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Seriously in need of help planning taper off Klonopin!


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I’m very frustrated and I’ve posted multiple times without much luck. I really need help with a tapering plan, the way to cut my pills, how to know how much I need to reduce each day or week, etc. I’m so lost because when I was tapering X I just made 0.5 cuts in rapid succession until I crashed and was nonfunctional, ended updosing and my signature explains the rest. So I have no idea what I am doing and I’m honestly ready to just cut my K by 0.5 mgs (1 mg tablets, no score line) and see how I feel. I am sick of this whole thing and I feel like I spent over a year spinning my wheels and setting myself up to be kindled. I’m really no better than I was when I started this journey over a year ago except I am at a slightly lower dose (by 1 mg)

If I had done this the right way I would probably be really close to being off benzos right now. It’s discouraging.  :-[

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Hi looking through a glass darkly,

 

What milligram tablets do you have? I was on 3 milligrams of kpin myself and I did a simple dry cut method.

With my taper I went to fast and now I’m cutting a lower percentage the lower I get in dose. I’m doing a slow taper from here on out. In my opinion a slow taper is so much better than a fast taper.  You could see in my signature.

 

Jacky♥️

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Hi looking through a glass darkly,

 

What milligram tablets do you have? I was on 3 milligrams of kpin myself and I did a simple dry cut method.

With my taper I went to fast and now I’m cutting a lower percentage the lower I get in dose. I’m doing a slow taper from here on out. In my opinion a slow taper is so much better than a fast taper.  You could see in my signature.

 

Jacky♥️

 

1 mg tablets for the rest of the month. I can probably get 0.5 next month. Do you use a scale and weigh your cuts?

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You should look at bob7 method on how to keep yourself organized while taking your dose everyday with a log book and pill organizer. That’s very important.  You should ask you doctor for .5 mg tablets they are easier to cut.

The best scale I used is a Gemini 20 scale. I hope someone else can stop by to explain everything in more detail.

Remember to get a pill organizer box and a phone alarm to remind you about your dose and very important is to have a log book.

 

This is bob7’ s method and it helped me tremendously

https://benzodrytapermath.com/

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You should look at bob7 method on how to keep yourself organized while taking your dose everyday with a log book and pill organizer. That’s very important.  You should ask you doctor for .5 mg tablets they are easier to cut.

The best scale I used is a Gemini 20 scale. I hope someone else can stop by to explain everything in more detail.

Remember to get a pill organizer box and a phone alarm to remind you about your dose and very important is to have a log book.

 

This is bob7’ s method and it helped me tremendously

https://benzodrytapermath.com/

 

Yes I plan on asking for smaller pills or liquid. I a pill organizer and I already keep alarms on my phone and iPad for my doses now, and did when I was tapering before. I also kept a notebook. The math goes right over my head. I can’t grasp any of that. I probably sound stupid but at this point all of that sounds like an advanced course in Mandarin and my brain isn’t registering any of it.  :-[

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This thread has detailed information on how to weigh your pills and how to do the maths http://www.benzobuddies.org/forum/index.php?topic=273984.0

 

9 pages just to figure out how to make a reduction? I can’t do this! I’m just going to end up rapid tapering or something. I’m so screwed

 

Looking through, don’t taper quickly, you most likely will have to reinstate if you taper quickly because it will be awful for awhile.

I never weighed my pills and I was able to cut my pills. I did specifically ask my doctor for .5 mg and.125mg pills.

You could do this. When I first started I couldn’t hold two thoughts together and forget about math, I was lost. But dry cutting my pills has been successful so far. I don’t think I will use any compounding pharmacy. I’ll keep cutting my dose as much as I can until I jump.

You could do this too.  :thumbsup:

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If you wish to begin tapering before your next appointment with your prescriber, here’s a simple approach for your consideration ….

 

Take 1mg in the morning and 1mg in the evening as usual.

 

For your middle daily dose, split a 1mg tablet into quarters using a high-quality pill splitter.  Take 3 of the resulting 4 pieces (about 0.75mg).  If you are concerned about the possibility that the Active Pharmaceutical Ingredient (API) in your tablets is not evenly distributed, save the extra quarter tablets from Days 1 -3.  On Day 4, take all three of the extra quarters.  (This will ensure that you consume all of the API in those tablets.) Repeat this process for Days 5-8 etc.

 

This will be 8.33% reduction in dose.  It is within our general guideline of 5-10% and should be tolerable given your relatively high starting dose.

