anytime.

        So not sure what to do !






        Splitting these normal tablets will not usually effect the absorption profile by any considerable amount, but it can still happen. As pharmanaut above explained, different systems can have different drug release profile. The only times we really tend worry about splitting a tablet would be if it is a modified release tablet, this is not the case for you. Just keep the split tablets in an amber bottle to protect from the light. I would split one tablet at time and only split another when you completely used 8 others.

        As for whether it is okay clinically for you to split the tablets further to 18.75 mg, if it's something you managed easily then by all means go for it. What's important is whether the dose is working for you and you're not getting any side effects. I was originally going to advise you to think of splitting in 8th but I did not know what tablets you would get (meaning I would not know their size). If this current dose is working for you, discuss it with your GP. Remember, this current dose is not a licensed dose so both you and your GP should agree to use it.
        Last edited by Mpharm.; 28th, November 2018, 10:34 PM.

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        • #19
          Originally posted by Energize View Post
          Honestly this all sounds very convoluted for what in principle should be a simple exercise.

          If a tablet completely dissolves in liquid I dose volumetrically. Otherwise I cut the tablet to the correct weight.
          How many medicines do you know that dissolve completely in water (most common solvent)? Sadly most drugs tend to form non-solution so such methods, although highly desirable, are not that practical. In in olden days we could have formulated a suspension in a pharmacy but it seems that's fallen out of favour these days.

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          • #20
            Originally posted by Mpharm. View Post



            Splitting these normal tablets will not usually effect the absorption profile by any considerable amount, but it can still happen. As pharmanaut above explained, different systems can have different drug release profile. The only times we really tend worry about splitting a tablet would be if it is a modified release tablet, this is not the case for you. Just keep the split tablets in an amber bottle to protect from the light. I would split one tablet at time and only split another when you completely used 8 others.

            As for whether it is okay clinically for you to split the tablets further to 18.75 mg, if it's something you managed easily then by all means go for it. What's important is whether the dose is working for you and you're not getting any side effects. I was originally going to advise you to think of splitting in 8th but I did not know what tablets you would get (meaning I would not know their size). If this current dose is working for you, discuss it with your GP. Remember, this current dose is not a licensed dose so both you and your GP should agree to use it.
            Hi just wanted to say thank you for reply’s. FYI the tablets I spilt into 1/8 is the mylan brand. They are about 1 inch diameter I think. If there are any bigger pills it would make splitting easier lol

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            • #21
              When weaning myself off amitryp, I cut the 10mg tabs into halves, then quarters.
              johnep

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              • #22
                Originally posted by Mpharm. View Post

                How many medicines do you know that dissolve completely in water (most common solvent)? Sadly most drugs tend to form non-solution so such methods, although highly desirable, are not that practical. In in olden days we could have formulated a suspension in a pharmacy but it seems that's fallen out of favour these days.
                Honestly I couldn't say, probably not many. I have had success in the past using ethanol or water as the solvent with a couple of medications, but I prefer to just cut the pill and weigh it on a sensitive scale if I need a fraction of a dosage.

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