I am Ready!!! Is this a sound taper plan? Jim, Bella?

OK!  I think I've got this! 

I want to thank everyone on this forum for their kindness and sharing of information.

Even with my fuzzy brain, I have read the Ashton Manual, read and reread tons of posts here, watched Benzo Brains Videos, studied Jim Hawk's and Bella Amis's Benzo Liquid Taper Help paper and played with the Taper Calculator. (Wicked BRILLIANT!!) I have been on Klonopin for nearly 17 years & have experienced many of the w/d symptoms I read about here...I am going s-l-o-w with this taper. I am hoping some of you veterans would be willing to look this over , make any recommendations and answer a few questions for me.

I will be doing a liquid taper using vodka as a solvent. I have the supplies.

The summary of my Plan from the calculator:

Medication: Name: Clonazepam - Tablet size: 1.5 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1.5 - Volume of liquid: 150 ml - Concentration: 0.02 mg/ml

Daily doses: Dose 1: .5 mg - Dose 2: .5 mg - Dose 3: .5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 21.05.0018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: Across doses - Combine with tablets: No - Attenuated ending: Yes

A couple questions:

1) Curious as to why it would be a good practice to combine tablets and solution?  Wouldn't it be gentler to cut each dose? Or would it not matter because the cut is so small? I can see it would be less tedious to have to take the liquid only once a day. So I'm thinking I may change to taper off the mid day dose first. Thoughts?

2) If I went to a pharmacy would they prepare the mixture, just as I would? using vodka? Do they just use the spreadsheet and the Help sheets? Is this something I have to ask the Doctor to order? Does my Insurance get involved?

I hope all this makes sense....

Thank you again!

Juelli

OK!  I think I've got this! 

 

I want to thank everyone on this forum for their kindness and sharing of information.

 

Even with my fuzzy brain, I have read the Ashton Manual, read and reread tons of posts here, watched Benzo Brains Videos, studied Jim Hawk's and Bella Amis's Benzo Liquid Taper Help paper and played with the Taper Calculator. (Wicked BRILLIANT!!) I have been on Klonopin for nearly 17 years & have experienced many of the w/d symptoms I read about here...I am going s-l-o-w with this taper. I am hoping some of you veterans would be willing to look this over , make any recommendations and answer a few questions for me.

 

I will be doing a liquid taper using vodka as a solvent. I have the supplies.

The summary of my Plan from the calculator:

Medication: Name: Clonazepam - Tablet size: 1.5 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1.5 - Volume of liquid: 150 ml - Concentration: 0.02 mg/ml

Daily doses: Dose 1: .5 mg - Dose 2: .5 mg - Dose 3: .5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 21.05.0018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: Across doses - Combine with tablets: No - Attenuated ending: Yes

 

A couple questions:

1) Curious as to why it would be a good practice to combine tablets and solution?  Wouldn't it be gentler to cut each dose? Or would it not matter because the cut is so small? I can see it would be less tedious to have to take the liquid only once a day. So I'm thinking I may change to taper off the mid day dose first. Thoughts?

2) If I went to a pharmacy would they prepare the mixture, just as I would? using vodka? Do they just use the spreadsheet and the Help sheets? Is this something I have to ask the Doctor to order? Does my Insurance get involved?

 

I hope all this makes sense....

 

Thank you again!

 

Juelli

Hi Juelli-

There is a couple of reasons to combine tablets & liquid. One reason is that it is easier to reduce minuscule amounts & maintain accuracy when one takes a tablet & small amount of liquid along with the tablet. Another reason is that some folks have found that they become sensitive & experience GI issues when taking a large quantity of pharmaceutical prepared liquid.

Some people find it to be gentler to cut a little from each dose, especially when one gets down in their taper & is experiencing symptoms. You can make this adjustment at any point in your taper. Start tapering from any dose as you see fit.

Most pharmacists will prepare as the doctor orders. If the doctor orders a suspension they will crush tablets & use a suspension vehicle such as Ora-Plus. If it is a standard script they will usually order it already prepared directly from a pharmaceutical manufacturer. Ethanol(pure alcohol) is usually used if this is the case. So no, vodka is an alternative that will work if ethanol is unobtainable.

The spreadsheet & help sheet is for you to follow as you taper & also to share what you are doing with whoever is managing your taper.

I have a question for you. In the bolded above, if your total daily dose is 1.5mg & each of your tablets are 1.5mg why are you using 1+1/2 tablets (2.25mg) along with 150ml to get a concentration .02mg/ml?

