Tapering liquid Rivotril

Two easy questions for all you alchemists.

1) If I have been taking is 0.20mg (2 drops) of Rivotril at 7PM and I change my routine and take 0.1mg (1 drop) at 7AM and another 0.1mg (1 drop) at 7PM, my daily dose is the same and the change should have no bad effects ?

2) Assuming the answer to question 1 is they are equivalent -- if I want to change my daily dose to 0.10mg (1 drop) what is the easiest (yet accurate) way for me to take 0.05mg (1/2 drop) at 7AM and 0.05mg (1/2 drop) at 7PM ? Will the solution keep ?

Thank you.

Sorry - @Libertas already pointed me to an answer...

http://www.benzobuddies.org/forum/index.php?topic=245494.msg3236429#msg3236429

(daily dose = 0.100 mg)

Morning (0.050 mg)

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 50 mL.  Drink remaining 50 mL.  Rinse glass with water and drink the rinse water.

Evening (0.050 mg)

Mix 1 drop Rivotril with 100 mL water in a glass.  Discard 50 mL.  Drink remaining 50 mL.  Rinse glass with water and drink the rinse water.

I have a measuring cup(?) in the kitchen with marking up to 250ml. 100ml sure does seem like a lot of water to mix 1 drop into. This just doesn't seem very 'scientific' (accurate)...

(1) Might I ask why you are considering splitting your dose?  Are you experiencing interdose withdrawal?

I’m not an alchemist but I do have a basic understanding of pharmacokinetics.  My understanding is that splitting your dose in the manner described would result in a ‘leveling out’ of the blood serum concentration of the drug. Instead of getting one ‘peak’ (Cmax) after your 7PM dose followed by a decrease in serum concentration, you would get two smaller peaks (one after the 7PM dose and a second after the 7AM dose).  The second set of peaks would be lower than the original peak because you would be ingesting less drug so the overall blood serum concentration would be somewhat lower, but more consistent.

(2) Regrettably, the accuracy of do-it-yourself (DIY) liquids (actually all DIY approaches) is unknown at this time.  However, anecdotal evidence from members who dilute prescription oral solutions suggests that the resulting liquids are ‘accurate enough’ for many individuals, especially if they follow ‘best practices’ for preparation and use (e.g. make smaller rather than larger batches, shake the liquid vigorously before using, measure the dose/reduction as quickly as possible before any precipitate - visible or invisible - settles out of suspension).

Happily, researchers at The School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin recently received funding to investigate whether DIY approaches allow safe and accurate dosing.  To learn more:

http://www.benzobuddies.org/forum/index.php?topic=269263.msg3383270#msg3383270

Thanks Libertas.

I don't understand why the norm isn't to split the dose to achieve a 'consistent blood serum concentration'. Personally, for the first 4-5 days after starting at a new level I do experience interdose withdrawal after 20-22 hours. I wonder how much 'anguish' could be avoided (for everyone) by splitting the dose. Especially if there is no harm.

Ok so I am going to forget mixing my own formulas. My current 'prescription' calls for me to 'jump' (is that the term used here ?) at my current level (0.20mg). So last night was #8 in the prescribed 15. When the 15 days are over (and I do feel pretty good for the last couple of days) I am going to split the 0.20mg for a week and then throw in a single dose per day at 0.10 mg for a week (or so) and then 'jump'.

My personal observation is that dose splitting works for some individuals but not for others.  It depends in part on the individual, the properties of the benzodiazepine (e.g. half-life), and (maybe) the dose amount (i.e., supratherapeutic, therapeutic, at/near subtherapeutic). Examples of ‘harms’ reported include: loss of therapeutic effect (the post-split serum concentration falls below the therapeutic threshold), intolerable daytime symptoms (e.g. sedation, short-term memory issues), and challenges associated with dosing multiple times a day.

Addendum: You might find the following discussion of interest:

http://www.benzobuddies.org/forum/index.php?topic=251494.msg3197617#msg3197617

I tried to split my doses, not because of interdose withdrawal but because I thought I had to switch to Valium eventually. I became extremely uncomfortable on two doses and less than a week in, I switched back to one dose. That's just my personal experience.

On your jumping dose question,  I personally think it's too high. Usually people start thinking about jumping around the Ashton equivalent which is 0.025mg.