Posted by Larry Hoover on March 30, 2007, at 10:42:39
In reply to Dose and Drug manufacturing, posted by Squiggles on March 30, 2007, at 8:30:47
> The advice to switch to liquid preparations, i found audacious.
It is the optimal way to titrate small doses. That's why pediatric formulations are so often liquids, as dose in that population is generally a function of body weight, a variable of an order of magnitude range.
For liquid medication, dose is directly proportional to volume. Moreover, nothing could be easier to measure, as pharmacies supply syringes for that purpose. Even if you had to make your own drug solutions, the syringes are not restricted access.
What is audacious about this?
> The same goes for lithium, which comes in 300mg caps. Some people may actually do better on 800mg or 700mg, but you can't cut a cap.
It's easy to cut a cap. I do it all the time. Measuring piles of powder by eye is still an option. Powder a pill/open a cap. Divide with razor blade. Done.
Or just do a variable dosing pattern. 900/600/600 averages 700. 900/900/600 averages 800. The peak/trough concentrations will only be slightly more extreme than if the manufacturer complied with your desires.
Another alternative is to visit a compounding pharmacy. They'll make up exactly what you want. Low-dose naltrexone therapy is only available by this method, for example.
If you're not willing to titrate *as your body apparently requires*, don't blame somebody else for that. There are numerous options, none of which are audacious in the least.