help with calculations for slow microtaper please

I need some help devising a microtaper plan for my son - age 24, from remaining 4mg of valium;  He tapered from 15mg to 4 over 12 months, mostly in 1 mg cuts.  Then hit a wall since hitting 4mg.  Re-stabilizing and holding now at 4mg.    He needs a very slow microtaper - I'm thinking maybe 10% per month maximum, maybe start with only 5% per month and see how it goes??  Is it better to speed it up and just get off the dang stuff? But I am worried that too fast will cause another bipolar relapse, but not fast enough will mean more withdrawal tolerance and make his bipolar unstable from that. Advice welcome!

How do I  do the calculations?

We have a 250cc cylinder (though I can order a 100cc);

mortar and pestle

2mg valium pills,

currently taking 2mg twice a day

will start July 1 if stable by then

not sure what % taper rate;  advice welcome

Thanks so much

I need some help devising a microtaper plan for my son - age 24, from remaining 4mg of valium;  He tapered from 15mg to 4 over 12 months, mostly in 1 mg cuts.  Then hit a wall since hitting 4mg.  Re-stabilizing and holding now at 4mg.    He needs a very slow microtaper - I'm thinking maybe 10% per month maximum, maybe start with only 5% per month and see how it goes??  Is it better to speed it up and just get off the dang stuff? But I am worried that too fast will cause another bipolar relapse, but not fast enough will mean more withdrawal tolerance and make his bipolar unstable from that. Advice welcome!

 

How do I  do the calculations?

 

We have a 250cc cylinder (though I can order a 100cc);

mortar and pestle

 

2mg valium pills,

currently taking 2mg twice a day

will start July 1 if stable by then

not sure what % taper rate;  advice welcome

 

Thanks so much

Actually, the calculation is very simple.  I do this here almost every day, so I'm actually going to explain the steps, so perhaps others can follow it.  I'll use your numbers.

1) Multiply the current dose X the percentage reduction:

4mg X 10% = .4mg

2)  Divide the cut amount (mgs) by the days:

.4/30 days = .013mg/day

You can do the same calculation using 5%/30 days, but that's a really slow taper.  Most folks have no trouble with 10%/30 days.

And if you create a .1mg=1ml solution*, then the 4mg starting dose is 40ml, and the daily reduction is .13mls.  You just multiply X 10 to convert mgs to mls.

*Your 1.mg=1ml solution must start with either Rx liqud (Diazepam Oral Solution), or made with a proper solvent (vodka or propylene glycol) and diluted with water.  Diazepam is NOT water soluble, and you can NOT make a solution from plain water.

Thank you, Builder! 

So, I have another question for you.  Can I do this:

Dissolve a 1mg (1/2 tab) of valium by dropping it into a 10cc syringe, add a bit of vodka to dissolve it, add water to the 10cc mark and shake.

Then have him decrease by 0.5cc on the syringe every 4 days? ( and take the other 3mg as tablets) (0.05mg reduction every 4 days) 

(It is hard to measure more accurately than 0.5cc on the 10 cc syringe)

I wondered if he could make up 4 of these pre-measured syringes at a time for use over 4 days?

This should drop his dose by 0.38mg per month or about 10%.

Do you think this would be smooth enough, rather than going down by 0.013mg daily?  (0.13cc reduction per day using the other method? -which I'm not sure I could measure that closely anyway)

Anyone ever tried this?  Do I need to worry about the vodka/water mixture in the plastic syringe or anything? 

Use about 1cc of Vodka? then 9 cc of tap water ok?

Wisconsin, I wonder if you can get a script for the liquid form of Valium. Then all you have to do is dilute with water. It's very easy.

Gardie

Thank you, Builder! 

 

So, I have another question for you.  Can I do this:

 

Dissolve a 1mg (1/2 tab) of valium by dropping it into a 10cc syringe, add a bit of vodka to dissolve it, add water to the 10cc mark and shake.

Then have him decrease by 0.5cc on the syringe every 4 days? ( and take the other 3mg as tablets) (0.05mg reduction every 4 days) 

(It is hard to measure more accurately than 0.5cc on the 10 cc syringe)

I wondered if he could make up 4 of these pre-measured syringes at a time for use over 4 days?

 

This should drop his dose by 0.38mg per month or about 10%.

 

Do you think this would be smooth enough, rather than going down by 0.013mg daily?  (0.13cc reduction per day using the other method? -which I'm not sure I could measure that closely anyway)

 

Anyone ever tried this?  Do I need to worry about the vodka/water mixture in the plastic syringe or anything? 

Use about 1cc of Vodka? then 9 cc of tap water ok?

Here's the simplest, most reliable procedure.

Dissolve 20mg in 40ml vodka (or PG) and add 160ml water*.  This gives you 200 ml of solution, ,1mg-1ml.  At current dose and proposed taper rate, this is about a 10-12 day supply.

Assuming you have 2ml tablets, and want to do part tablets, part liquid...*

Using the previous calculation, follow this schedule:

2mg tablet  +              20ml (2mg) liquid

2mg  +                        19.87ml  (1.97mg)

2mg  +                        19.74ml (1.97mg)

2mg  +                        19.61ml (1.97mg)

Plastic equipment is fine.  I usually recommend mixing and storing in a re-claimed glass jar (olives/pickles/salad dressing, etc), but any covered container is OK.

In addition to a mix/store container, youi will need a 1ml and 10ml oral syringe.  Readily available from Amazon, or often free from your pharmacy.

*You can also just do all liquid, actually a little easier, IMO.

** Regardless of the quantity you prepare, the ratios will always be 1mg:2ml vodka:8ml water.

If you can get a scrip for Diazepam Oral Solution, you will dilute that 9:1, so again, you have a .1mg=1ml solution.