Valium dosing question maybe builder(?)

I think you guys are scaring everybody to death in here with this discussion, including me.

 

I started vodka taper, because Milk didn't work for me. And now that's possibly bad?

 

I can't read the whole texts at the moment, my focus is too bad.

 

Why would vodka taper be bad?

I sympathise, Tman85. But I don't suppose that you are suggesting that I should instead ignore my genuine and serious concerns about what is being suggested as 'fact', when it appears to not be based on any science, research or study. It is anecdote at best, and the anecdotes are mixed. Suppose if I had posted nothing, and you later experienced problems and I replied with, 'yeah, I was concerned about the advice given, but I didn't wish to upset anyone by voicing my concerns'. I'd rightly be considered a cowardly asshole.

builder,

 

I do not have time to address all this now. But I strongly suggest you make a study of bioavailability. Yes, 1mg is 1mg. But that is not whole story. Blood levels do not vary between brands of pills simply because of differences in dosage of the active ingredient. They also vary due to bioavailability. Converting to a liquid probably incurs even greater changes to bioavailability. Then there are issues around stability with home brew formulation. I do not understand how you can dismiss these potential problems as non-existent when there is a whole branch of chemistry dedicated to their study.

 

Let me just ask you directly, Colin.

 

I'm using tablets of 2 mg, 1 mg, 0,5 mg, 0,2 mg, 0,1 mg. From taperingstrips.

 

Now I'm at 3,3 mg.

 

I take the following pills. 2 mg, 1 mg, and 0,2 mg.

 

Then I get 0,1 mg. Crush it, add 1 ml vodka. Add 49 mm water. Take 5 ml out every day.

 

Could you please explain me if there would be dangers in that? In any of that? Just for my personal reassurance?

 

Thank you!

In that particular narrow example, where you are titrating a dose of 0.1mg out of a total dose of 3.3mg Valium(?) - there is probably no real risk nor benefit. Even if the whole 0.1mg is rendered ineffective, it only represents a loss of 3% of your total dose. Valium has a relatively long half-life, so any reduction made to the dose occurs gradually over some days (up to a week or two). This is why for many Valium is the ideal benzo to use for a taper.

I should also point out, you added no details of your taper, dose, particular benzo, etc. to your opening post. You have no signature line. You also edited out all content from your Intro post from when you joined the forum, thus removing any details you might have included there. Irrespective, your particular circumstances do not affect the argument. And at the same time, if I now understand your taper regimen correctly, you do not need to titrate your pills anyway - it will likely only complicate and make less certain what you are already doing. The use of tapering strips would seem ideal. Why monkey about with it?

builder,

 

I do not have time to address all this now. But I strongly suggest you make a study of bioavailability. Yes, 1mg is 1mg. But that is not whole story. Blood levels do not vary between brands of pills simply because of differences in dosage of the active ingredient. They also vary due to bioavailability. Converting to a liquid probably incurs even greater changes to bioavailability. Then there are issues around stability with home brew formulation. I do not understand how you can dismiss these potential problems as non-existent when there is a whole branch of chemistry dedicated to their study.

 

Let me just ask you directly, Colin.

 

I'm using tablets of 2 mg, 1 mg, 0,5 mg, 0,2 mg, 0,1 mg. From taperingstrips.

 

Now I'm at 3,3 mg.

 

I take the following pills. 2 mg, 1 mg, and 0,2 mg.

 

Then I get 0,1 mg. Crush it, add 1 ml vodka. Add 49 mm water. Take 5 ml out every day.

 

Could you please explain me if there would be dangers in that? In any of that? Just for my personal reassurance?

 

Thank you!

 

It that particular narrow example, where you are titrating a dose of 0.1mg out of a total dose of 3.3mg Valium ?) - there is probably no real risk nor benefit. Even if the whole 0.1mg is rendered ineffective, it only represents a loss of 3% of your total dose. Valium has a relatively long half-life, so any reduction made to the dose occurs gradually over some days (up to a week or two). This is why for many Valium is the ideal benzo to use for a taper.

