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clonazepam tablets homogenous?


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Hi,

 

There is a mystery for me, I dry taper Rivotril with lab scale for a year, and I assume all brand of Clonazepam tablets are homogeneous, bigger their weight is, more Clonazepam they contain.

 

In my country there are a lot of people who titrate, they dissolve the tablet into water and using different ml syringes to achieve the dose.

There can be even 12mg weight difference between the lowest and highest weight tablet, how they don't feel any problems?

 

Thank you for replies.

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I’m not sure what you’re asking, if someone is using liquid titration, they would go by the milligrams of the tablet, meaning the medication strength, not the actual weight of the pill. 
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The weight of Rivotril pills which contain 0,5 mg clonazepam varies between ~145-155mg.

I assume the pills with 145mg weight contain less than 0,5 mg clonazepam, and the 155mg weight ones contain more than 0,5mg clonazepam.

Is it correct?

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My understanding of this is that it is not the actual amount of drug (I use the term drug now rather than medication) that is different but the fillers within the pill.  So, when the pill is dissolved in the water (or whatever you are using for the suspension), the amount of the drug is accurate, but there may be more filler in one pill versus the next which is why they vary in weight.

 

Fillers can actually create a lot of problems for people.  That is why when pharmacies change their brand of script, sometimes people can have a reaction to the change.  Withdrawal symptoms can increase due to the change.  I have often wondered about that myself.  Some people taper more easily off of some 'brands' than others because their bodies react to the fillers used.

 

I, also, think that is why is can be more 'accurate' to use liquid titration rather than a scale.  I use liquid titration, and I can see the fillers settle to the bottom after I shake it up...it separates, but the drug stays suspended in the liquid.

 

I hope that answers your question.  That is what I have learned over time looking into this.  I am not saying I am 100% correct because I am not a chemist.  I am just passing on what I have learned based on the information that is out there.  I remember trying to micro-taper using a jeweller scale, and I decided against it.  Not for this reason, but moreso because I just didn't have the cognitive functioning to do the 'work' of the weighing and shaving.  Either way, it is not an exact science.  It can't be.  We can just do the best we can dividing pills up that were never designed to be micro-dosed to begin with.

 

Would like to know others' thoughts on this....

 

Warmly,

F

 

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The weight of Rivotril pills which contain 0,5 mg clonazepam varies between ~145-155mg.

I assume the pills with 145mg weight contain less than 0,5 mg clonazepam, and the 155mg weight ones contain more than 0,5mg clonazepam.

Is it correct?

 

No, there is pill weight and there is dose weight. Pill weight is measured in grams and contains active ingredient plus fillers etc. The dose weight is what your doctor is actually prescribing and is measured in mg. Each pill will have 0.5mg active ingredient of Clonazepam regardless of the pill weight.

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The weight of Rivotril pills which contain 0,5 mg clonazepam varies between ~145-155mg.

I assume the pills with 145mg weight contain less than 0,5 mg clonazepam, and the 155mg weight ones contain more than 0,5mg clonazepam.

Is it correct?

 

No, there is pill weight and there is dose weight. Pill weight is measured in grams and contains active ingredient plus fillers etc. The dose weight is what your doctor is actually prescribing and is measured in mg. Each pill will have 0.5mg active ingredient of Clonazepam regardless of the pill weight.

 

Yes, exactly.  That is what I tried to express in my long-winded way.  Sorry, y'all.  That is how my brain works these days.  I can't seem to condense my thoughts.

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In this case I have been dry tapering badly for 1 year as I assumed the pills are homogeneous, I only need to count with pill weight...

Than I might have done very bad for my nervous system...

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W2BFree: Although the weight of your pill is not the same as the weight of the drug in the pill, they are related. If you reduced your pill weight by 10%, then you reduced the amount of drug you ingested by 10%.

 

Pills contain the Active Pharmaceutical Ingredient (API) plus other ingredients known as excipients.

 

An excipient is a substance included with the API to perform a specific function or functions.  For example, excipients may enhance the stability or therapeutic effect of the API.  Excipients may also bulk up solid dosage forms or aid in the manufacturing process by facilitating flowability.  Finally, excipients may contribute to the stability of the API once it is packaged by preventing degradation over the expected shelf-life.

 

Consequently, the weight of a pill is not the same as the weight of the API.  The pill weighs more because it includes both the API and excipients.

 

For example, a 0.5mg clonazepam pill contains 0.5mg of the API but can weigh 170mg due to the added excipients.