 

Keep a daily taper log.  Use the data in the log to determine your withdrawal pattern — that is, how many days does it take for withdrawal symptoms to emerge, peak, and stabilize (i.e. stop changing in nature and number and become tolerable).  Note: Clonazepam has a relatively long half-life; it can take one to two weeks for a dose change to fully ‘register’.

 

As I shared in a previous post, you sound like a good candidate for a combination approach using lower dose clonazepam tablets and a professionally compounded liquid.  Here’s what Stage 1 of such a taper might look like:

 

0.5mg in tablet form + 0.5mg in liquid form, taper liquid to zero as tolerable

0.5mg in tablet form + 0.5mg in liquid form, taper liquid to zero as tolerable

0.5mg in tablet form + 0.5mg in liquid form, taper liquid to zero as tolerable

 

To implement the above plan, you would need to find and vet a compounding pharmacist. Also, your prescriber would need to write two prescriptions — one for the tablets and one for the compound.

 

ADDDENDUM: I should have added … one of the major advantages of finding and working with a reputable compounding pharmacist is they should be willing to help you with the math. 

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This thread has detailed information on how to weigh your pills and how to do the maths http://www.benzobuddies.org/forum/index.php?topic=273984.0

 

9 pages just to figure out how to make a reduction? I can’t do this! I’m just going to end up rapid tapering or something. I’m so screwed

 

Looking through, don’t taper quickly, you most likely will have to reinstate if you taper quickly because it will be awful for awhile.

I never weighed my pills and I was able to cut my pills. I did specifically ask my doctor for .5 mg and.125mg pills.

You could do this. When I first started I couldn’t hold two thoughts together and forget about math, I was lost. But dry cutting my pills has been successful so far. I don’t think I will use any compounding pharmacy. I’ll keep cutting my dose as much as I can until I jump.

You could do this too.  :thumbsup:

 

How are you getting the amounts in your signature if you don’t weigh them? How specifically do you cut your pills to those doses? See how lost I am?  :-\

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If you wish to begin tapering before your next appointment with your prescriber, here’s a simple approach for your consideration ….

 

Take 1mg in the morning and 1mg in the evening as usual.

 

For your middle daily dose, split a 1mg tablet into quarters using a high-quality pill splitter.  Take 3 of the resulting 4 pieces (about 0.75mg). If you are concerned about the possibility that the Active Pharmaceutical Ingredient (API) in your tablets is not evenly distributed, save the extra quarter tablets from Days 1 -3.  On Day 4, take all three of the extra quarters.  (This will ensure that you consume all of the API in those tablets.) Repeat this process for Days 5-8 etc.

 

This will be 8.33% reduction in dose.  It is within our general guideline of 5-10% and should be tolerable given your relatively high starting dose.

 

Keep a daily taper log.  Use the data in the log to determine your withdrawal pattern — that is, how many days does it take for withdrawal symptoms to emerge, peak, and stabilize (i.e. stop changing in nature and number and become tolerable).  Note: Clonazepam has a relatively long half-life; it can take one to two weeks for a dose change to fully ‘register’.

 

As I shared in a previous post, you sound like a good candidate for a combination approach using lower dose clonazepam tablets and a professionally compounded liquid.  Here’s what Stage 1 of such a taper might look like:

 

0.5mg in tablet form + 0.5mg in liquid form, taper liquid to zero as tolerable

0.5mg in tablet form + 0.5mg in liquid form, taper liquid to zero as tolerable

0.5mg in tablet form + 0.5mg in liquid form, taper liquid to zero as tolerable

 

To implement the above plan, you would need to find and vet a compounding pharmacist. Also, your prescriber would need to write two prescriptions — one for the tablets and one for the compound.

 

Okay, so I’m confused about the bolded part? I take those on the 4th day, but how many days would I be doing at this rate? Also, if I can get a compounded liquid or manufacturer’s liquid would I still really need the tablets too? Or do I really need the liquid? I’m still very stressed about this, why does it have to be so freaking complicated? I’m in tolerance and I’m already miserable and having major mental symptoms so I just need to feel like I’m doing something to get started on tapering without waiting weeks!

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You would hold your dose constant at 2.75mg until you stabilize.  At this point, we don’t know how long that will be because we do not know what your withdrawal pattern is.

 

There are several advantages of using a combination of regular tablets and compounded liquid. Two of them are: (1) it keeps as much of your dose as possible in a form that your body is accustomed to and (2) it decreases cost (tablets are inexpensive; depending on your insurance, there may or may not be out-of-pocket costs for the compound).

 

 

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You would hold your dose constant at 2.75mg until you stabilize.  At this point, we don’t know how long that will be because we do not know what your withdrawal pattern is.

