Request for personal titration taper plan

[[ly...]]

I have been on .5 of klonopin for 7 years. I tapered off before; it took a year. I went back to the full .5 mg dose after a well-meaning doc advised me to. Now two years later I'm trying to taper again.

 

I'm OK with a long taper and am willing to try the titration plan. I am super sensitive to this drug. Before finding BB yesterday, I went from taking .5 to .375 for 1.5 weeks (per my new doc's instructions). But now I'm really struggling. I took .5 just now because I have a 14 month old daughter and I'm not able to parent went I feel this way.

 

Should I taper 5% at a time? Should I go back to .5 and then start tapering from there since I'm a mess right now? (I couldn't get out of bed today.)

 

Thank you!

[[...]]

It has not been long so I'd say chances are good that if you go back to the full dose you can stabilize and feel well.  That is what I would do.  Then figure out a taper plan that will let you live your life.  I'd give microtapering a good look.

[[ly...]]

OK, thank you! I am new to this community. I've been reading posts about microtapering. I've read about using milk and using vodka. I think reducing by 1% would work best for me. For a klonopin 1% taper, would milk (mixed daily) or vodka (mixed weekly) be preferable or does it not matter?

 

Also, I'm not sure how my Pdoc is going to react to a microtaper. She has prescribed me .125 mg of disolvable klonopin tablets. She wants me to take 3 of these a day (which is a 25% rate of reduction from .5 mg). I cannot function on this. I couldn't get out of bed yesterday. I have a year old baby, so this is not acceptable.

 

Have any of you had to convince your Pdoc to let you try this method? My doc is good, but has the bedside manner of a shark. I'm afraid of her reaction.

[[...]]

25% is way too much in one step.  As a general guide, an overall reduction ~10% a month is good for a lot of people...some can do more, some less.  The cuts should be small, so 1% at a time should be okay, but what I recommend trying first is daily microtaper.  I say this because it makes the most use of the drug to help you.

 

Whole milk, vodka/water, or PG/water...they all work.  I prefer PG/water or vodka/water to avoid the issues with milk.

 

You could try to sell it to her as, "the same thing, just gentler."

[[ly...]]

Thank you SG57! So I've read the microtaper plan from "builder." I'm a little afraid of messing something up since my .5 mg tablets of klonopin are so precious.

 

Could someone confirm my math if I want to do a 1% reduction per day of a daily dose of .5 mg (to create a 10-day batch)?

 

1) crush a 10 day supply = 10 .5 mg tablets of klonopin and add to 60 ml bottle

2) mix with 5 mls of vodka

3) add water to fill 60 ml bottle

 

Now what dosing would I use to start with .5 mg? And then to cut 1% at a time?

 

[[bu...]]

Thank you SG57! So I've read the microtaper plan from "builder." I'm a little afraid of messing something up since my .5 mg tablets of klonopin are so precious.

 

Could someone confirm my math if I want to do a 1% reduction per day of a daily dose of .5 mg (to create a 10-day batch)?

 

1) crush a 10 day supply = 10 .5 mg tablets of klonopin and add to 60 ml bottle

2) mix with 5 mls of vodka

3) add water to fill 60 ml bottle

 

Now what dosing would I use to start with .5 mg? And then to cut 1% at a time?

 

That will work, but then each ml will contain .083mgs K.  why not add 45 mls water, so you end up with 50mls liquid,  each ml contains .1mg K.  Much easier to calculate doses and cuts using a 1mg=10ml solution.

[[...]]

Thank you SG57! So I've read the microtaper plan from "builder." I'm a little afraid of messing something up since my .5 mg tablets of klonopin are so precious.

 

Could someone confirm my math if I want to do a 1% reduction per day of a daily dose of .5 mg (to create a 10-day batch)?

 

1) crush a 10 day supply = 10 .5 mg tablets of klonopin and add to 60 ml bottle

2) mix with 5 mls of vodka

3) add water to fill 60 ml bottle

 

Now what dosing would I use to start with .5 mg? And then to cut 1% at a time?

