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Hildagard needs a taper plan, Please!


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How do I reach someone who can help me with a taper plan?

I'd like to start 11/5/19

My Daily dose is: 3mg Klonipin

Tablets are 1mg

I take 3 mg a day

As I am also bipolar I feel a 1% reduction is best.

I have a 100ml Cylinder

I've read everything I can find on the forum and understand the process but I read there are members that can help you with spreadsheets.

As I often get muddled, I need a good cheat sheet, to put it mildly.

I'm so grateful you are all here. I hope to be a support to others one day myself. I'll rephrase that, I will be a support to other one day when I'm ready.

Anxiously awaiting a reply,

Hildagard 

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Hello Hildagard,

 

We'll try to help you get ready to start your taper on 11/5.

 

Are you able to obtain a compounded liquid suspension of clonazepam from a reputable compounding pharmacy? 

 

It might be a good idea at the start, due to the fairly high dose you are taking, to consider using regular tablets and compounded suspension at the start. We have a member who was on a similar dose of clonazepam who used this method successfully.

 

In the US, 0.5mg regular tablets which are scored are available as well as and 0.125mg and 0.25mg orally disintegrating tablets.

 

Once I hear back from you, we'll start to formulate a plan.

 

pianogirl

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Okay, I found your post. Thank you so much for your reply. I do have access to a compounding pharmacy in a nearby town. I was also a nurse, before the fall, so I really comfortable crushing and using the milk method. I only leave home once a week, if I'm lucky to get to go somewhere. I would depend on my Son in law, who is awesome, to go to the compounding pharmacy to get my meds. I try to be as independent as I can since I need so much help as is. If it is once a month that wouldn't be too bad.

Is there any other information I can provide to assist?

Thank you again for reaching out,

Hug, Love and Light!

Hildagard

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Okay, I found your post. Thank you so much for your reply. I do have access to a compounding pharmacy in a nearby town. I was also a nurse, before the fall, so I really comfortable crushing and using the milk method. I only leave home once a week, if I'm lucky to get to go somewhere. I would depend on my Son in law, who is awesome, to go to the compounding pharmacy to get my meds. I try to be as independent as I can since I need so much help as is. If it is once a month that wouldn't be too bad.

Is there any other information I can provide to assist?

Thank you again for reaching out,

Hug, Love and Light!

Hildagard

 

Hello Hildagard,

 

I'm so glad you have a compounding pharmacy nearby and a helpful son in law.

 

I don't believe you need a spreadsheet.  To be honest, a taper plan is just that, a plan. It's very important to listen to your body rather than adhere to a strict regimen of tapering.

 

Since you are on a pretty significant dose of klonopin, if it were me, I would start out using a combination of compounded klonopin and tablets.  Once the dose gets lower you can likely change to all liquid.

 

The first step would be to obtain the compounded klonopin.  We have a couple of members doing just what I mentioned above. 

 

Next, you could begin by taking 0.5mg of one of your daily doses in tablet form, and use the  liquid to reduce the other 0.5mg.  If that works ok , you could switch another one of your daily doses from 0.5mg and again use the liquid to reduce the other 0.5mg.

 

I'll be back with more information about the 1% reduction and the use of milk or other possible titration liquids.

 

PG  :smitten:

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If my doctor insists in the compounding pharmacy and is willing to prescribe the liquid I can look at that.

I think it likely I'll have to use my current three pills and the milk method. What seems harder to other seems just right for me. I rarely leave home.

I tied here from lack of transportation. Thanks PG for all your doing.

 

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If my doctor insists in the compounding pharmacy and is willing to prescribe the liquid I can look at that.

I think it likely I'll have to use my current three pills and the milk method. What seems harder to other seems just right for me. I rarely leave home.

I tied here from lack of transportation. Thanks PG for all your doing.

 

I will be back later today with some more information for you. 

 

The reason I suggested a compounded formula of klonopin is so that you have the best available form of your medication in terms of quality. 

 

Using milk may work for you, whole milk is necessary for the high lipid content.

 

Whatever you will need to use, we'll work with.  I will be back after a few hours.

 

 

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Hello Hildagard,

 

I have a couple of questions for you if you will be using klonopin tablets for your titration.

 

1. Are your tablets scored?

 

2. You mentioned that you have a 100ml  cylinder, do you also have or can get syringes, oral or regular slip-tip syringes?  Since you were a nurse, I'm assuming you are comfortable using syringes, is this correct?