 

There are several advantages of using a combination of regular tablets and compounded liquid. Two of them are: (1) it keeps as much of your dose as possible in a form that your body is accustomed to and (2) it decreases cost (tablets are inexpensive; depending on your insurance, there may or may not be out-of-pocket costs for the compound).

 

Thanks for explaining this to me. I swear I used to not be so dim, but lately I feel like I’m lucky if I manage to get through the day without a full breakdown.  :-[  I have such terrible cog fog and so many mental symptoms that I don’t know if I’ll even be able to tell when I stabilize, to be honest. I already have physical symptoms as well so that’s going to be another difficult way to tell. I guess I just gauge it on how much worse I feel? That’s also tough because I have a few not too terrible days once in a good while so I don’t know? I remember when I first started tapering Xanax I was making 0.5 mg cuts and I did fine the first few cuts but I kept making those big cuts as my dose got lower so it caught up on me in a few months really terribly. I definitely don’t want to make that mistake again. So I will start tomorrow with my afternoon dose. I’m going to get my old notebook out and set it up tonight.

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You’re welcome.  Your daily taper log will be your best source of data on how you are responding to reductions so tip of the hat for setting up a notebook.  To avoid harming yourself by obsessing/ruminating about your symptoms or current situation, I encourage you to keep it simple.  For example, record the date as well as the times and amounts of your daily doses.  Around the same time each day, record two global ratings — one for your withdrawal symptoms and one for your functionality level.  Use a scale such as 0 = no symptoms, able to perform all essential daily tasks to 10 = intolerable symptoms, unable to perform any essential daily tasks.  Add a brief note about anything that might have affected how you felt/functioned that day (e.g. a stressful event; changes in diet, medications, supplements).  Graphing the global ratings can help you detect patterns in the data over time.
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In case you are considering the possibility of using the combination regular tablet and compounded liquid approach I described upthread …

 

Below is a link on how to find and vet a compounding pharmacist as well as a link to a stability-tested formulation for a compounded clonazepam suspension (your compounding pharmacist may have access to other formulations so be sure to ask).

 

Links:

 

How to Find a Compounding Pharmacy

https://www.wikihow.health/Find-a-Compounding-Pharmacy

 

0.1mg/mL Clonazepam Oral Suspension from Nationwide Childrens Hospital

https://www.nationwidechildrens.org/-/media/nch/specialties/pharmacy/compounding-formulas/clonazepam-oral.ashx

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Well, I can’t get accurate cuts with my crappy pill splitter.  >:(  I either eyeball it and end up with little crumbs after the 4th day (which is what happened. Yes I now have 4 messed up pills because I tried it a few times and even by hand.) Or I take uneven pieces. I can get a good “half” but it’s definitely bigger than the other piece so I thought about taking the “bigger half” and then a half of the other half, if that makes sense. Or…. I just wait a few weeks.  :-\  I should order a new pill cutter anyway. Any suggestions on a good one?

 

As far as a compound pharmacy I actually have one near me, a smaller family owned one and they have awesome reviews and have apparently been in business for a long time, and I believe they accept my insurance according to their website. So at least I know that much. I am going to give them a call tomorrow and make sure. Thank you for the questions to ask the pharmacist. It helps because I would have never thought of all those things.

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I’m glad the ‘finding and vetting a compounding pharmacist’ questions were helpful.  A caring and competent compounding pharmacist can be a valuable ally during benzodiazepine cessation.

 

Here’s the pill splitter I used:

 

EqualSplit Pill Splitter

https://a.co/d/9XMJgeO

 

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Well the compounding pharmacy is out of the question. The pharmacist said he’s never done a benzodiazepine! He said he can but never has as “most people just cut their pills” and he didn’t sound very clued in about tapering with liquid. I’m not even going to mess with that. I guess it’s going to be direct cuts then. I suppose it makes the most sense to wait until I see my psych in a few weeks and get 0.5 tablets.

The pill splitter Libertas linked has sort of mixed reviews so if anyone has any suggestions for cutting pills as accurately as possible I’m open.

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Point of clarification … you asked me what pill-splitter I had used and I provided the information requested.  I was not making a recommendation. I had some of the same issues reported in the reviews when I was using this product to split a pill for a pet. 

 

I should note that we do have several other members who are quite satisfied with this device.  I suspect whether or not a given pill-splitter performs satisfactorily has much to do with the properties of the pill being split (my pet’s pill was quite small and brittle). 

 

I hope you are able to find something that works for you.

