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Milk Titration-Math Check And A few More Questions


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I am starting my milk titration, hopefully the right way. The plan that was suggested by Libertas was to decrease my afternoon dose from .5mg to .375mg to equal my morning dose. I was doing that by cutting my pills which we thought was not accurate. I am on the right track. Thank you Libertas!

I wanted to make sure that my new liquid morning dose is correct. I am keeping that .375mg. I was down by .007mg, but decided to just leave the morning dose at .375mg. I have my .5mg in 50cc of milk and I pull off 12.5cc to equal the .125mg that I had already cut. Just want to make sure that is correct. That is my first concern.

Secondly, I find that my pills don't dissolve very well, even though I make it 24 hours ahead and shake throughout the day. Should I just crush it? I think when I water tapered many moons ago, I did crush first. I want my dose to be as even as possible. My poor brain.

Thirdly, does anyone have a period of time of where they have to get used to switching methods.

Like a fool, I tried to weigh and cut dry taper. I got way off on my math or my scales just were not accurate. It is probably what I did. I looked back to April and beginning of May and I cut by almost by .1mg. I figured it out and went back up, as I was in agony. Live and learn. I am thinking my CNS is still not stable. I am sticking with this method as the milk is agreeing with me and it the best bet for me. Why do people use large amounts of liquid and a small dose of Benzo to taper.?  I was thinking the more dilute, the less accurate? I am clueless.

Also, in the beginning of my milk taper I was measuring using a 100cc pyrex cup. I used to have a lab cylinder and different sizes of syringes of which I now have again. I found out that the measuring cup was not accurate. Don't know why I am mentioning this, but I am.

I don't want to taper more than 2-4% of my total dose monthly. My CNS is so sensitive and I am older. I was thinking maybe .002mg everyday or every other day. May .001mg.

This is not a rush for me at this point. I want this to be my last and hopefully successful try.

Hopefully I made sense. Greatly appreciated.

 

Dana

 

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Hello, Dana. You are most welcome.

 

(1) Your math is correct.

 

(2) Tablets from different manufacturers ‘behave’ differently when  liquid is added to them.  Some tablets disintegrate/disperse quickly, whereas others take longer.  For example, members have reported that clonazepam tablets from Teva do not disintegrate as readily as clonazepam tablets from Activas.

 

To help ‘jump start’ the tablet disintegration/dispersion process, some individuals add a little water to cover the tablet then let the tablet/water mixture sit for a period of time (say 5 - 15 minutes).  If the tablet still hasn’t dispersed, you could also try using a glass rod (or a similar smooth, non-reactive implement) to gently break the tablet into evenly sized particles.  Then you would add the milk. 

 

If you try the above, I suggest you use distilled or purified water (depending on where you live, tap water may contain chemicals that have the potential to interact with the excipients in the tablet). Be sure to record the amount of water you use — you will need to decrease the volume of milk by that amount.  For example, in your case, if you use 1mL of water to disperse the tablet, you would add 49mL of milk instead of 50mL.

 

I also suggest you rinse the glass rod with the milk as you add the milk to your mixing container.  That way, any particles of drug/excipient adhering to the glass rod will be included in your liquid.

 

PS You may still see particles in your milk. Please do not discount them!  They may contain the API (Active Pharmaceutical Ingredient) and/or excipients that affect the bioavailability and pharmacokinetic profile of the API.  (This is why it’s important to shake your liquid to disperse the particles as evenly as possible and measure your reduction/dose quickly before the particles settle out suspension.)

 

(3) Tip of the hat for recognizing you need to give your body sufficient time to adjust to the new liquid dosage form.  Given clonazepam’s relatively long half-life, I’d suggest waiting at least a week to make sure all is well.

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Dana, I experienced this with clonazepam also - even when I crushed it, it wouldn't dissolve in milk.  I don't know who the manufacturer of my tablets was so I can't help you there.  But whatever liquid you use, like Lib said, shaking or stirring your mix and dosing it immediately will get you the best result under the circumstances.  But like Lib also said, clonazepam has a long-ish half-life so if the dosing is a bit uneven, you will likely have more wiggle room than with a short-acting benzo.

 

All the best to you - you have a great attitude!

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Dana, I experienced this with clonazepam also - even when I crushed it, it wouldn't dissolve in milk.  I don't know who the manufacturer of my tablets was so I can't help you there.  But whatever liquid you use, like Lib said, shaking or stirring your mix and dosing it immediately will get you the best result under the circumstances.  But like Lib also said, clonazepam has a long-ish half-life so if the dosing is a bit uneven, you will likely have more wiggle room than with a short-acting benzo.