 

3. Since you take klonopin 3 times a day, which dose seems to help the most? Which helps the least?

 

Once I hear back from you I'll have more information for you.

 

PG  :smitten:

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Hello, I hope you are having a lovely day!

To answer your questions:

1. Yes they are scored

2. Got the syringes covered.

Hard to say, but I would say the first-morning dose, 6am. I have been able to cut in half many days. Then by 2 pm, Im ready for a dose because I start getting edgy, muscle cramping, chest hurts, choking feeling, then I have found a full dose is needed to stop the rapid thinking so I can shut my brain down and go to sleep, 10 pm.

I know that isn't the right way but ive been trying to cut back.

I have a laundry list of weird symptoms, like many.

Thank you, Hildagard

 

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Hello, I hope you are having a lovely day!

To answer your questions:

1. Yes they are scored

2. Got the syringes covered.

Hard to say, but I would say the first-morning dose, 6am. I have been able to cut in half many days. Then by 2 pm, Im ready for a dose because I start getting edgy, muscle cramping, chest hurts, choking feeling, then I have found a full dose is needed to stop the rapid thinking so I can shut my brain down and go to sleep, 10 pm.

I know that isn't the right way but ive been trying to cut back.

I have a laundry list of weird symptoms, like many.

Thank you, Hildagard

 

Hello Hildagard,

 

Thanks for the good wishes, yes, I did have a lovely day. I hope you did as well.

 

I don't have a lot of time for specifics tonight but I am concerned about your inconsistent dosing. Do you cut the morning dose in half frequently? It's best to keep a steady amount of klonopin in your blood stream and reduce slowly from that amount.  Klonopin is a very strong benzo, so cutting a half a dose is significant.

 

I know the feeling of impatience but we'll find a way for you do taper slowly with as little impact on your cns as possible.

 

I'm glad you have the syringes and the fact your tablets are scored is also good. 

 

I'll get back to you tomorrow.

 

PG  :smitten:

 

 

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Good morning Hildagard,

 

To get you started with a taper, let me ask you a question. 

 

1. You said you wish to taper 1%, but over how many days?  Tapering that much per day would be too much, too drastic of a reduction.

 

2. Some people who start at higher doses can go a little faster, at the start.

 

3. No taper plan is set in stone, everyone needs to experiment and see what works best for them.

 

4. Many people will adjust the taper rate throughout the process, based on symptoms, to make withdrawal as easy as possible on the nervous system.

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I trust you have done enough of this that you could make a good suggestion. I want a slow taper so would 1% a week or every two weeks be better? I do have multiple issues and tolerance withdrawals are significant. My emotional stability can be shakey on an hourly basis. But I've been like that for years. I'm tough and I've been fighting hell a long time. I wouldn't be here if I didn't know I could do this.

I'll quit cutting doses. I've been doing that for a long time because I want off. But, I want off forever and that has to be done the right way.

Thank you again! Hope you are well!

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I trust you have done enough of this that you could make a good suggestion. I want a slow taper so would 1% a week or every two weeks be better? I do have multiple issues and tolerance withdrawals are significant. My emotional stability can be shakey on an hourly basis. But I've been like that for years. I'm tough and I've been fighting hell a long time. I wouldn't be here if I didn't know I could do this.

I'll quit cutting doses. I've been doing that for a long time because I want off. But, I want off forever and that has to be done the right way.

Thank you again! Hope you are well!

 

Hello Hildagard,

 

You are tough and a fighter, just as everyone is that I've met here.  You are strong enough to do this and you have the right attitude.

 

1% a week or 2 weeks sounds good.  I'm glad you will stabilize on a steady dose. Will this dose total be the 3mg per day you spoke of at the top of this thread?

 

It's a little late here so tomorrow I'll put more information up for you.  You will be in charge of your taper and can make adjustments if you feel they are necessary. 

 

The right way will be the way that works best, we'll get you started with some ideas.

 

Take good care,

 

PG  :smitten:

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Good morning Hilda,

 

It looks like you are ready to start the process.

 

First of all I have one question: Do you want to make a 1% reduction per week and hold or do you want to make daily reductions?