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Point of clarification … you asked me what pill-splitter I had used and I provided the information requested.  I was not making a recommendation. I had some of the same issues reported in the reviews when I was using this product to split a pill for a pet. 

 

I should note that we do have several other members who are quite satisfied with this device.  I suspect whether or not a given pill-splitter performs satisfactorily has much to do with the properties of the pill being split (my pet’s pill was quite small and brittle).  I hope you are able to find something that works for you.

 

I did ask for any suggestions on a pill splitter. I hope I find one that works for me too, which is why I am asking for more recommendations. I don’t want to put money out for one that seems iffy, but I’m sure every one online is going to have some mixed reviews so if there’s a different way to cut pills besides a pill splitter contraption I am also asking about that as well.

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There's no way you'll ever be close to accurate with any pill splitter gizmo. You're going to need a scale to get an accurate (or close to it) split. I wouldn't worry about the math too much, it doesn't really matter how many mg of the dose you're at, just weigh the pill on the scale in grams and subtract the % from it's weight.
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This is so frustrating! Do I need a scale now? I can’t just make direct cuts until I get to the lower doses? I see why people just say screw it and either rapid taper by the way doctors usually recommended or just end up staying on these freaking drugs! This whole thing is absolutely stressful and complicated and I don’t know what the hell to do.
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This is so frustrating! Do I need a scale now? I can’t just make direct cuts until I get to the lower doses? I see why people just say screw it and either rapid taper by the way doctors usually recommended or just end up staying on these freaking drugs! This whole thing is absolutely stressful and complicated and I don’t know what the hell to do.

 

Hi!

 

I just started direct cut tapering from 1mg ClonazePam (once daily) in Dec. 22. I was/am as lost as you. The math seems overwhelming, but once you get it it makes sense. Having the basic tools helped me immensely:

 

Gemini 20 scale (Amazon) You must calibrate each time you use. Scales are very, very, very sensitive. Get new batteries. You don’t know how old the ones in scale are. I tried the Smart Weigh Scale first, but it was a dud. Read the instructions and calibrate. Get used to it.

Weekly pill organizer box

Single edged razor blades (pill cutters aren’t great for me and I have scored pills)

Metal nail file (for shaving)

Calculator

Notebook for recording dose and tracking symptoms

 

Most importantly, have a plan, but let your body guide you. How I am doing my taper follows, but it might be different than how you want to approach this. I have 0.5 scored ClonazePam (orange pills. used to take yellow unscored, but insurance changed.) which each weigh approx 165g, but they differ A LOT. I take only one dose a day. It’ll be harder to cut as I get to a smaller dose so I may have to switch to water taper or find a compounding RX, as Libertas suggested.

 

Cut and hold: Subtract 5%-10% from current dose per month seems common, but symptoms will guide you. Holds are normal. Do not updose. You can ride it through. Calculate: 5% reduction is dose weight in grams x 0.95, 10% reduction is x 0.9. You make every cut from current dose, not starting dose.

 

I cut and weigh a weeks worth every Sunday. It’s easier and you only have to calibrate the scale for that day. Always recalibrate weekly or when starting new cut.

 

You can also try micro-tapering, which is filing off a minuscule amount every 1-2 days. You can always hold if symptoms are unbearable. I have not tried this, so I don’t know dosing schedule, but it’s probably like the liquid water taper. These are both covered in the Titration section.

 

Libertas helped me, along with many others. He makes a point that at your current dose, being off by a few grams is probably not going to cause issues. If you’re going to do dry cut and hold or dry microtaper, you will need a scale and the few other things I mentioned.

 

I noticed that, for me, the symptoms hit hardest about 5 days after a 5% cut and it’s usually just one or two really uncomfortable nights. My first cut was eyeballed and may have been 12% or more. I felt it around day 8-9. We are all different.

 

I hope I didn’t make things more complicated for you. I’d trust the people here who have been going through this for awhile. I’ve been told: Go as slowly as comfortable. Be your own guide, but don’t hold too too long unless you’re going through an additional stressful event. Ask questions. Don’t read horror stories. Be mindful of your health/stress levels. Avoid major changes if possible. Know you will heal. Be patient. The latter is the hardest for me.

 

Also, I hope you checked the link to https://benzodrytapermath.com/. The one from bob7. I need to and my words may be redundant. I truly know how you are feeling. It has to be worth the effort though. It is for me and I have many shitty days and many fairly okay days, but my life situation isn’t great right now. That matters. I know you can do it. Apologies if I’ve said things you already know.

 

❤️

C

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