The Klonopin Klub#2

[[Mo...]]

Dehytq2 - I wish earplugs helped and I could use them.  I had customs made but my left ear is so tender, I can't even get it in.  Even with them, believe it or not, and they are 25 DB reduction, I still can hear things too loud.  Audiologists are saying I'm one of the most extreme they have seen.  I have always kind of had sensitive hearing but this is nothing comparable.  I also have tinnitus now and it's gotten worse, and my ears pop, flutter, vibrate.  It's extremely scary and bizarre.  I have been shaking and trembling for months now.  I have been in acute for months.  I cannot stay in bed as I have akathisia.  Do you not?  Also, looks like you tried Valium and it did not work for you?  I only added it in 1 day several months ago and did not cross b/c of other new SX but I'm tempted to try again as I'm that desperate, though I know I just need to get off the med.

 

Libertas - sorry you are still having trouble with the homemade liquid.  I tried it and though it is absolutely the most accurate, I don't know why it would not do well for me.  I may try again though b/c I am desperate.  Did you finally adjust and if so, how long did it take for you? Milk or vodka/water for you? I tried for 5 days but was sinking fast on it. 

 

Final - Thank you for the info. on the pharmacies.  I will check them out.  Many do not deal with other states or only certain states but it would be good to get that info.  How were you cutting your doses?  Were they able to accurately microtaper?  I also used to use Doctor's Best a long time ago.  I have considered trying again but I get so agitated easily.  I'm also very dried out, from this withdrawal and unfortunately, because I am on other meds too (sigh).  Before, when I've been on the magnesium, I got dried out more but I may need to give it another go.  Try to remember that the depression is related to your medication and your situation.  You can/will come through this.  Depression is tough as I have it/have had it many times but you will come through this, likely as soon as you are off the K. 

[[Fi...]]

 

Final - Thank you for the info. on the pharmacies.  I will check them out.  Many do not deal with other states or only certain states but it would be good to get that info.  How were you cutting your doses?  Were they able to accurately microtaper?  I also used to use Doctor's Best a long time ago.  I have considered trying again but I get so agitated easily.  I'm also very dried out, from this withdrawal and unfortunately, because I am on other meds too (sigh).  Before, when I've been on the magnesium, I got dried out more but I may need to give it another go.  Try to remember that the depression is related to your medication and your situation.  You can/will come through this.  Depression is tough as I have it/have had it many times but you will come through this, likely as soon as you are off the K.

 

Thank you for MO7B for your encouragement about getting off and the reminder about depression. It's so hard to separate out the depression from the medication.  I get so worried about the depression lifting.

 

I do understand that dry feeling from magnesium but I'm trying to drink more water.  I found I only need a small amount at time.

 

I do think those compounding pharmacies do ship to other states.  I did the prescription pills on a monthly basis.  But I only lasted a month on them.

 

 

 

[[De...]]

Mo7b, I M so sorry you are feeling way. I kmow the feeling when it gets so bad you dont know how you can take it anymore. Youbwill get through this. Just keep saying this to shall pass. Keep distracting.  Deep breathing. I know it is so hard. I wish i knew more about dosing. I co from x to v and it was done wrong. That is what put me in all the physical pain and it was awful. I swithched to k and got on gabapentin. I did not know what else to do. It helped alot. So maybe the v would have worked but my dd didnt have a clue and i didnt either. This whole thing is terrible. I dont think i have akathadia. I did have it once and it is gone. I remember i could not sit still. I did go away. I just feel very anxious when i walk around the house and shaky. Its like i have to get back to my bed and im ok. Maybe its ptsd. Ugh. I am so sorry that we are going through this. We will heal.

[[Th...]]

Hey everyone, I’ve been holding for the past 4 months trying to stabilize. I’m now ready to start tapering again. I got my Gemini scale and am ready to do daily dry micro cuts. I’ve heard that .003 k per day is an average amount that people cut. I still don’t understand the math between the weight of the pill and the dose amount I want to cut. Right now I’m on .875 k and dosing 6:30 pm and 10:30 pm.

[[Bi...]]

Hey everyone, I’ve been holding for the past 4 months trying to stabilize. I’m now ready to start tapering again. I got my Gemini scale and am ready to do daily dry micro cuts. I’ve heard that .003 k per day is an average amount that people cut. I still don’t understand the math between the weight of the pill and the dose amount I want to cut. Right now I’m on .875 k and dosing 6:30 pm and 10:30 pm.

 

What is the dose size of the pills you will be cutting, 0.5mg or 1.0mg?  What is the weight of a full uncut pill?  And you're splitting .875mg evenly between 2 doses per day (0.4375mg twice per day)?