 

I would suggest you work on the morning dose first, since you said this one has the least effect. The night before is the best time to prepare the formula.  You really don't need to use a mortar and pestle. The problem with this is that you would lose some of the medication due to surface transfer.

 

You would need a glass jar with a solid leak proof top.  You would then add 100 mL of whole fat homogenized milk to the jar. Place your morning dose in the jar. Place the jar in the refrigerator and let the tablet, dissolve, suspend or whatever it does in the liquid. There is no clear cut answer to what happens to the tablet in a liquid. 

 

In the morning, remove the formula and give a gentle but firm back and forth shake. Try not to be too vigorous as to create a foam. Drink all the milk in the jar, rinse the jar with distilled water 2-3 times and drink the water each time.

 

I would suggest doing a 'trial run', that is, no reducing until you see how your body reacts to the liquid formula.

 

I look forward to hearing from you.

 

pianogirl

 

 

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Dear PG,

I'll do a trial run tonight and try the liquid. But honestly, there is no, "the liquid is not working". It has to. Nothing is working now anyway. It is just bad to worsening symptoms. As to the answer to your question, I really don't know how to answer.

I've been in tolerance withdrawal for years, maybe a decade. I want off. Change can be tough but I'm determined. There is no hope otherwise. So I like the idea of slow but steady, with holds as needed. I don't do as well with jolts. I hope I'm explaining myself well. Sort of, slow but steady wins the race!

So with all that said, I would say small daily reductions as opposed to weekly. I can always switch if needed. Would you agree or based on my goal and what you know of my history, would you suggest something else?

I'm humble, This is an area I absolutely depend on this forum's advice. Its the only place I've seen with help.

Bless all who are here to help.

Thank you Pianogirl for all your help.

Hildagard

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Dear PG,

I'll do a trial run tonight and try the liquid. But honestly, there is no, "the liquid is not working". It has to. Nothing is working now anyway. It is just bad to worsening symptoms. As to the answer to your question, I really don't know how to answer.

I've been in tolerance withdrawal for years, maybe a decade. I want off. Change can be tough but I'm determined. There is no hope otherwise. So I like the idea of slow but steady, with holds as needed. I don't do as well with jolts. I hope I'm explaining myself well. Sort of, slow but steady wins the race!

So with all that said, I would say small daily reductions as opposed to weekly. I can always switch if needed. Would you agree or based on my goal and what you know of my history, would you suggest something else?

I'm humble, This is an area I absolutely depend on this forum's advice. Its the only place I've seen with help.

Bless all who are here to help.

Thank you Pianogirl for all your help.

Hildagard

 

 

Hello Hildagard,

 

Your message is very clear, thanks!

 

I guess a better explanation for waiting to begin the taper is to allow your body to adjusts to the change to liquid.  This is your taper Hilda, you are in charge and can make whatever decision is best for you. We'll certainly support you.

 

Tonight is one step forward in your journey to be benzo free!

 

PG  :smitten:

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Dear PG,

I liquified my am 1mg. Klonopin last night. Today is hell as usual.  Should I start liquifying all three doses? Go to liquid only?

I saw where you can taper daily by removing your daily taper from your first dose then add the other doses for the day then dividing the total into my 3 doses. That spreads the day's reduction across the day instead of from a single dose.

Could that work into the plan or do you have any knowledge of this method?

Thanks PG for being here for me.

Sincerely, Hildagard

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Dear PG,

I liquified my am 1mg. Klonopin last night. Today is hell as usual.  Should I start liquifying all three doses? Go to liquid only?

I saw where you can taper daily by removing your daily taper from your first dose then add the other doses for the day then dividing the total into my 3 doses. That spreads the day's reduction across the day instead of from a single dose.

Could that work into the plan or do you have any knowledge of this method?

Thanks PG for being here for me.

Sincerely, Hildagard

 

Hello Hildagard,

 

I would not expect any changes to how you feel now. What I'm reading is that you feel like you normally do, right?

 

I would take transitioning to liquid one step at a time, just like you will reduce just one dose ( the morning) dose at the start.  Too many changes can be challenging for the nervous system to deal with.

 

Once you start titrating you can split the dose between the other pills to distribute the dose more evenly. 

 

I continue to suggest that you wait and let your body adjust to the liquid before starting the reductions. I'll post more about the tiny daily reductions later tonight or tomorrow morning.

 

PG  :smitten:

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Ok PG, I'm humbled!