If you want to use pharma liquid your doctor will have to specify this in your script. He will also need to specify the concentration you plan on using unless you are planning on diluting it yourself (which is generally preferred) I don't know about your insurance.

OK!  I think I've got this! 

 

I want to thank everyone on this forum for their kindness and sharing of information.

 

Even with my fuzzy brain, I have read the Ashton Manual, read and reread tons of posts here, watched Benzo Brains Videos, studied Jim Hawk's and Bella Amis's Benzo Liquid Taper Help paper and played with the Taper Calculator. (Wicked BRILLIANT!!) I have been on Klonopin for nearly 17 years & have experienced many of the w/d symptoms I read about here...I am going s-l-o-w with this taper. I am hoping some of you veterans would be willing to look this over , make any recommendations and answer a few questions for me.

 

I will be doing a liquid taper using vodka as a solvent. I have the supplies.

The summary of my Plan from the calculator:

Medication: Name: Clonazepam - Tablet size: 1.5 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1.5 - Volume of liquid: 150 ml - Concentration: 0.02 mg/ml

Daily doses: Dose 1: .5 mg - Dose 2: .5 mg - Dose 3: .5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 21.05.0018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: Across doses - Combine with tablets: No - Attenuated ending: Yes

 

A couple questions:

1) Curious as to why it would be a good practice to combine tablets and solution?  Wouldn't it be gentler to cut each dose? Or would it not matter because the cut is so small? I can see it would be less tedious to have to take the liquid only once a day. So I'm thinking I may change to taper off the mid day dose first. Thoughts?

2) If I went to a pharmacy would they prepare the mixture, just as I would? using vodka? Do they just use the spreadsheet and the Help sheets? Is this something I have to ask the Doctor to order? Does my Insurance get involved?

 

I hope all this makes sense....

 

Thank you again!

 

Juelli

 

Hi Juelli-

 

There is a couple of reasons to combine tablets & liquid. One reason is that it is easier to reduce minuscule amounts & maintain accuracy when one takes a tablet & small amount of liquid along with the tablet. Another reason is that some folks have found that they become sensitive & experience GI issues when taking a large quantity of pharmaceutical prepared liquid.

 

Some people find it to be gentler to cut a little from each dose, especially when one gets down in their taper & is experiencing symptoms. You can make this adjustment at any point in your taper. Start tapering from any dose as you see fit.

 

Most pharmacists will prepare as the doctor orders. If the doctor orders a suspension they will crush tablets & use a suspension vehicle such as Ora-Plus. If it is a standard script they will usually order it already prepared directly from a pharmaceutical manufacturer. Ethanol(pure alcohol) is usually used if this is the case. So no, vodka is an alternative that will work if ethanol is unobtainable.

 

The spreadsheet & help sheet is for you to follow as you taper & also to share what you are doing with whoever is managing your taper.

 

I have a question for you. In the bolded above, if your total daily dose is 1.5mg & each of your tablets are 1.5mg why are you using 1+1/2 tablets (2.25mg) along with 150ml to get a concentration .02mg/ml?

 

If you want to use pharma liquid your doctor will have to specify this in your script. He will also need to specify the concentration you plan on using unless you are planning on diluting it yourself (which is generally preferred) I don't know about your insurance.

Thank you so much for reading this over and helping me.

I just cut and pasted the summary of my plan from the calculator that's where that info came from. but if it doesn't make sense I must have screwed it up. I guess I just don't understand what im doing on the calculator. I thought I did.

Since i never had a regular daily dose and took K "as needed" I took a week to figure out that I can tolerate .5mg 3 X day. am, noon, pm

What do you suggest? I want a liquid taper (which I will make myself with vodka as a solution- forget the parmacy) and I agree, I want to combine tablets.  I have 1 mg tablets. I take 3 x .5mg/day  I want an attenuated ending. I put this into the calculator and am pasting it here :

Summary

Medication: Name: Clonazepam - Tablet size: 1 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1 - Volume of liquid: 5 ml - Concentration: 0.20 mg/ml

Daily doses: Dose 1: 0.5 mg - Dose 2: 0.5 mg - Dose 3: 0.5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 20.05.2018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: First doses first - Combine with tablets: Yes - Attenuated ending: Yes

(i am sorry I can't figure out how to insert the table.)

Is this correct now? ty!

Juelli

 

 

Thank you so much for reading this over and helping me.

 

I just cut and pasted the summary of my plan from the calculator that's where that info came from. but if it doesn't make sense I must have screwed it up. I guess I just don't understand what im doing on the calculator. I thought I did.