 

I’ll close by sharing a common misconception in case you encounter it.  It is not uncommon to read posts claiming that excipients are just ‘binders and fillers’ that ‘don’t matter.’  I hope the above explanation makes it clear that excipients DO matter.

 

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W2BFree: Although the weight of your pill is not the same as the weight of the drug in the pill, they are related. If you reduced your pill weight by 10%, then you reduced the amount of drug you ingested by 10%.

 

Pills contain the Active Pharmaceutical Ingredient (API) plus other ingredients known as excipients.

 

An excipient is a substance included with the API to perform a specific function or functions.  For example, excipients may enhance the stability or therapeutic effect of the API.  Excipients may also bulk up solid dosage forms or aid in the manufacturing process by facilitating flowability.  Finally, excipients may contribute to the stability of the API once it is packaged by preventing degradation over the expected shelf-life.

 

Consequently, the weight of a pill is not the same as the weight of the API.  The pill weighs more because it includes both the API and excipients.

 

For example, a 0.5mg clonazepam pill contains 0.5mg of the API but can weigh 170mg due to the added excipients.

 

I’ll close by sharing a common misconception in case you encounter it.  It is not uncommon to read posts claiming that excipients are just ‘binders and fillers’ that ‘don’t matter.’  I hope the above explanation makes it clear that excipients DO matter.

 

I am very interested in this.

 

I am trying to understand.  So, if a pill is to have .5mg of API, but each pill weighs differently...what is accounting for that variation?  The only way to account for it would be, in layman terms, the filler/binder weight, no?  The API cannot vary in weight.

 

Is this correct?  I am understanding correctly?

 

Warmly,

F

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Faith, your basic understanding is correct. Libertas will correct me if I'm wrong as she's extremely knowledgeable about this, but each country has it's own regulating body prescribing the regulations for API variations. There might be a very slight variation in the production of pills when it comes to API. I'm in Australia and my doctor once told me that Australia allows for a maximum of 10% leeway variation on API weight.

 

 

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jelly baby is correct.  Different countries have different quality standards with respect to the amount of variation allowed in API weight.  I do not know if there are also standards for the amount of variation allowed in excipient weight.
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So, I think it is important for W2BFree to know that she has not done anything wrong.

 

Here we are left to our own devices to take pills and somehow make-shift a micro-dosing system in order to help ourselves off.  Not all can afford to have their meds compounded.  With what we have to work with, I think we are all doing the very best we can with what we have to work with, and we are successful is accomplishing quite a bit under these conditions...whichever method we have chosen.  That is my main concern regarding this post.  For no one to feel as though they have done something 'wrong' or that they have done more damage.  I have so much respect for what we are all doing to handle our predicaments on our own to make our tapers as tolerable as possible.

 

Thank you for the educational information.  As I said, I was trying to find out as much about this as possible as I am on Clonazepam, too, and I noticed the pill weight differences and I was trying to understand how to navigate it...if I could at all.  I had to accept that it was not going to be an exact science.  Not while we are doing it ourselves using the resources available to us without having a pharmacy compound for us.

 

Warmly,

F

 

 

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Thank you for all the replies.

 

Libertas, I was only aiming for the pill weight, as thought the pills are a homogeneous mass.

Started with 2 and half pills of 0,5mg clonazepam, I took them as 380mg sum weight (152mg per pill), I tapered this 380mg sum weight whatever way I cut from the pills, I even used the remnant powder and all size of pieces.

 

I assume this is very bad...

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Regrettably, I do not have experience with either pill-shaving/weighing or pill-powder/weighing. 

 

I hope other members who do will come forward to offer support.

 

I agree with Faith25624  — we have to do the best we can with the options available to us.  Speaking of options, is the 2.5mg/mL Rivotril oral solution available in your country?  We have multiple members who have used it to taper successfully (some taper from it ‘as is’; others dilute it to achieve lower concentrations).  Unlike do-it-youself liquids made with regular pills, the Rivotril liquid is a homogeneous solution so every milliliter of the liquid contains the same amount of drug.

 

Edit: corrected typo in member username to ensure redaction

 

 

 

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I’m sorry to hear that.  I know we have several currently active members who are dry tapering clonazepam.  Let’s hope one or more of them stops by.
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Thank you.

 

I believed 0,5mg Rivotril (clonazepam) is homogeneous, that's why depending on pill weight the API can be 3% more or 3% less per pills, than average.