 

All the best to you - you have a great attitude!

 

Hi Kate,

 

Thanks so much for sharing your experience with the K tablets. I use Teva brand. Sometimes they do dissolve and other times, no matter how much I shake it over a 24 hour period, I find a small undissolved piece of the pill. I do shake the mixture before puling and drinking. Maybe too much.

I thank you for your encouragement. I try to have a good attitude, but I am getting weary at my age.

I just feel like there is the fortitude to keep on going and trying.

I went through hell with the C/T so many years back and I know that you also went through hell and here you are on this forum helping people. We are very grateful to have you.

 

Dana

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Hello, Dana. You are most welcome.

 

(1) Your math is correct.

 

(2) Tablets from different manufacturers ‘behave’ differently when  liquid is added to them.  Some tablets disintegrate/disperse quickly, whereas others take longer.  For example, members have reported that clonazepam tablets from Teva do not disintegrate as readily as clonazepam tablets from Activas.

 

To help ‘jump start’ the tablet disintegration/dispersion process, some individuals add a little water to cover the tablet then let the tablet/water mixture sit for a period of time (say 5 - 15 minutes).  If the tablet still hasn’t dispersed, you could also try using a glass rod (or a similar smooth, non-reactive implement) to gently break the tablet into evenly sized particles.  Then you would add the milk. 

 

If you try the above, I suggest you use distilled or purified water (depending on where you live, tap water may contain chemicals that have the potential to interact with the excipients in the tablet). Be sure to record the amount of water you use — you will need to decrease the volume of milk by that amount.  For example, in your case, if you use 1mL of water to disperse the tablet, you would add 49mL of milk instead of 50mL.

 

I also suggest you rinse the glass rod with the milk as you add the milk to your mixing container.  That way, any particles of drug/excipient adhering to the glass rod will be included in your liquid.

 

PS You may still see particles in your milk. Please do not discount them!  They may contain the API (Active Pharmaceutical Ingredient) and/or excipients that affect the bioavailability and pharmacokinetic profile of the API.  (This is why it’s important to shake your liquid to disperse the particles as evenly as possible and measure your reduction/dose quickly before the particles settle out suspension.)

 

(3) Tip of the hat for recognizing you need to give your body sufficient time to adjust to the new liquid dosage form.  Given clonazepam’s relatively long half-life, I’d suggest waiting at least a week to make sure all is well.

 

Libertas,

 

Thank you so much for answering my questions and giving me the suggestions.

I don't discount 1 particle as it could be the active ingredient Benzo.

Yes, I have to give my body time to get used to this method. I am not even starting to decrease the afternoon dose, yet. I am pulling off the 12.5cc-.125mg from the morning dose to make it .375mg from the dry dose of cutting the pills. I believe that is affecting me right now. I had severe anxiety yesterday, which got better after the afternoon dose which was .5mg. I really believe that I need to get used to pulling off the 12.5cc for a while and hope I am getting the most accurate dose.

Thanks for giving me the suggestion to hold for a week. I may hold 2 weeks and see how I feel.

I needed that permission, as I am so driven to start when I am not ready.

I wonder why people do the huge amount of liquid and taper. Doesn't that dilution make more inaccurate? I heard that and I am so inclined to believe it. I am doing great with the 50cc of milk at a time. It does not bother my gut at all.

Again, thank you for helping me.

 

Dana

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Dana, I experienced this with clonazepam also - even when I crushed it, it wouldn't dissolve in milk.  I don't know who the manufacturer of my tablets was so I can't help you there.  But whatever liquid you use, like Lib said, shaking or stirring your mix and dosing it immediately will get you the best result under the circumstances.  But like Lib also said, clonazepam has a long-ish half-life so if the dosing is a bit uneven, you will likely have more wiggle room than with a short-acting benzo.

 

All the best to you - you have a great attitude!

 

Hi Kate,

 

Thanks so much for sharing your experience with the K tablets. I use Teva brand. Sometimes they do dissolve and other times, no matter how much I shake it over a 24 hour period, I find a small undissolved piece of the pill. I do shake the mixture before puling and drinking. Maybe too much.

I thank you for your encouragement. I try to have a good attitude, but I am getting weary at my age.

I just feel like there is the fortitude to keep on going and trying.

I went through hell with the C/T so many years back and I know that you also went through hell and here you are on this forum helping people. We are very grateful to have you.

 

Dana

 

I'm not young either Dana!  I understand the weariness since I had it also while tapering.  It got old for about halfway through but by then I began to feel a bit better and that encouraged me.  Stay connected to the support here and wherever else you can find it.  That sustains us as well. 

 

Kate    :thumbsup:

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