The first day, I felt a little more jittery but I got busy and it passed. I had liquified the first dose but not all three. I was also very emotional but that just a typical rough day.

The second day I liquified all doses. I cried all day along with crazy thoughts (benzo hell). My daughter heard it in my voice and made me tell her what was going on in my head and we talked about how my mind was lying to me. We decided that maybe this was a reaction to the liquid. But I've had times like this for years. So hard to know.

Today I'm much better, little depression. Had about 2 hours my body was trembling then Poof, calm. This evening more positive able to write, doing well.

Then there is tomorrow....

I see the point of going slow even with switching to liquid. I am swishing with water to get all the medication.

I just wanted to give you an update and say thanks for your words of caution. I'm grateful for your suggestions.

Sincerely, Hildagard

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Ok PG, I'm humbled!

The first day, I felt a little more jittery but I got busy and it passed. I had liquified the first dose but not all three. I was also very emotional but that just a typical rough day.

The second day I liquified all doses. I cried all day along with crazy thoughts (benzo hell). My daughter heard it in my voice and made me tell her what was going on in my head and we talked about how my mind was lying to me. We decided that maybe this was a reaction to the liquid. But I've had times like this for years. So hard to know.

Today I'm much better, little depression. Had about 2 hours my body was trembling then Poof, calm. This evening more positive able to write, doing well.

Then there is tomorrow....

I see the point of going slow even with switching to liquid. I am swishing with water to get all the medication.

I just wanted to give you an update and say thanks for your words of caution. I'm grateful for your suggestions.

Sincerely, Hildagard

 

It sounds like things are going pretty well, under the circumstances. Thanks so much for the update.

 

Let's see how you feel after a week of transitioning to liquid and I'll give you information about starting your taper.

 

Have a good weekend.

 

PG  :smitten:

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[14...]

Hello Hildagard,

 

We'll try to help you get ready to start your taper on 11/5.

 

Are you able to obtain a compounded liquid suspension of clonazepam from a reputable compounding pharmacy? 

 

It might be a good idea at the start, due to the fairly high dose you are taking, to consider using regular tablets and compounded suspension at the start. We have a member who was on a similar dose of clonazepam who used this method successfully.

 

In the US, 0.5mg regular tablets which are scored are available as well as and 0.125mg and 0.25mg orally disintegrating tablets.

 

Once I hear back from you, we'll start to formulate a plan.

 

pianogirl

Hi Pianogirl, Sounds like you know what you are doing.  Would you please help with a taper plan for .75 Klonopin taken 3 times a day (.25 each dose).  Thank you.
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Hello Hildagard,

 

We'll try to help you get ready to start your taper on 11/5.

 

Are you able to obtain a compounded liquid suspension of clonazepam from a reputable compounding pharmacy? 

 

It might be a good idea at the start, due to the fairly high dose you are taking, to consider using regular tablets and compounded suspension at the start. We have a member who was on a similar dose of clonazepam who used this method successfully.

 

In the US, 0.5mg regular tablets which are scored are available as well as and 0.125mg and 0.25mg orally disintegrating tablets.

 

Once I hear back from you, we'll start to formulate a plan.

 

pianogirl

Hi Pianogirl, Sounds like you know what you are doing.  Would you please help with a taper plan for .75 Klonopin taken 3 times a day (.25 each dose).  Thank you.

 

Hello Lookinup,

 

Let me ask you a few questions:

 

1.  What kind of taper are you looking for, a direct simple dry cut taper, a dry titration, or a liquid titration?

 

2. How much do you want to reduce, percentage wise, per day or per week?

 

3. Are your tablets scored?

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[14...]

Hello Hildagard,

 

We'll try to help you get ready to start your taper on 11/5.

 

Are you able to obtain a compounded liquid suspension of clonazepam from a reputable compounding pharmacy? 

 

It might be a good idea at the start, due to the fairly high dose you are taking, to consider using regular tablets and compounded suspension at the start. We have a member who was on a similar dose of clonazepam who used this method successfully.

 

In the US, 0.5mg regular tablets which are scored are available as well as and 0.125mg and 0.25mg orally disintegrating tablets.

 

Once I hear back from you, we'll start to formulate a plan.

 

pianogirl

Hi Pianogirl, Sounds like you know what you are doing.  Would you please help with a taper plan for .75 Klonopin taken 3 times a day (.25 each dose).  Thank you.