 

For example ~half year ago I made my daily dose from a pill weighting 148mg and a 42mg pill chunk or

a 154mg pill and a 36mg pill chunk and I didn't feel much difference on 190mg overall weight.

 

When I decreased this overall weight 190mg by 4%, the next day I experienced the withdrawal effect for 3-6 days, after it stop, I became "stable".

 

How is it possible? I'm sensitive to this drug, usually feel 2-3% differences.

 

 

 

I just did the math according to your info, my actual pills weight 149-158mg very mostly, one 147mg exception.

I take two radical cases...

when my 190mg daily dose is from heaviest pills:

190 = 158 + 32, 158mg contains 0,5mg API, 0,5 + 0,1376 = 0,6376mg API altogether

when my 190mg daily dose is from lightest pills:

190 = 149 + 41, 149mg contains 0,5mg API, 0,5 + 0,1012 = 0,6012mg API altogether

 

0,6012 : 0,6376 = 0.05708 => 5,71% difference between these two radical cases, I would feel the typical head problems of such withdrawal the next day.

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I’m not familiar with the approach described in the thread jelly baby shared so cannot comment on the calculations in your latest post.  I do wonder if you might be conflating pill weight with API weight (API = Active Pharmaceutical Ingredient). Perhaps the following will help.

 

You are using brand name clonazepam, manufactured by Roche. Brand name manufacturers typically hold themselves to high quality standards.  One of our members who worked for a brand name manufacturer in quality assurance indicated the standard for the amount of API in tablets was 97-103% (or +/- 3%).  He said most of the time the variation was even less than this (i.e. 2%, 1% or 0%).

 

Your concerns about obtaining accurate doses are understandable.  Have you considered working with a compounding pharmacist?  For example, there’s a compounding pharmacy in The Netherlands that makes very low dose clonazepam tablets using the pure bulk drug powder (API) as the drug source instead of regular tablets (see link below).  Compounding pharmacists can also make liquid dosage forms of clonazepam.

 

Tapering strip

https://www.taperingstrip.com/

 

ADDENDUM: I neglected to mention that the compounding pharmacy in The Netherlands ships to other countries, including Argentina, Australia, Belgium, Brazil, France, Germany, India, Japan, Spain, Sweden, Switzerland, the United Kingdom, and the United States.  (Select the pull-down menu labeled ‘Country’ at the top of the website to view these.)

 

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Thank you vm for all your info.

 

I contacted with Rivotril's manufacturer, Cheplapharm in EU.

 

They're not able to answer that the pills are homogeneous, and higher pill weight means higher clonazepam content, they just can tell the pills correspond to the required specifications.

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That sounds like a typical canned response.  Thank you for reminding me that Cheplapharm acquired the rights to Rivotril from Roche back in 2021; I had forgotten this.

 

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Yes, can project anything on this answer, can project my expectation of higher pill weight means higher API, as they don't say yeah we have exaclty 0,5mg clonazepam in each pill, but opposite can be true too.
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Yes, can project anything on this answer, can project my expectation of higher pill weight means higher API, as they don't say yeah we have exaclty 0,5mg clonazepam in each pill, but opposite can be true too.

 

Hi W2BFree. Your assumptions are correct. The tablets come from a relatively homogenous mass that has been mixed up so that the density is reasonably uniform. That being said, if you take .170 g of this mass, perhaps you get about 0.5 mg clonazepam. If you take .165 g of this mass, the "uniform" density says you're getting a bit less clonazepam, and if you have a bit more of this mass, you have a bit more clonazepam. So the best way to handle this is to take the average weight of 10 or more pills, and use that weight as your pill weight. Once you have that, do all your calculations and cut all your pills as if they weigh that amount. That's what I do, and that's what most people do who dry taper. There is no better way to account for the slight differences. You assume a uniform density and file away with confidence.

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Thank you!

 

I did the same in the past even used remnant powder.

 

I explained the situation more and got a reply from rivotril manufacturer:

 

"Thank you very much for the renewed feedback and the explanations regarding your enquiry. You have helped me to see your problem more clearly.

I have contacted our quality department again. The answer we received was that the tablet masses differ within a certain range when they are released.

We assume that the mass is homogeneous within the ranges. Unfortunately, we cannot provide a higher precision, as we do not have any data on this.

Perhaps there is a possibility to import Rivotril drops into your country via a pharmacy with a valid medical prescription?"

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