 

I should also point out, you added no details of your taper, dose, particular benzo, etc. to your opening post. You have no signature line. You also edited out all content from your Intro post from when you joined the forum, thus removing any details you might have included there. Irrespective, your particular circumstances do not affect the argument. And at the same time, if I now understand your taper regimen correctly, you do not need to titrate your pills anyway - it will likely only complicate and make less certain what you are already doing. The use of tapering strips would seem ideal. Why monkey about with it?

I removed my opening post because benzobuddies removed too much info to be valueable. I will be doing a lot against benzo's, but never mind that now. (Edit: I will write my story again, and I will add my signature again. Hopefully benzobuddies won't delete anything  )

The hits of 0,1 mg are hitting me too hard.

So if I take 0,1 mg, make a solution out of it with 50ml, take out 5ml, I will be tapering of with 0,01 instead of 0,1. Why would that not work?

I removed my opening post because benzobuddies removed too much info to be valueable. I will be doing a lot against benzo's, but never mind that now.

 

The hits of 0,1 mg are hitting me too hard.

 

So if I take 0,1 mg, make a solution out of it with 50ml, take out 5ml, I will be tapering of with 0,01 instead of 0,1. Why would that not work?

You are missing the point. In your very narrow example, it probably will make no difference how inaccurate it might be, because you are titrating a 0.1mg pill out of a total dose of 3.3mg. That equates to just 3% of your dose. So even if the whole 0.1mg is rendered ineffective, it has only a marginal effect upon the total dose you absorb. However, if your dose was, for example, 5mg/day, and all you had were 5mg pills, you would be titrating all your dose. Now, if the whole dose was rendered ineffective, you'd be going from 5mg to zero in a single step - obviously, this is not recommended. Maybe you consider that an unlikely occurrence. Maybe it is, maybe not. It is not possible to determine how stability might be negatively impacted. Instead, suppose any of these things occurred:

• Only part of the benzodiazepine went into solution because it had reached saturation point, and the remainder lay on the bottom of the container?
   
   
  
  • Or, maybe you spot this and swill around the contents, thus creating a concentration gradient of benzo in the liquid (thus, seriously impacting your ability to extract an accurate dose)
     
     
    

  [*]Suppose that the bioavailability is quite low with the pill, and by making into a liquid, bioavailability shoots up from 0.45 to 0.9*. You have increased the AUC by 100%, doubling the dose.

   

   

  [*]Instead of the pill gradually disintegrating over an hour or two, gradually being absorbed, this step is effectively bypassed and instead absorption is rapidly increased, giving rise to a higher C_max and increased risk of interdose withdrawal symptoms.

   

   

  [*]Some of the pill might not have been absorbed at all when in pill form (read my previous post about penetration rate, excipients, etc.), so the bioavailability might significantly increase if it is made into a liquid

   

   

  [*]There is significant affect upon the stability of the active ingredient, thus decreasing the dose for a given volume.

* I should have pointed out before in my reply to builder, although 1mg is 1mg, the stated 'dose' actually takes into account bioavailability. So, an IV dose really does contain the amount stated (because all the dose is considered to be 'available'). However, you usually cannot expect the whole dose of a pill to be absorbed (lower bioavailability). So, there is more active ingredient in the pill to account for this effect. And, different brands will compensate by varying amounts because of their differing bioavailability profiles.

These are just the potential problems which immediately spring to an untrained mind. I am sure there are many others. Some of those effects will tend to cancel (work in opposite directions), while others will tend compliment (make the situation worse). There is no way for us to know what will actually happen, to what degree, and it will vary depending upon the pill brand and the specific modifications carried out on the pill. But you could potentially vastly increase the bioavailability and increase the speed of absorption (both working to increase peak blood levels of the drug). Conversely, you could saturate the alcohol and the benzodiazepine is not fully soluble anyway (so sedimentation occurs) and you attempt to swill the contents, but this induces a concentration gradient and you sample form a relatively low point of concentration. These would all work together to decrease the dose. Or a mixture. Who knows. I do not. And until people start providing actual citations, I will advise caution. So far, no one here has even demonstrated that they have even heard of pharmacokinetics, bioavailability, etc. I think if they had, they would have been far more cautions in their claims.