 

For example, Roche brand name klonopin weighs around 170mg for both the 0.5mg and 1.0mg pills.  If you were to use the 0.5mg strength pills, you would want to cut a dose size of 0.4375/0.5 X 170mg = 148.75mg.  So you would weigh 149mg out of the 170mg pills for each dose.  When you want to make a cut, you drop your earlier dose to 148mg.  Next cut you drop both doses to 148mg, etc.

 

Use a percent change calculator every month to determine how much pill you need to cut, in order to hit your target % drop for the month. 

 

https://www.calculatorsoup.com/calculators/algebra/percent-change-calculator.php

 

Say you want to drop 5% in a month.  If you start with 2x 149mg doses per day, for a total of 298mg of dry pill consumed each day, then using the calculator, you would want to be consuming 283mg of dry pill per day at the end of the month.  That would mean your early dose would be 141mg and your late dose would be 142mg at the end of the month (down from 149mg each).  Since the drop in dry pill weight consumed each day in that month is 15mg (298-283), you would simply drop 1mg from 1 of your 2 daily doses every 2nd day. 

 

Make sure to use the actual weight of your brand of clonazepam pills, this was just an example.  Maybe there's an easier way to think about this, but this is the way my brain works.

 

It's really late and I'm tired.  I hope I didnt screw up any math, don't go by any of these numbers!  I'll check back tomorrow if you have questions.  And maybe someone else has an easier way to think about this.

[[Th...]]

For the sake of simplicity let’s just say I wanted to cut .5 mg tablet by 10% every 2 weeks. How much per day?

[[Co...]]

For the sake of simplicity let’s just say I wanted to cut .5 mg tablet by 10% every 2 weeks. How much per day?

 

How many tablets do you take per day? The reason I ask is because 10% of one tablet out of five would be only 2% cut to your dose every 14 days.

 

Assuming that you take 1 tablet per day:

 

10% / 14days = 0.714% of a tablet per day. I'd round that to 0.7%. I'd further round to the nearest 1% of the sum cut. So:

 

Day0: full pill

Day1: 0.7% (1%)

Day2: 1.4% (1%)

Day3: 2.1% (2%)

Day4: 2.8% (3%)

Day5: 3.5% (4%)

Day6: 4.2% (4%)

Day7: 4.9% (5%)

Day8: 5.6% (6%)

Day9: 6.3% (6%)

Day10: 7% (7%)

Day11: 7.7% (8%)

Day12: 8.4% (8%)

Day13: 9.1% (9%)

Day14: 9.8% (10%)

 

Now, I have no idea which benzodiozepine you take, your total dose,how you are feeling, or the taper plan you have followed thus far. The above it is to simply answer your specific question.

[[Th...]]

I take K. My dosing schedule is .25 mg at 6:30 pm and .625 mg at 10:30 pm. I need to cut my .125 from my 10:30 pm dose first. How much would I have to cut in pill weight so that it equals 0.003 mg of dosage?

[[Bi...]]

For the sake of simplicity let’s just say I wanted to cut .5 mg tablet by 10% every 2 weeks. How much per day?

 

Since you are using 0.5mg pills, and assuming they weigh 170mg when they are full and uncut (You should really weigh your pill to make sure).  That means at a starting dose of 0.875 mg you are consuming a total of 298mg of dry pill every day.  If you want to decrease by 10% in 2 weeks, then you should be consuming a total of 268mg of dry pill per day at the end of 2 weeks.  That is a drop of 30mg (.030g) of dry pill weight.  30mg divided by 14 days means you should shave off about .002 from your total dose each day.  It doesn't matter if you remove it from your early dose or late.  Or cut .001 from both.

 

These numbers should be recalculated every month.  If not, and you continue shaving off .002 per day, the % decrease per 2 weeks will increase over time from 10%.

 

To answer the question about .003 mg of drug reduction.  If your 0.5mg pills weigh 170mg, then  (170mg X .003mgK) / 0.5mgK =1.02mg.  In other words, shaving off 1mg (.001g) from your pill would be equivalent to removing just under 0.003mg of drug.  If your pills dont weigh 170mg, this is incorrect.

[[Th...]]

Thank you! So I’m safe in reducing.002 for a month then recalculate?

[[Bi...]]

Thank you! So I’m safe in reducing.002 for a month then recalculate?

 

You're welcome, good luck with it!

 

Yeah, it will stay fairly close to 10%/2 weeks for the first month.  By month 2, shaving off .002 per day would put you at 12.6-14.4% decrease every 2 weeks.  So each month, as your total dose decreases, you need to shave less per day (or even every other day) in order to hit a 10% target. 

 

I'm doing 3% per month, cause my body is wrecked.  So if you need help, let me know, I'll be around.

[[Mo...]]

