Posted by fachad on July 4, 2002, at 17:07:05
In reply to Re: Focalin vs. Ritalin? (and Focalin Dose Questions), posted by BekkaH on July 3, 2002, at 23:41:57
Bekka,
Answers to your questions below.
Bekka: Can any pharmacy make them (custom strength caps) up? I've never heard of this...fachad: No, regular pharmacies like grocery store or chain drug store pharmacies do not do any compounding or custom meds. All they do is count pre-made pills from big bottles and put the correct number into little bottles, which IMHO, is an awful waste of the specialized skills and training of a pharmacist.
In contrast, a compounding pharmacy can make custom strengths, or custom combination meds, or custom delivery systems like liquids or lozenges or topical creams or whatever. The possibilities are endless.
Most insurance won't pay for this - but the two compounding pharmacies I contacted have very reasonable prices, which was really a surprise to me.
It's something you may want to look into if you have problems with adverse effects due to too high standard dosages.
Bekka: Mix the contents of the capsule with 4 oz or 8 oz (or however much you want) of applesauce.
Regarding the applesauce thing, I just open the capsule into water and stir vigourlsy until it looks completely dissolved and equally mixed. Then I drink the amount that has the right amount of milligrams. I don't know how you could ensure equal mixing in applesauce.
Bekka: Do you take Dex immediate release or SR?
fachad: I take immediate release 10 mg Dextrostat generic tablets. It's far less expensive than the Dexedrine Spansules. Besides, it lasts a long time for me, not like Ritalin which wears off in less than 2 hrs.
Bekka: So, would you say that you're taking approximately 2.5-3 mg of Surmontil a day?
fachad: Yikes, it's hard to guess, but I'd guess more like 5 - 10mg of Surmontil. I had the Compounding Pharmacy call my pdoc for the RX for the 2.5 mg caps, I'll know soon what the optimum dose is for me.
Bekka: when I do take Ritalin, I take approximately 30-40 mg. When I take Concerta, I take 54 mg.
fachad: I took Ritalin 30 mg a day for a quite a while. When Concerta came out, 36mg seemed a lot less than 30 mg Ritalin, so I took 54mg.
Bekka: I have been told that the Methylphenidate dosing is supposed to be twice the number of milligrams that you'd take of Dexedrine.
fachad: I've heard the same rule of thumb. I think I should have been taking more Concerta all along, but my insurance will only pay for one pill per day, period.
Since I am taking 40mg of Dex, that would imply that I should take 80mg Ritalin. Since Focalin is supposed to be half the Ritalin dose, I'm guessing it should be the same as dex, 40mg. But the package insert talks like the FDA prescribing limit is 20 mg per day. That's why I was wondering if anyone had been RX'd more than 20 mg/day.
Take care,
fachad.
> > > By the way, how is your Surmontil trial coming along?
> >
> > Still taking it in tiny doses. I'm seeing my pdoc in a few weeks and I'm going to ask then for the custom 2.5 mg capsules. (They can be made at a compounding pharmacy.) Till then, it's just open the capsule and take a "little bit". Maddeningly unscientific, but the best I can do for now.
>
> Very interesting. Can any pharmacy make them up? I've never heard of this. It sounds like a good idea since I have so much trouble combining meds. I usually need to take teensy tiny doses of any 2nd or 3rd meds. Usually I can't even try a third med due to adverse interactions.
>
> When opening up capsule medicines, as long as they are not time release, you can also try this: Mix the contents of the capsule with 4 oz or 8 oz (or however much you want) of applesauce. Mix it very well so the medicine is well distributed. Then take the number of ounces that should contain the number of milligrams of the medicine you mixed in. Of course, this assumes that the medicine is well distributed and that it dissolves well, etc. Again, it's not very scientific, but it's better than taking the whole capsule.
>
> > >How much Dexedrine are you able to combine with the Surmontil?
> >
> > Well, I take 40mg/day of Dex.
>
> Do you take Dex immediate release or SR? So, would you say that you're taking approximately 2.5-3 mg of Surmontil a day?
>
> > The Surmontil is a unique TCA in that it does not affect either NE or 5-HT reuptake, so it should not potentate the pressor effects of dex. I limit the Surmontil dose because of other side effects like dry mouth, constipation and possibility of weight gain, not because of interactions with dex.
> >
> > I'm encouraged that you found Focalin so potent. How much Ritalin do you take? How much Focalin did you take?
>
> Well, I tried Focalin only briefly. I don't think I took more than 10 mg, but I know someone who took 10 mg twice a day and liked it much bettter than Ritalin (fewer side effects). I am currently on Dexedrine, but when I do take Ritalin, I take approximately 30-40 mg. When I take Concerta, I take 54 mg. I have been told that the Methylphenidate dosing is supposed to be twice the number of milligrams that you'd take of Dexedrine. I take 25-30 mg of Dex per day, but for some reason, I've never been able to tolerate 50-60 mg of Ritalin immediate release. I will try Focalin again some time. It takes a while to get used to any of these meds, and I didn't give Focalin enough time to work.
>
> Bekka
poster:fachad
thread:110960
URL: http://www.dr-bob.org/babble/20020628/msgs/111415.html