All this is from a layman's perspective. I have no training in these fields. But I think I understand just enough to know that I know nothing. I hope one of the pharmacists or pharmacologists here (or those with training in these fields) see these posts and jump in. The problem I have is people stating absolutes about this when there are none. To establish absolutes, there would need to be experiments, tests and studies. There really is no sense in attempting to dismiss a whole scientific field with seat-of-your-pants proclamations of certainty and gut feelings as though they are fact.

I removed my opening post because benzobuddies removed too much info to be valueable. I will be doing a lot against benzo's, but never mind that now.

 

The hits of 0,1 mg are hitting me too hard.

 

So if I take 0,1 mg, make a solution out of it with 50ml, take out 5ml, I will be tapering of with 0,01 instead of 0,1. Why would that not work?

 

You are missing the point. In your very narrow example, it probably will make no difference how inaccurate it might be, because you are titrating a 0.1mg pill out of a total dose of 3.3mg. That equates to just 3% of your dose. So even if the whole 0.1mg is rendered ineffective, it has only a marginal effect upon the total dose you absorb. However, if your dose was, for example, 5mg/day, and all you had were 5mg pills, you would be titrating all your dose. Now, if the whole dose was rendered ineffective, you'd be going from 5mg to zero in a single step - obviously, this is not recommended. Maybe you consider that an unlikely occurrence. Maybe it is, maybe not. It is not possible to determine how stability might be negatively impacted. Instead, suppose any of these things occurred:

• Only part of the benzodiazepine went into solution because it had reached saturation point, and the remainder lay on the bottom of the container?
   
   
  
  • Or, maybe you spot this and swill around the contents, thus creating a concentration gradient of benzo in the liquid (thus, seriously impacting your ability to extract an accurate dose)
     
     
    

  [*]Suppose that the bioavailability is quite low with the pill, and by making into a liquid, bioavailability shoots up from 0.45 to 0.9*. You have increased the AUC by 100%, doubling the dose.

   

   

  [*]Instead of the pill gradually disintegrating over an hour or two, gradually being absorbed, this step is effectively bypassed and instead absorption is rapidly increased, giving rise to a higher C_max and increased risk of interdose withdrawal symptoms.

   

   

  [*]Some of the pill might not have been absorbed at all when in pill forum (read my previous post about penetration rate, excipients, etc.), so the bioavailability might significantly increase if it is made into a liquid

   

   

  [*]There is significant affect upon the stability of the active ingredient, thus decreasing the dose for a given volume.

 

* I should have pointed out before in my reply to builder, although 1mg is 1mg, the stated 'dose' actually takes into account bioavailability. So, an IV dose really does contain the amount stated (because all the dose is considered to be 'available'). However, you usually cannot expect the whole dose of a pill to be absorbed (lower bioavailability). So, there is more active ingredient in the pill to account for this effect. And, different brands will compensate by varying amounts because of their differing bioavailability profiles.

 

These are just the potential problems which immediately spring to an untrained mind. I am sure there are many others. Some of those effects will tend to cancel (work in opposite directions), while others will tend compliment (make the situation worse). There is no way for us to know actually what will happen, to what degree, and it will vary depending upon the pill brand, and the specific modifications carried out on the pill. But you could potentially vastly increase the bioavailability and increase the speed of absorption (both working to increase peak blood levels of the drug). Conversely, you could saturate the alcohol and the benzodiazepine is not fully soluble anyway (so sedimentation occurs) and you attempt to swill the contents, but this induces a concentration gradient and you sample form a relatively low point of concentration. These would all work together to decrease the dose. Or a mixture. Who knows. I do not. And until people start providing actual citations, I will advise caution. So far, no one here has even demonstrated that they have even heard of pharmacokinetics, bioavailability, etc. I think if they had, they would have been far more cautions in their claims.

 

All this is from a layman's perspective. I have no training in these fields. But I think I understand just enough to know that I know nothing. I hope one of the pharmacists or pharmacologists here (or those with training in these fields) see these posts and jump in. The problem I have is people stating absolutes about this when there are none. To establish absolutes, there would need to be experiments, tests and studies. There really is no sense in attempting to dismiss a whole scientific field with seat-of-your-pants proclamations of certainty and gut feelings as though they are fact.

