Titration for Continuous Release Z Drugs

Perhaps this has been addressed elsewhere?  If so, please feel free to point me in the right direction.

I am planning to come off Ambien CR 12.5 mg.  My understanding is that the "CR" (continuous release) part of Ambien CR presents a challenge.

After no luck with countless pharmacies, I reached a compounding pharmacy in New York which asserts it can support me.  The pharmacist there proposes suspending regular Ambien in a continuous release liquid.

My (new) prescribing physician is very supportive but does not have firsthand experience with such an approach.  It would be an experiment.

Are there other methods I might consider?

Thanks!

Hi, Lady. 

If you can afford the compounding pharmacy, that's probably the easiest.  If not, you could try the titration method people often use for a benzo taper.  I don't have experience with the CR form of ambien but maybe someone else does.

Hi,

I didn't realise that there are continuous release liquids available - this sounds like a good solution. This will allow you take make pretty small cuts to your dose (probably better than pill-splitting), and you will have the benefit of the Ambien being released slowly. Let us know how you get on.

Good luck.

PS For anyone else taking CR versions of their benzos, the reason why you cannot pill-split these tablets is because they will no longer work as CR (Continuous Release) tablets. You would probably suffer interdose withdrawal symptoms, and your blood levels would actually spike higher immediately after taking your dose, even if you are taking a smaller dose.

Hi,

 

I didn't realise that there are continuous release liquids available - this sounds like a good solution. This will allow you take make pretty small cuts to your dose (probably better than pill-splitting), and you will have the benefit of the Ambien being released slowly. Let us know how you get on.

 

Good luck.

 

PS For anyone else taking CR versions of their benzos, the reason why you cannot pill-split these tablets is because they will no longer work as CR (Continuous Release) tablets. You would probably suffer interdose withdrawal symptoms, and your blood levels would actually spike higher immediately after taking your dose, even if you are taking a smaller dose.

Colin, at the risk of sounding stupid. would this apply to klon? i am taking the generic brand. just thought id ask since that grabbed my attention continuous release of benzo.

ambien is one hell of a nasty drug to be on (i dont mean to discourage anyone by that). my dr prescribed it to me years ago and said it was non addictive. not to say hes a bad dr. just maybe misinformed. i cut it cold turkey and had weeks of miserable nights. however sleep came back to me. as it will for you im sure lady. good luck with the journey.

dave

Thanks, LIB.  Things are going very well since cutting the drug dramatically (by 50%).  I sleep BETTER, not worse. 

Still researching the titration options and will post back here on my findings.  My next target cut date is 5/22.  (I'm allowing a few weeks before the next cut because I just made a huge reduction.)

:yippee:  I'm glad things are getting better! That's awesome for such a large cut!

I hope this continues throughout!

Amanda 

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Colin, at the risk of sounding stupid. would this apply to klon? i am taking the generic brand. just thought id ask since that grabbed my attention continuous release of benzo.

 

 

Hiya Dave,

Not stupid! Are you asking if klon has a continuous release version? Not that I am aware of. I just checked my nursing drug handbook, though it's a couple of years old so it is possible they have since come up with one. You could do an internet search or call a pharmacy.

After a lot of research, and a very good discussion with my prescribing MD and a compounding pharmacist, I've decided to go with a compounded liquid preparation of Ambien for the rest of my taper.

The pharmacist will suspend "regular" (non-CR) Ambien in a continuous release liquid.  This will help avoid the middle-of-the-night rebound many users of regular Ambien experience.  And, because it's a liquid, it will allow relatively easy and accurate control of dosing.

I was pleasantly surprised to learn that the cost would only be slightly higher than the normal cost of Ambien.

For what it's worth, I spoke with several compounding pharmacists before finding one knowledgeable on the subject.  I'd encourage anyone researching their CR taper options to take their time and call several compounding pharmacies.  There is a wide range of perspectives in the pharmacy community and many are willing to spend a few minutes discussing your objectives and sharing their expertise.

Ladyofthenite,

That's good news. As I said before, I wasn't aware of continuous release liquid - this should make reducing your dose far simpler and cuts out the potential problem of interdose withdrawal if you were to use ordinary Ambien and titration.

Let us know how things progress.

Hi,

 

I didn't realise that there are continuous release liquids available - this sounds like a good solution. This will allow you take make pretty small cuts to your dose (probably better than pill-splitting), and you will have the benefit of the Ambien being released slowly. Let us know how you get on.

 

Good luck.

 

PS For anyone else taking CR versions of their benzos, the reason why you cannot pill-split these tablets is because they will no longer work as CR (Continuous Release) tablets. You would probably suffer interdose withdrawal symptoms, and your blood levels would actually spike higher immediately after taking your dose, even if you are taking a smaller dose.

 

Colin, at the risk of sounding stupid. would this apply to klon? i am taking the generic brand. just thought id ask since that grabbed my attention continuous release of benzo.

 

ambien is one hell of a nasty drug to be on (i dont mean to discourage anyone by that). my dr prescribed it to me years ago and said it was non addictive. not to say hes a bad dr. just maybe misinformed. i cut it cold turkey and had weeks of miserable nights. however sleep came back to me. as it will for you im sure lady. good luck with the journey.

 

dave

Hi,

Sorry, I missed the above post - just read it now.

What I wrote only applies to CR (Controlled Release), XR (Extended Release), SR (Sustained Release) and similar slow release tablets. Standard benzo tablets are unaffected by pill-splitting.

Hi Ladyofthenight,

I've split off your useful and informative post about locating compounding pharmacies and a willing doctor to provide the prescription. I've added it as sticky topic at the top of this board.

http://www.benzobuddies.org/forum/index.php?topic=13545.0

Thanks.