 

Since i never had a regular daily dose and took K "as needed" I took a week to figure out that I can tolerate .5mg 3 X day. am, noon, pm

 

What do you suggest? I want a liquid taper (which I will make myself with vodka as a solution- forget the parmacy) and I agree, I want to combine tablets.  I have 1 mg tablets. I take 3 x .5mg/day  I want an attenuated ending. I put this into the calculator and am pasting it here :

Summary

Medication: Name: Clonazepam - Tablet size: 1 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1 - Volume of liquid: 5 ml - Concentration: 0.20 mg/ml

Daily doses: Dose 1: 0.5 mg - Dose 2: 0.5 mg - Dose 3: 0.5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 20.05.2018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: First doses first - Combine with tablets: Yes - Attenuated ending: Yes

 

(i am sorry I can't figure out how to insert the table.)

 

Is this correct now? ty!

 

Juelli

 

This is what I would do: I would start out at a 10% reduction with the attenuating ending. If at some point your symptoms escalate where they are intolerable, you can always easily slow down the reduction rate or percentage.

Solution preparation:

1) Put 1-1mg tablet in a Pocket Size Vial

2) Add 1ml ethanol. Let sit 10 minute. Shake well

3) Add 9ml distilled water. Shake well

4) Draw out dose using 100 increment tuberculin syringe and a 10 ml syringe

Click on image

 

 

Thank you so much for reading this over and helping me.

 

I just cut and pasted the summary of my plan from the calculator that's where that info came from. but if it doesn't make sense I must have screwed it up. I guess I just don't understand what im doing on the calculator. I thought I did.

 

Since i never had a regular daily dose and took K "as needed" I took a week to figure out that I can tolerate .5mg 3 X day. am, noon, pm

 

What do you suggest? I want a liquid taper (which I will make myself with vodka as a solution- forget the parmacy) and I agree, I want to combine tablets.  I have 1 mg tablets. I take 3 x .5mg/day  I want an attenuated ending. I put this into the calculator and am pasting it here :

Summary

Medication: Name: Clonazepam - Tablet size: 1 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1 - Volume of liquid: 5 ml - Concentration: 0.20 mg/ml

Daily doses: Dose 1: 0.5 mg - Dose 2: 0.5 mg - Dose 3: 0.5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 20.05.2018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: First doses first - Combine with tablets: Yes - Attenuated ending: Yes

 

(i am sorry I can't figure out how to insert the table.)

 

Is this correct now? ty!

 

Juelli

 

 

This is what I would do: I would start out at a 10% reduction with the attenuating ending. If at some point your symptoms escalate where they are intolerable, you can always easily slow down the reduction rate or percentage.

 

Solution preparation:

1) Put 1-1mg tablet in a Pocket Size Vial

2) Add 1ml ethanol. Let sit 10 minute. Shake well

3) Add 9ml distilled water. Shake well

4) Draw out dose using 100 increment tuberculin syringe and a 10 ml syringe

 

Click on image

Dear Bella,

Thank you! Thank you SO much!! That makes so much sense. I am so sorry that I couldn't figure that out myself and I am very appreciative for your time and expertise.

I will feel confident presenting this plan to my doctor.

With much gratitude!

Juelli

Well, my PCP looked at the plan and his eyes were glazed over then he said he would feel better if a psychiatrist looked it over.  So, I have an appointment with a Psychiatrist who, I was told, is very conservative afa prescribing meds would rather people meditate, do yoga, therapy, use cbd oil or get a MM card!  So, hopefully, after June14 I will be on a dr 'approved' taper plan. Although, I never said I was going to wait til then to start the plan.

I will forever be amazed at the speed in which I was prescribed this medication. Less than a 5 minute conversation and I had a script in my hand.

Thank you again for your help Bella!

Juelli

 

 

Thank you so much for reading this over and helping me.

 

I just cut and pasted the summary of my plan from the calculator that's where that info came from. but if it doesn't make sense I must have screwed it up. I guess I just don't understand what im doing on the calculator. I thought I did.

 

Since i never had a regular daily dose and took K "as needed" I took a week to figure out that I can tolerate .5mg 3 X day. am, noon, pm

 

What do you suggest? I want a liquid taper (which I will make myself with vodka as a solution- forget the parmacy) and I agree, I want to combine tablets.  I have 1 mg tablets. I take 3 x .5mg/day  I want an attenuated ending. I put this into the calculator and am pasting it here :

Summary

Medication: Name: Clonazepam - Tablet size: 1 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1 - Volume of liquid: 5 ml - Concentration: 0.20 mg/ml

Daily doses: Dose 1: 0.5 mg - Dose 2: 0.5 mg - Dose 3: 0.5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 20.05.2018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: First doses first - Combine with tablets: Yes - Attenuated ending: Yes

 

(i am sorry I can't figure out how to insert the table.)

