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Question

Posted on: March 6 2013

Maniprex in syrup?

I have a Pati ë NT here who do not want to swallow tablets and they must take Maniprex. Now my question was to make an oral solution. I have already been asked about Neurolithium but apparently that is out of the trade and only still available on the French market (which it also makes expensive and it is reasonably urgent). Can I work with better lithium citrate because it is soluble in water. I have seen that I have to pack about 1.5 à 2 times the quantity as lithium carbonate (because prolonged release). Or do I work better with lithium carbonate in suspension form? But is there no risk of interaction via lithium ions? And the pH adjustment? The tablet is also enteric encased. Ph? I've just tried to crush a tablet of Maniprex and rub it with propylene glycol and then water added and vigorously shaken.

Answer

I only see the carbonate available as lithium salt with a solubility of 15g per litre. But we would not be able to prepare the citrate salt from the carbonate.

In The USP is a lithium citrate syrup described. Per 5ml contains 8mEq which is equivalent to the amount of 300mg Li-carbonate. The Litium citrate can be prepared from Li-carbonate and citric acid in a ratio so that we obtain approximately dilithium citrate.

from the reaction of 2 mol Li-carbonate (MG = 73.9) with 2 mol citric acid anh. (MG = 192) We get 2 mol diLi citrate (MG = 203).

this equation allows to calculate how much citric acid anh. You have to add to your amount of Li-carbonate.

There is also 0.3% v/V ethanol present. Nothing is mentioned about the other ingredients.

Neurolithium are potable ampoules with Li-gluconate (1 or 2g in 5 or 10ml water) plus 50 or 100mg NaCl. This would correspond to 34.35 mg or 68.7 mg Li.