Ah man, now I really don't know what to do anymore. I thought my plan was brilliant

So I guess you are saying I should just stick to the taperingstrips reducing with 0,1 mg?

Ah man, now I really don't know what to do anymore. I thought my plan was brilliant

 

So I guess you are saying I should just stick to the taperingstrips reducing with 0,1 mg?

I try my damnedest to avoid telling what anyone should do with their taper. But Valium tapering strips, with 0.1mg decrements, seems like the ideal way to taper. You are already on the benzodiazepine Prof. Ashton thought ideal, and you can reliably reduce your dose by amounts smaller by a factor of ten! The long half-life provides a cushion to each reduction - you do not get that with shorter half-life tablets.

I expect that the reality is that you cannot noticeably negatively affect your taper via titrating such a small proportion of your dose. If the whole 0.1mg should be spoiled, it can only account for 3% drop to your dose. This is generally will within what is tolerable when tapering Valium. And if we go in the other direction (where bioavailability shoots up), by how much? Realistically, I'd find it hard to believe that it could be multiples of the stated dose. What I will say is that if I was using a method where I could rely upon the dose, and it allowed me to make very small cuts, and from a modest daily dose, I think I would stick with what is tried and tested.

The thing to keep in mind is that experiencing withdrawal symptoms is to be expected by most of us around here. There is no good evidence that there is any way to guarantee avoiding symptoms. Smaller, more frequent cuts are generally better tolerated than less frequent, larger cuts. But there are limits to this. We should keep in mind, even with Valium and its relatively long half-life, we should expect interdose reductions to blood concentrations of 10% or more. And most usually tolerate this just fine. So, getting hung up on the accuracy of a reductions of about about 0.3% (5ml from 50ml of liquid, a tenth of 0.1mg from a total dose of 3.3mg) makes little sense. And, we should expect variations of dose in individual pills of at least a few percent. (5% of your 2mg pill equates to 0.1mg). But you should not let this unduly worry you. The important, overarching factor is the overall taper picture. We generally tolerate these differences in dosage just fine. Try not to worry about it. These larger factors just put into perspective that concentrating on the accuracy of tiny amounts when there are regularly much larger changes (which we generally tolerate) is a waste of time, energy and emotional strength.

I think you will be fine.

Ah man, now I really don't know what to do anymore. I thought my plan was brilliant

 

So I guess you are saying I should just stick to the taperingstrips reducing with 0,1 mg?

 

I try my damnedest to avoid telling what anyone should do with their taper. But Valium tapering strips, with 0.1mg decrements, seems like the ideal way to taper. You are already on the benzodiazepine Prof. Ashton thought ideal, and you can reliably reduce your dose by amounts smaller by a factor of ten! The long half-life provides a cushion to each reduction - you do not get that with shorter half-life tablets.

 

I expect that the reality is that you cannot noticeably negatively affect your taper via titrating such a small proportion of your dose. If the whole 0.1mg should be spoiled, it can only account for 3% drop to your dose. This is generally will within what is tolerable when tapering Valium. And if we go in the other direction (where bioavailability shoots up), by how much? Realistically, I'd find it hard to believe that it could be multiples of the stated dose. What I will say is that if I was using a method where I could rely upon the dose, and it allowed me to make very small cuts, and from a modest daily dose, I think I would stick with what is tried and tested.

 

The thing to keep in mind is that experiencing withdrawal symptoms is to be expected by most of us around here. There is no good evidence that there is any way to guarantee avoiding symptoms. Smaller, more frequent cuts are generally better tolerated than less frequent, larger cuts. But there are limits to this. We should keep in mind, even with Valium and its relatively long half-life, we should expect interdose reductions to blood concentrations of 10% or more. And most usually tolerate this just fine. So, getting hung up on the accuracy of a reductions of about about 0.3% (5ml from 50ml of liquid, a tenth of 0.1mg from a total dose of 3.3mg) makes little sense. And, we should expect variations of dose in individual pills of  at least a few percent. (5% of your 2mg pill equates to 0.1mg). But this should not worry you. The important, overarching factor is the overall picture. We generally tolerate these differences in dosage just fine; I suggest that you instead concentrate on the larger, overall taper picture. Try not to worry about it. These larger factors just put into perspective that concentrating on accuracy of tiny amounts when there are regularly much larger changes (which we generally tolerate) is a waste of time, energy and emotional strength.

