Reduced to much

[[Li...]]

ok thxs  I feel quit off, very small dose 0.045,  my vision  and energy are off but think should at least get to 5mg Valium

 

You’re welcome.  I’m sorry your vision and energy are off. 

 

Just double-checking ….

 

Did you mean to write that you think you should get to the equivalent of 0.5mg of Valium (or 0.025mg of clonazepam) before quitting?

 

 

[[bo...]]

5mg of valium  according to  a conversion 0.04 is already  5mg of val? but then 0.025 is to  I'm confused

[[Li...]]

Per Ashton …

 

5mg of Valium/diazepam is equivalent to 0.25mg of Rivotril/clonazepam.  In other words, diazepam is 20 times less potent than clonazepam.  To convert a given dose of diazepam to an equivalent dose of clonazepam, you divide by 20.

 

Ashton suggests a quit/jump dose of 0.5mg diazepam (not 5mg; note the decimal place).

 

0.5 divided by 20 equals 0.025mg.

 

So 0.5mg of diazepam is equivalent to 0.025mg of clonazepam.

 

Note:

 

To convert a given dose of clonazepam to an equivalent dose of diazepam, you multiply by 20.

 

So, 0.04mg of clonazepam is equivalent to 0.8mg of diazepam (0.04 times 20 equals 0.8 ).

[[bo...]]

thankyou so much, this is what I use  https://clincalc.com/Benzodiazepine/

I appreciate it!

[[Li...]]

You’re welcome. 

 

Thank you for letting us know you have been using the ClinCalc calculator, not Ashton to make your conversions.  This explains why you have been so confused.

 

If you have not already done so, please be sure to read the ‘About This Calculator’ information included with the ClinCalc calculator.  It states in part:

 

About This Calculator

 

This conversion tool estimates a reasonable equipotent dose between two benzodiazepines. Unlike opioid equipotent dosing, benzodiazepine equivalence is much less evidence-based and poorly described in the literature. In fact, most benzodiazepine equivalence estimates are based on expert opinion, uncited tables in published documents, and clinical practice.

 

All benzodiazepine conversions used in this calculator are based on published equipotent dose estimates. The bulk of these publications come from an alcohol withdrawal setting using oral dosage forms. The following guiding principles govern the calculator's logic:

 

- When equivalence discrepancies exist in the literature, a reasonable dose range is provided to emphasize the lack of confidence in the conversions

- Unless otherwise stated, all conversions are based on oral dosage formulations

 

Large Dosing Ranges

 

Due to discrepancies in the literature, many benzodiazepine conversions may have a potential conversion range that is extremely variable (eg, by a factor of 10x or greater). These wide ranges of confidence highlight the lack of firm, evidence-based literature supporting specific conversion ratios.

 

Issues with Benzodiazepine Conversions

 

In addition to an overall lack of evidence to support specific conversions, there are a number of other limitations that should be recognized[/b]:

 

Varying durations of action - Due to differences in half-life, active metabolites, and drug accumulation, benzodiazepine conversions should account for single-dose versus multiple-dose situations. Currently no conversion estimates capture this difference.

 

Patient-specific factors - No equipotent conversion considers hepatic function, renal function, age, inter-patient metabolic variability, or drug interactions. Benzodiazepine metabolism and excretion can differ significantly; therefore, alterations in drug disposition will alter the relative potencies and durations of each benzodiazepine.

 

Lack of FDA oversight - Unlike opioid conversions, the FDA does not require manufacturers to describe equivalent dose or potency of benzodiazepines within the package insert.

 

Given the numerous issues with benzodiazepine equivalence, the importance of reasonable clinical judgment, clinical experience, appropriate patient monitoring, and dose titration are of even greater significance.

[[bo...]]

could I use 2 syringes, lets say 0.045  clonaz. 4.5  so 4 in a 10ml  and 5 in a 1ml?

[[Li...]]

could I use 2 syringes, lets say 0.045  clonaz. 4.5  so 4 in a 10ml  and 5 in a 1ml?

 

Hello, bonty.  We meet again.

 

(1) Are you now diluting your Rivotril/clonazepam liquid to achieve a concentration of 0.01mg/mL?

(2) Is your current dose 0.045mg clonazepam?

(3) Did you mean to write ‘0.5 in a 1mL’ instead of ‘5 in a 1mL’ in your post above?

 

If so, then yes, you could use a 10mL syringe to measure 4mL of the 0.01mg/mL liquid and a 1mL syringe to measure 0.5mL of the liquid to achieve a dose of 0.045mg.

 

PS 1: I’ve included a link below to a video about how to choose the right capacity syringe to measure a given volume of liquid. 

 

PS 2: When you have a minute, would you please update your signature with the reductions you’ve made since 8/27?

 

Link:

Using the Right Liquid Oral Syringe and Giving the Correct Amount

(View ‘Choose the Right Syringe’ at the 0:49 mark.)

[[bo...]]

Thank you yes 0.5ml for the 1ml

0.045 yes and holding had a bad syringe so couldn't make proper reductions

now have new but someone mentioned the 1ml can be useful

I hope I can make it to 0.0025  bc its becoming very challenging.