For anyone who is interested in trying a compounded suspension using almond oil from a compounding pharmacy, I found one that does it routinely.  I am going to try it because what I am doing now is not working well and I don't know if I'm getting the right dose - the ODT tablets are not scored and I feel like they are processing right through my system. 

 

I spoke to the pharmacist and she said they make this suspension a LOT for people.  They do not use a specific tablet, however.  They have the bulk powder that comes from PCCA and use that so I do not know how it would compare to any of the pill versions - whether it is "weaker" or "stronger".  She said they could also do this with Diazepam but, likely because it comes in a liquid already, they don't do it often.  She didn't recommend that I try to switch, which I get.  I hesitate also but I'm having major I/D withdrawals right now. 

 

Just wanted to pass along.

 

https://www.pharmacysolutionsonline.com/contact-us.php

[[Li...]]

Mom, thank you ever so much for sharing this info.  By doing so, you help us all.

 

That’s very interesting they can get “bulk powder” from PCCA.  Does this mean they can get the API (active pharmaceutical ingredient) aka active drug substance (i.e. no other ingredients).  I was told by a compounding pharmacy where I live that they could not get the API for clonazepam b/c it is a controlled substance. 

[[Bi...]]

Interesting indeed, thanks Mom0f7.  I'll file this away for a rainy day.  It seems like it could start pouring any moment.

[[Mo...]]

Libertas,

 

That is what I am assuming because she told me that any compounding pharmacy that uses the pills to crush and make aren't doing it correctly b/c of the fillers.  The pharmacist was very knowledgeable and she said they do this one a LOT.  She even said they could do .375 mg per ML, which is way too concentrated but she said they could customize however I want.

 

I'm trying to work on my math at how I could get do this with a microtaper, since I need to go ultra slow, how much oil I could tolerate at one time, etc. 

 

I found these 1 ML syringes on Amazon - that have a 1/100 per 1 ML marking.  If I am trying to go down by .001 mg or .002 mg per day (or even .005 mg every 2-5 days), I'm trying to think of how I could get this to work.  Any suggestions?  I'm at .368 mg but will go back to .375 mg possibly.  I do worry about changing brands again b/c it could be a huge shock to my system.

 

https://www.amazon.com/1ml-Syringe-Only-Sterile-Syringes/dp/B01DARL378/ref=sr_1_1_sspa?keywords=1ml+syringe&qid=1569870966&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEyV1owMzZLQk1IM0RPJmVuY3J5cHRlZElkPUEwODU1OTU0MVQwOU9ONFc4VTU2USZlbmNyeXB0ZWRBZElkPUEwOTQyMzI5M1RXS1VRN05XRFQ0MCZ3aWRnZXROYW1lPXNwX2F0ZiZhY3Rpb249Y2xpY2tSZWRpcmVjdCZkb05vdExvZ0NsaWNrPXRydWU=

[[Li...]]

Hello again MO7B.

 

Three thoughts ...

 

1) 0.375mg per mL is a relatively high concentration, it also makes for difficult math.  Any possibility they could compound a 0.1 mg per mL suspension?  If not, then “where there’s a will, there’s a way” to work with 0.375.

 

2) You’ve probably already done this, but have you confirmed with the compounder that whatever they prepare can be measured accurately with an oral syringe?  I know zippo about suspensions using oil, but I wonder if there might be issues with viscosity or stickiness?

 

3) Smart you to get tuberculin syringes with 0.01mL gradations! I know nothing about the manufacturer for the syringes you found on Amazon, but I have read that BD (Becton Dickinson) is a well-know, reputable brand.  Here’s a source:

 

1 mL Syringes without Needle BD 309628, 309659, 329650, BD Syringe

https://www.vitalitymedical.com/bd-tuberculin-syringe-only.html

 

You’d want the slip tip.

[[Mo...]]

Libertas,

Yes, she said they could make it in any concentration that I want but the less concentrated, the more expensive.  She said they can make it how I want but she was surprised by how "dilute" I am requesting it.  So if I did a .1 mg/ML, I think I make this work, right?  I don't know why she thinks this is "dilute" b/c to me, to take 1.25 ML three times per day doesn't seem like a lot.

 

And yes, she told me that they would send a 1 ML syringe and the bottle would have a special cap.

 

I have a feeling that this isn't necessarily a "cheap" option, just FYI, and she refused to give me an estimate.  Wanted the doctor to call her and discuss and give an order b/f she quoted me.  I don't care, though, if it works.

 

Also, they are not licensed in every state.  They are licensed in my state but not in my neighboring state.   

[[Fi...]]

Thank you! So I’m safe in reducing.002 for a month then recalculate?

 

You're welcome, good luck with it!

 

Yeah, it will stay fairly close to 10%/2 weeks for the first month.  By month 2, shaving off .002 per day would put you at 12.6-14.4% decrease every 2 weeks.  So each month, as your total dose decreases, you need to shave less per day (or even every other day) in order to hit a 10% target. 