 

Hello Lookinup,

 

Let me ask you a few questions:

 

1.  What kind of taper are you looking for, a direct simple dry cut taper, a dry titration, or a liquid titration?

 

2. How much do you want to reduce, percentage wise, per day or per week?

 

3. Are your tablets scored?

Thank you for getting back to me. My tablets are .5 and scored.  What do you recommend for the taper method and reduction? 
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Hello Hildagard,

 

We'll try to help you get ready to start your taper on 11/5.

 

Are you able to obtain a compounded liquid suspension of clonazepam from a reputable compounding pharmacy? 

 

It might be a good idea at the start, due to the fairly high dose you are taking, to consider using regular tablets and compounded suspension at the start. We have a member who was on a similar dose of clonazepam who used this method successfully.

 

In the US, 0.5mg regular tablets which are scored are available as well as and 0.125mg and 0.25mg orally disintegrating tablets.

 

Once I hear back from you, we'll start to formulate a plan.

 

pianogirl

Hi Pianogirl, Sounds like you know what you are doing.  Would you please help with a taper plan for .75 Klonopin taken 3 times a day (.25 each dose).  Thank you.

 

Hello Lookinup,

 

Let me ask you a few questions:

 

1.  What kind of taper are you looking for, a direct simple dry cut taper, a dry titration, or a liquid titration?

 

2. How much do you want to reduce, percentage wise, per day or per week?

 

3. Are your tablets scored?

Thank you for getting back to me. My tablets are .5 and scored.  What do you recommend for the taper method and reduction?

 

Hello,

 

I have one more question based on your signature. Are you still taking Ambien? If you are, are you planning to taper off it as well?

 

Each person should pick the taper plan that works best for them. There is no one size fits all in terms of withdrawal.

 

Many people, including myself, followed a direct simple taper as presented in the Ashton Manual. Other's prefer a slower taper plan. Remember, nothing in set in stone and you can change at any time to make withdrawal as easy as possible on the central nervous system.

 

Take a look at Titration FAQ'S.  This gives good information about titration with either tablets or liquids.

 

Titration FAQ'S

 

Let us know which direction you'd like to start in and we'll proceed from there.

 

PG  :smitten:

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[14...]

Hello Hildagard,

 

We'll try to help you get ready to start your taper on 11/5.

 

Are you able to obtain a compounded liquid suspension of clonazepam from a reputable compounding pharmacy? 

 

It might be a good idea at the start, due to the fairly high dose you are taking, to consider using regular tablets and compounded suspension at the start. We have a member who was on a similar dose of clonazepam who used this method successfully.

 

In the US, 0.5mg regular tablets which are scored are available as well as and 0.125mg and 0.25mg orally disintegrating tablets.

 

Once I hear back from you, we'll start to formulate a plan.

 

pianogirl

Hi Pianogirl, Sounds like you know what you are doing.  Would you please help with a taper plan for .75 Klonopin taken 3 times a day (.25 each dose).  Thank you.

 

Hello Lookinup,

 

Let me ask you a few questions:

 

1.  What kind of taper are you looking for, a direct simple dry cut taper, a dry titration, or a liquid titration?

 

2. How much do you want to reduce, percentage wise, per day or per week?

 

3. Are your tablets scored?

Thank you for getting back to me. My tablets are .5 and scored.  What do you recommend for the taper method and reduction?

 

Hello,

 

I have one more question based on your signature. Are you still taking Ambien? If you are, are you planning to taper off it as well?

 

Each person should pick the taper plan that works best for them. There is no one size fits all in terms of withdrawal.

 

Many people, including myself, followed a direct simple taper as presented in the Ashton Manual. Other's prefer a slower taper plan. Remember, nothing in set in stone and you can change at any time to make withdrawal as easy as possible on the central nervous system.

 

Take a look at Titration FAQ'S.  This gives good information about titration with either tablets or liquids.

 

Titration FAQ'S

 

Let us know which direction you'd like to start in and we'll proceed from there.

 

PG  :smitten:

[/quot Thanks for your reply. Yes,I would like to get rid of the Ambien. I think it is giving me interdose withdrawal symptoms because of its short half life.  I would like to start with a direct simple taper and see how it goes.  Do you recommend doing the Ambien first?  Thanks again for your help. 

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