Water taper question

[[Mi...]]

I’m preparing to do a water taper of klonopin in the fall.  I take 0.75mg at night.  I make this dose with two, 0.125 tablets and one 0.5 tablets.  I will be going very slow.  Can I just water taper the 0.125 tablet first and take the other two pills and so on?  Also - I’ve seen some reviews that some people don’t like water tapers while others rave about them - any reviews appreciated.  I am super sensitive to any change.  Thank you. 

[[Pa...]]

Hi @[Mi...], I hear milk is actually the better choice for Klonopin for solubility issues but water will work fine too, you just need to agitate it before you drink and drink the rinse water to get all of the particles you may have missed.

You've asked a good question and the answer is yes, you can take your tablets and liquid titrate the rest.  As for which method is best, people have their favorites but there isn't one method that works better than another, its all about your lifestyle and what works for you.

[[Mi...]]

4 hours ago, [[P...] said:

Hi @[Mi...], I hear milk is actually the better choice for Klonopin for solubility issues but water will work fine too, you just need to agitate it before you drink and drink the rinse water to get all of the particles you may have missed.

You've asked a good question and the answer is yes, you can take your tablets and liquid titrate the rest.  As for which method is best, people have their favorites but there isn't one method that works better than another, its all about your lifestyle and what works for you.

Thank you @[Pa...] I have 0.125 dissolvable wafers so I was thinking this would work in water - do you happen to know? Still on the hunt for a benzo wise doctor that can advise me in this… 

[[Li...]]

Just now, [[M...] said:

 I have 0.125 dissolvable wafers so I was thinking this would work in water - do you happen to know?

Hello @[Mi...].  The 0.125mg clonazepam tablets you have are ODTs — Orally Disintegrating Tablets.  As their name implies, they are designed to disintegrate (as in fall apart, disperse) quickly in saliva.  However, this does not mean the clonazepam in the ODTs dissolves (i.e. goes into solution).  

Do-it-yourself liquids made with clonazepam ODTs and water are suspensions not solutions.  Consequently, as @[Pa...] noted, it will be important to shake the liquid well before using it to disperse the drug particles as evenly as possible throughout the liquid before measuring.

Another option to consider is to use whole fat, homogenized milk instead of water.  Here’s what The Maudsley Deprescribing Guidelines has say about using milk:

“Benzodiazepines are more soluble in oil or fat than in water (Macheras et al 1990).  When mixed with full-fat homogenized milk, some or all of the drug will dissolve in the milk fat.  This should form an evenly dispersed emulsion when shaken vigorously ….” (Horowitz & Taylor, 2024, p. 341)

 

 

 

[[Mi...]]

44 minutes ago, [[L...] said:

Hello @[Mi...].  The 0.125mg clonazepam tablets you have are ODTs — Orally Disintegrating Tablets.  As their name implies, they are designed to disintegrate (as in fall apart, disperse) quickly in saliva.  However, this does not mean the clonazepam in the ODTs dissolves (i.e. goes into solution).  

Do-it-yourself liquids made with clonazepam ODTs and water are suspensions not solutions.  Consequently, as @[Pa...] noted, it will be important to shake the liquid well before using it to disperse the drug particles as evenly as possible throughout the liquid before measuring.

Another option to consider is to use whole fat, homogenized milk instead of water.  Here’s what The Maudsley Deprescribing Guidelines has say about using milk:

“Benzodiazepines are more soluble in oil or fat than in water (Macheras et al 1990).  When mixed with full-fat homogenized milk, some or all of the drug will dissolve in the milk fat.  This should form an evenly dispersed emulsion when shaken vigorously ….” (Horowitz & Taylor, 2024, p. 341)

Thank you @[Pa...] and @[Li...] I do have a compounding pharmacy that will make me a liquid suspension - but my doctor has implied she doesn’t feel confident in this suspension.  That it perhaps won’t give me an accurate dose.  Any opinions on this? I’m nervous to make my own suspension and mess it up.  I’d love to just make cuts - but the fact that I could gradually adjust the dose every two days (or so) makes me think this would be the most gentle taper option as I seem to be very sensitive.  TIA for any advice or thoughts on this.  

[[Pa...]]

Hi @[Mi...], a reputable compounding pharmacy should be able to provide a reliable solution for you, in fact @[Li...] has shared a few questions you can ask your pharmacist to ensure you're getting what you need.  I'm not sure why your doctor is concerned, although a few members have noted they needed time to adjust to the new formulation before tapering it and other members will dilute the solution in order to get smaller reductions.  Maybe your doctor isn't aware of the tricks of the trade we've learned here.

I'm sure if you do decide to make your own liquid that you'll do just fine, I know it looks complicated but its really not, have you looked at this video?  

 

 

[[Pa...]]

Hey @[Mi...], can you do me a favor?  Since you've pretty much decided on a liquid taper, could you start a thread on the taper planning forum so we can get into the specifics of your planned taper?

It would also be a huge help to those contributing to your plan to understand your medical and medication situation so if you would be kind enough to fill in your history, that would be very helpful.  Just go to your profile and hit edit profile, then fill it in and submit.  

Benzodiazepine Taper Strategies (Planning) - Benzodiazepine Withdrawal Support (benzobuddies.org)

[[Mi...]]

12 minutes ago, [[P...] said:

Hi @[Mi...], a reputable compounding pharmacy should be able to provide a reliable solution for you, in fact @[Li...] has shared a few questions you can ask your pharmacist to ensure you're getting what you need.  I'm not sure why your doctor is concerned, although a few members have noted they needed time to adjust to the new formulation before tapering it and other members will dilute the solution in order to get smaller reductions.  Maybe your doctor isn't aware of the tricks of the trade we've learned here.

I'm sure if you do decide to make your own liquid that you'll do just fine, I know it looks complicated but its really not, have you looked at this video?  

Thank you @[Pa...] this is a great video.

[[Mi...]]

Just now, [[P...] said:

Hey @[Mi...], can you do me a favor?  Since you've pretty much decided on a liquid taper, could you start a thread on the taper planning forum so we can get into the specifics of your planned taper?

It would also be a huge help to those contributing to your plan to understand your medical and medication situation so if you would be kind enough to fill in your history, that would be very helpful.  Just go to your profile and hit edit profile, then fill it in and submit.  

Benzodiazepine Taper Strategies (Planning) - Benzodiazepine Withdrawal Support (benzobuddies.org)

Thank you @[Pa...] yes I can do that