 

Is this correct now? ty!

 

Juelli

 

 

This is what I would do: I would start out at a 10% reduction with the attenuating ending. If at some point your symptoms escalate where they are intolerable, you can always easily slow down the reduction rate or percentage.

 

Solution preparation:

1) Put 1-1mg tablet in a Pocket Size Vial

2) Add 1ml ethanol. Let sit 10 minute. Shake well

3) Add 9ml distilled water. Shake well

4) Draw out dose using 100 increment tuberculin syringe and a 10 ml syringe

 

Click on image

 

Hi again Bella,

I appears I've run into a bit of a snag. 

I’m set to start the taper, finally I have all the supplies and did a practice today drawing up with no problem.

I wanted to print out the spreadsheet to keep track of everything. I used the calculator and entered in the information just as you showed me however the spreadsheets are not the same in the Dose 1 column. (I’m sorry I don’t know how to paste it into this post.)

Yours shows:

Dose 1

[mg: 0.4893]  [=ml: 4.89]  (NO +TABLET column)

Mine shows:

Dose 1

[mg: 0.4893]  [=ml: 2.39] [+tablet: 1/4 T]

Dose 2 and Dose 3 are like yours.

How do I get rid of that +tablet column under Dose 1 so I am taking only liquid? 

Should I ask the Dr when I see him in 2 weeks to Rx me .5 mg tablets--- if you think that would be easier? Although I may need help to calculate .5 tabs if I can't get this right!

Thank you again for your help. I really appreciate it.

Juelli

 

 

Thank you so much for reading this over and helping me.

 

I just cut and pasted the summary of my plan from the calculator that's where that info came from. but if it doesn't make sense I must have screwed it up. I guess I just don't understand what im doing on the calculator. I thought I did.

 

Since i never had a regular daily dose and took K "as needed" I took a week to figure out that I can tolerate .5mg 3 X day. am, noon, pm

 

What do you suggest? I want a liquid taper (which I will make myself with vodka as a solution- forget the parmacy) and I agree, I want to combine tablets.  I have 1 mg tablets. I take 3 x .5mg/day  I want an attenuated ending. I put this into the calculator and am pasting it here :

Summary

Medication: Name: Clonazepam - Tablet size: 1 mg - Planned quit dose: 0.025 mg/day - Suggested quit dose: 0.025 mg/day

Liquid solution: Number of tablets: 1 - Volume of liquid: 5 ml - Concentration: 0.20 mg/ml

Daily doses: Dose 1: 0.5 mg - Dose 2: 0.5 mg - Dose 3: 0.5 mg - Dose 4: 0 mg - Dose 5: 0 mg - Dose 6: 0 mg

Planned reduction: Start date: 20.05.2018 - Reduction percent: (N/A) % - Reduction quantity: 0.075 mg - Period: 14 days - Reduction order: First doses first - Combine with tablets: Yes - Attenuated ending: Yes

 

(i am sorry I can't figure out how to insert the table.)

 

Is this correct now? ty!

 

Juelli

 

 

This is what I would do: I would start out at a 10% reduction with the attenuating ending. If at some point your symptoms escalate where they are intolerable, you can always easily slow down the reduction rate or percentage.

 

Solution preparation:

1) Put 1-1mg tablet in a Pocket Size Vial

2) Add 1ml ethanol. Let sit 10 minute. Shake well

3) Add 9ml distilled water. Shake well

4) Draw out dose using 100 increment tuberculin syringe and a 10 ml syringe

 

Click on image

 

 

Hi again Bella,

 

I appears I've run into a bit of a snag. 

 

I’m set to start the taper, finally I have all the supplies and did a practice today drawing up with no problem.

 

I wanted to print out the spreadsheet to keep track of everything. I used the calculator and entered in the information just as you showed me however the spreadsheets are not the same in the Dose 1 column. (I’m sorry I don’t know how to paste it into this post.)

 

Yours shows:

Dose 1

[mg: 0.4893]  [=ml: 4.89]  (NO +TABLET column)

 

Mine shows:

Dose 1

[mg: 0.4893]  [=ml: 2.39] [+tablet: 1/4 T]

 

Dose 2 and Dose 3 are like yours.