 

That will work, but then each ml will contain .083mgs K.  why not add 45 mls water, so you end up with 50mls liquid,  each ml contains .1mg K.  Much easier to calculate doses and cuts using a 1mg=10ml solution.

 

Yes, I agree, go with a number that makes the math easy.  I'd use at least 20ml of alcohol to ensure dissolving that much K and then dilute with 480ml water.  It might be better to begin with a one-day dose and make bigger batches once you get the hang of it, just my opinion.

 

Also, 1% a day is rather fast.  I like to start people at 8% a month to see how things go.  This would be .0015mg a day.

[[ly...]]

Thank you again! This is so helpful.

 

So I just communicated with my Pdoc. She recommends to alternate the new dose: take .5 mg one night and then .375 mg the next night, etc. She also prescribed 300 mg of neurontin to take.

 

I don't know. She's been a good doc, but doesn't seem to get how sensitive I am to this drug. I was with another doc when I took the full year to taper (I've been through 4 Pdocs over the last few years).

 

I'm not sure how to proceed. I meet with my current Pdoc next week.

 

 

[[...]]

Thank you again! This is so helpful.

 

So I just communicated with my Pdoc. She recommends to alternate the new dose: take .5 mg one night and then .375 mg the next night, etc. She also prescribed 300 mg of neurontin to take.

 

I don't know. She's been a good doc, but doesn't seem to get how sensitive I am to this drug. I was with another doc when I took the full year to taper (I've been through 4 Pdocs over the last few years).

 

I'm not sure how to proceed. I meet with my current Pdoc next week.

 

Yeah, alternating days comes up and is a common thought of both docs and patients.  But the prevailing wisdom here is it is a bad idea.  I agree.  If the goal is to keep blood levels steady, why would you do this?  The average dose for that schedule is .4375mg/day...a 12.5% cut.  I would not advise either that dose schedule or a 12.5% cut.  Much better to dose more frequently and cut smaller.

[[ly...]]

Again, thank you! When I tapered before, I don't think it went smoothly (I used the alternating dosage approach)...so that is probably why.

 

There are a few compounding pharmacies in my town. Has anyone had luck with getting klonopin in liquid form? I can see my Pdoc being much more willing to go with the titration plan if a professional were to do it vs. me (especially if I tell her I'm dissolving it in vodka).

[[...]]

Again, thank you! When I tapered before, I don't think it went smoothly (I used the alternating dosage approach)...so that is probably why.

 

There are a few compounding pharmacies in my town. Has anyone had luck with getting klonopin in liquid form? I can see my Pdoc being much more willing to go with the titration plan if a professional were to do it vs. me (especially if I tell her I'm dissolving it in vodka).

 

If the drug half life is very long and you metabolize it slowly an alternate day dosing might work, but in general it is not a good idea.  I think keeping blood levels as even as possible (within reason) is helpful to tapering, and long periods between doses works against this.

 

If you are in the USA, compounding pharmacies or homemade are the only way to make liquid K.

[[ly...]]

Thanks again! This post has been really helpful.

 

I just spoke to a compounding pharmacy near me. The pharmacist said he could make a liquid of klonopin or capsules. I asked how small of capsules he could make and he said "as small as you would like." I think I'd rather go with the liquid form. However, he said that the liquid would only be good for 15 days. So I'll have to ask my Pdoc to write a script for a 15-day supply with refills (so 15 days of .5 mg, but I won't need all of it because of the microtaper). I see her next week. I'm really hoping she'll write the script for me.

 

Has anyone else had the 15-day limit? Or had to convince their Pdoc to go for a compounded script?

 

I'm going to go back up to my .5 mg dose until I see her next week. I need to be fully functioning to travel on 95, visit with my family, and cook a Thanksgiving meal while also caring for my 1-year-old daughter.

[[...]]

Liquids are more flexible and flexibility is important with tapering. IMO, benzos scream for liquid. Fifteen days seems short to me. I have never heard of one that short.