 

I'm doing 3% per month, cause my body is wrecked.  So if you need help, let me know, I'll be around.

 

Just popping into say I'm doing around 3% a month too because my body has been though the ringer.  Glad I'm not the only one.

[[Fi...]]

Libertas,

Yes, she said they could make it in any concentration that I want but the less concentrated, the more expensive.  She said they can make it how I want but she was surprised by how "dilute" I am requesting it.  So if I did a .1 mg/ML, I think I make this work, right?  I don't know why she thinks this is "dilute" b/c to me, to take 1.25 ML three times per day doesn't seem like a lot.

 

And yes, she told me that they would send a 1 ML syringe and the bottle would have a special cap.

 

I have a feeling that this isn't necessarily a "cheap" option, just FYI, and she refused to give me an estimate.  Wanted the doctor to call her and discuss and give an order b/f she quoted me.  I don't care, though, if it works.

 

Also, they are not licensed in every state.  They are licensed in my state but not in my neighboring state. 

This is really interesting. My psychiatrist had suggested using olive oil at one point but I have lost faith in her and only use her for prescribing. 

 

The fact that they dont add anything appeals to me because the additional fillers is what did me in wirh the compounding pills. 

 

I have to reread the math part again but basically you are thinking of getting something that will exactly match 1mg to 1 mll of medication? 

 

Thanks for finding this information.

 

 

 

 

[[Mo...]]

Final, olive oil burns my throat.  I am praying this helps some.  I am in such dire straights right now, but I know I just have to push through b/c it's so bad and I don't believe I will heal until off.  I tried to hold a week, tried to go slow but little to no help.  But even still, many months ahead of me.

 

It would be .1 mg to 1 ML is what I'm thinking but she thought this was too dilute but I don't care. 

[[Fi...]]

Final, olive oil burns my throat.  I am praying this helps some.  I am in such dire straights right now, but I know I just have to push through b/c it's so bad and I don't believe I will heal until off.  I tried to hold a week, tried to go slow but little to no help.  But even still, many months ahead of me.

 

It would be .1 mg to 1 ML is what I'm thinking but she thought this was too dilute but I don't care.

 

I am on the same boat you are.  I too dont think I will heal till I'm off and will have to push as well.  I have been holding for 8 days due to a bad wave but if it doesn't lift. I will be cutting again.

 

I know you are the first one to try this here and I will supporting you as you do.  Please keep us posted on how it is going.

I

[[Li...]]

MOF7B:

 

It sounds like the compounding pharmacist may not have much experience with patients who are discontinuing their benzodiazepines by making small, graduation reductions in dose over time (i.e. titration). 

 

You are correct that 1.25mL of a suspension with a concentration of 0.1mg/mL would equal 0.125mg per dose.  And, as we all know, that’s still a hefty dose of this particular benzodiazepine (per Ashton, 0.5mg of clonazepam is equivalent to 10mg of diazepam).

 

Just curious ... have you asked the compounder for the source of the formulation they are proposing to use?  Perhaps a USP Compounded Preparation Monograph?  For more info about USP monographs, visit:

 

Compounded Preparations Monographs (CPMs) | USP

https://www.usp.org/compounding/compounded-preparation-monographs

 

[[Mo...]]

The way she spoke, she did say that people use it a lot for titration but I don't believe that most that are tapering are quite as sensitive as many of us on here. 

 

I can't tolerate anything acidic and most pharmacists use an agent such as oraplus which would burn my throat...I do have concerns if I'm honest about the "shelf" life/stability of going this route but I feel like I need to try it.

[[Fi...]]

The way she spoke, she did say that people use it a lot for titration but I don't believe that most that are tapering are quite as sensitive as many of us on here. 

 

I can't tolerate anything acidic and most pharmacists use an agent such as oraplus which would burn my throat...I do have concerns if I'm honest about the "shelf" life/stability of going this route but I feel like I need to try it.

 

I reacted to Oraplus as well, made my stomach upset.  I understand your sensitivity and have it too. 

[[Bi...]]

Thank you! So I’m safe in reducing.002 for a month then recalculate?

 

You're welcome, good luck with it!

 

Yeah, it will stay fairly close to 10%/2 weeks for the first month.  By month 2, shaving off .002 per day would put you at 12.6-14.4% decrease every 2 weeks.  So each month, as your total dose decreases, you need to shave less per day (or even every other day) in order to hit a 10% target. 

 

I'm doing 3% per month, cause my body is wrecked.  So if you need help, let me know, I'll be around.

 

Just popping into say I'm doing around 3% a month too because my body has been though the ringer.  Glad I'm not the only one.

 

Hey good to meet you.  Too bad the circumstances aren't a bit better. ;I