 

I think you will be fine.

Thanks man! I really appreciate this 

Builder what are the other 7- 8 other inactive ingredients in valium? Thank you

For example.  This would probably vary some from one mfgr to another.

"In addition to the active ingredient diazepam, each tablet contains the following inactive ingredients: colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, pregelatinized starch (corn) and sodium lauryl sulfate. The 5 mg tablets also contain FD&C Yellow No. 6 Aluminum Lake. The 10 mg tablets also contain FD&C Blue No. 1 Aluminum Lake and D&C Yellow No. 10 Aluminum Lake."

https://www.drugs.com/pro/diazepam-tablet.html#s-34089-3

Sorry to the OP, here we are again...

 

I had problems switching to liquid (vodka)... I dont expect anyone to have the exact same problems I did, Yet many people have reported issues, -Some I have seen as far back as 2013/14... There was also a little survey some time ago that had a number of negative responses... I also have had a number of people PM me saying same...

Whatever the reasons might be, I dont particularly care.. We dont need “debunking” nor to be told its BS... And I guess while it might be true that its “in some peoples heads” Bluntly stating it is so, is far from supportive for most people... I tend to be pretty quiet on it due to the potential fear factor, but that said, many of those I have spoken to about it are pretty clear and realistic or whateva people...

 

I believe you are referring to a thread that Jim Hawk made? Here's a link if anyone is interested:

http://www.benzobuddies.org/forum/index.php?topic=200707.0

I'm so thankful that Jim Hawk started that thread as it gave me a pretty good idea of what to expect when I started a liquid taper.

I started tapering from 2 MG of Klonopin last July. Since I was apprehensive about the transition to liquid I decided to titrate 1 MG using propylene glycol while still taking 1 MG dry. This worked out okay for me.

Once I got to 1 MG, I switched to all liquid which was somewhat of a problem for me. It wasn't a seamless transition at all and I abandoned it after 4 days. I then went back to half and half and this worked out okay for me until this week as I'm now down to .5 MG a night.

This isn't directed at you as much as anyone else who will read this (Colin?), but I'm not sure how to taper this last .5 MGs? I use 1 MG pills and I was under the impression that you could cut it up to four times. Is it okay to do this as I was planning to do half and half again down to .25 MG?

Are people here saying that propylene glycol is not okay? I ask this because I was coming off a pretty high dose so maybe the efficacy of that method was a nonissue? My concern is with dropping to a lower amount using this method.

If propylene glycol is not okay then I guess I will have to try alcohol. Milk is not an option since I travel a lot for work.

These past couple of threads have been a real eye opener for me. If I go to all liquid I may just stick with the same dose for a few weeks so that my body can adjust to it.

Hello, ihpsdm.  First and foremost, congratulations on getting to 0.5mg from 2.0mg - that’s a major accomplishment!  If you’d like input from other members on how they have tapered from 0.5mg, you might consider posting to the support group for clonazepam/Klonopin at:

http://www.benzobuddies.org/forum/index.php?topic=163449.msg2967314#msg2967314

(The above links to the current last post.)

Members there have devised a variety of strategies (both “dry” and “wet”)  to make small reductions in their dose using a variety of tapering schedules.

For example, if you are in the US, clonazepam is available in 0.125mg and 0.25mg orally disintegrating tablets.

Hello, ihpsdm.  First and foremost, congratulations on getting to 0.5mg from 2.0mg - that’s a major accomplishment!  If you’d like input from other members on how they have tapered from 0.5mg, you might consider posting to the support group for clonazepam/Klonopin at:

 

http://www.benzobuddies.org/forum/index.php?topic=163449.msg2967314#msg2967314

(The above links to the current last post.)

 

Members there have devised a variety of strategies (both “dry” and “wet”)  to make small reductions in their dose using a variety of tapering schedules.

 

For example, if you are in the US, clonazepam is available in 0.125mg and 0.25mg orally disintegrating tablets.

Thank you Libertas!