 

How do I get rid of that +tablet column under Dose 1 so I am taking only liquid? 

 

Should I ask the Dr when I see him in 2 weeks to Rx me .5 mg tablets--- if you think that would be easier? Although I may need help to calculate .5 tabs if I can't get this right!

Thank you again for your help. I really appreciate it.

 

Juelli

Hi juelli-

Jim's program has some limitations. So to get around these limitations what I did is in the blue box labeled "planned reduction" is select "with tablets" then print, then select  "without tablets" & print. Print BOTH charts & use the all liquid figures for the dose you want to take as "all liquid" (I used windows"paint" to cut & paste the liquid column to use in conjunction with the combination column) Use BOTH charts if that is how you want to taper. 

Yes, I would use .5mg tablets, then redo chart. I hope this makes sense now....sorry about any confusion.

Hi juelli

Yours shows:

Dose 1

[mg: 0.4893]  [=ml: 4.89]  (NO +TABLET column)

 

Mine shows:

Dose 1

[mg: 0.4893]  [=ml: 2.39] [+tablet: 1/4 T]

 

Dose 2 and Dose 3 are like yours.

I have perhaps an explanation for that  . Not so far away when combining solution with tablets, the smallest splittable unit used by the program was half a tablet. The calculation from Bella Amis in your hands has been based on that. Later on with Bella Amis we decided that we can further split a tablet to quarters. Your new generated report is now based on the quarter of a tablet. The cons is that before you just had to split a tablet to halves and now you need to split it to quarters

The program has been designed to not report the empty +tablet column when option "Combine with tablets" is set to "No". When it is set to "Yes", this column is there to let user know the quantity of tablets (none or quarters or halves) to take in combination with the volume of solution in blue.

Should I ask the Dr when I see him in 2 weeks to Rx me .5 mg tablets

You don't need to. Just split the 1 mg tablet to 4 quarters. They do not need to be rigorously the same size as the main ingredient of the tablet in very low quantity does not change much from one quater to another. When you see [mg: 0.4893]  [=ml: 2.39] [+tablet: 1/4 T], you will draw up 2.39 ml and drink it together with a quarter of a tablet. Together they will make the dose of 0.4893 mg.

Hope it helps.

Jim and Bella! 

Thank you! Your explanations are such a relief!!!! Some days I feel I've lost my mind, how delightful to know, at least in this instance, I still have it!

I will print both plans and be on my way!!

Also, since the therapist suggested the Dr will Rx .50mg once I'm tapered down to 1 mg/day, am I correct in understanding that I would prepare the solution the same as Bella described (below), only using two .50mg instead of the 1mg? or would I need to increase the vodka to 2 ml adding 8 ml H20?

___________________________

{Solution preparation:

1) Put 1-1mg tablet in a Pocket Size Vial

2) Add 1ml ethanol. Let sit 10 minute. Shake well

3) Add 9ml distilled water. Shake well

4) Draw out dose using 100 increment tuberculin syringe and a 10 ml syringe}

_____________________________

With much gratitude,

Juelli

Hi juelli

I would prepare the solution the same as Bella described (below), only using two .50mg instead of the 1mg?

Yes you are correct as both will give 1 mg of benzo.

Before I started to taper Clonazepam, I had 2 different tablet sizes from the same manufacturer: .5 mg and 2 mg. The 2 mg has been bought later on when I realized that the quantity of .5 mg tablets is small in its bottle. To address my request doctor gave me an order for 2 mg tablets that I need to split in quarters for my .5 mg nightly dose. Well, you might not believe it but the quarter of the 2 mg tablet was much stronger than the .5 mg . As a result I just used the 2 mg tablets. Until today I have not found any credible explanation for that. So just in case you feel comfortable with the 1 mg tablet, then possibly stick to it until the end.

Wish you a smooth journey towards a full recovery.

Hi Jim!

Well, that is interesting regarding the different doses/strengths.  Dr shouldn't have any problem with that.

Well,I took my first titrated dose with 1/4 tablet... I am officially tapering!  Bella had suggested some 12ml vials, so I just made up the solution and drew up enough for 5 days. The whole process came back quickly after years of drawing up my son's insulin 2-3 x day! (He was diagnose with JD 35 years ago.) He now uses an insulin pump but suggested that my life would be easier if I used his extra pump for my titration...Ever hear of anyone doing that? I googled it but-nothing.

I also read with interest your explanation of Milk vs Vodka.  Thank you for that information. You really have a gift for explaining complex concepts and putting them into layperson's terms.

I thank my lucky stars for finding this forum!

Juelli