Help using compounded Valium to do Taper

Hello BB members. I had problems finding a Dr where I live to prescribe me Valium for my Taper. I managed to find one who uses compounded Valium for Tapering. The advantage he said was it would be easy to even dose 3 times a day 8 hours apart and also it would be easy to change the cut amount. It is pure Valium in almond oil.

I had asked him to start the Taper at 3%. I had a bad experience before with a C/T from Klonopin. So I am pretty conservative.

Starting dose was 30mg of Valium So 3% was a .9mg cut which I asked to hold for 10 days before my next cut. So each cut is .9mg. I know that as I get lower in dosage the % will increase. I have had no problems yet except for Tinnitus and bad headaches. I am not sure if the headaches are related to the Valium or due to a sinus problem or another cause.

Anyway I was not sure if I should set a % limit for any cut . Say like 5% or try to keep the maximum cut lower than 5%

I know if I were to get major sxs that it would not be wise to updose. I would probably have to tough it out and hold until the symptoms subside before I make another cut

I also know many BB members here reduce their cut amounts as they near the lower dosages and also increase their hold times.

I would appreciate any member's experience advice or suggestions as  how to make this a successful and as painless as possible taper

Thanks  Rob

Hello BB members. I had problems finding a Dr where I live to prescribe me Valium for my Taper. I managed to find one who uses compounded Valium for Tapering. The advantage he said was it would be easy to even dose 3 times a day 8 hours apart and also it would be easy to change the cut amount. It is pure Valium in almond oil.

Hi Rob,

Sounds good.

I had asked him to start the Taper at 3%. I had a bad experience before with a C/T from Klonopin. So I am pretty conservative.

I can understand your hesitance after your bad experience. It would be highly unusual to react poorly to a single 3% cut of Valium. The thing to remember is that with a long half-life benzodiazepine, it takes time for blood levels to drop with the corresponding cut to dose. So, although you might cut 3% of your dose, it will take a week or two for your blood levels to drop accordingly. When you feel more confident, I think you will find that you can tolerate larger cuts to Valium than 3%. Alternatively, you might make your 3% compounded cuts more regularly, but this could work out rather expensive for you (new prescriptions every week, say). What I mean is, you would be unlikely to notice much difference between a cut of 3% every week, and 6% every two weeks (I mean with Valium - not short half-life benzodiazepines).

Please understand, these figures are just examples. You should taper at a rate which bests suits you, and make cuts of a size with which you feel confident. Try to put out of your mind what happened before. This is not a cold turkey, and any cuts will take effect only gradually because of Valium's long half-life value.

Starting dose was 30mg of Valium So 3% was a .9mg cut which I asked to hold for 10 days before my next cut. So each cut is .9mg. I know that as I get lower in dosage the % will increase. I have had no problems yet except for Tinnitus and bad headaches. I am not sure if the headaches are related to the Valium or due to a sinus problem or another cause.

Just to point out that there is very little difference between a cut of 0.9mg and 1mg (half of a 2mg tablet). 2mg tablets of Valium are easily divided in two, or even in to quarters (and are far cheaper than compounded meds). If you were to make a cut of just 0.5mg (a quarter of a tablet), you could make a new cut sooner, so the overall taper rate might be unaltered. The important thing to consider with these small cuts is your overall taper rate, not the size of each individual cut. If ever your withdrawal symptoms begin to spike to intolerable levels, you would stabilise your dose until your feel better.

If you are taking compounded meds, of course the size of the cuts can be controlled quite tightly. Future reductions could be to any size agreed upon between you and your doctor. In your shoes, I think I would consider larger cuts at this stage, and then perhaps slow the taper rate later (maybe to the rate you have decided upon now). At the very end, you might even make smaller cuts, but many people manage cutting 1mg Valium every 1-2 weeks, even at the end. Others reduce the size of cuts to 0.5mg for the last few cuts. But, this all comes down to how you react. And, given your past experience, of course I understand your caution.

It is unusual for people to need to make very small cuts to Valium because of its long half-life. I am not meaning to put you off compounding your dose, I am just trying to provide you with an alternative approach in case they should become applicable or desirable. Certainly, there is nothing wrong with the plan you have outlined. At this rate, you would complete your taper in about 11 months.

Anyway I was not sure if I should set a % limit for any cut . Say like 5% or try to keep the maximum cut lower than 5%

I know if I were to get major sxs that it would not be wise to updose. I would probably have to tough it out and hold until the symptoms subside before I make another cut

I don't understand. I thought you were intending to stick to cuts of 3%. A 1mg cut from your present dose of 30mg would equal 3.33%. From 29mg, it would be a little higher. Only when you reach a dose of 20mg and reduce dosage to 19mg would your cut equal 5%. Though, I suggest that deciding upon maximum cuts at this stage is premature. There is great variability in what individuals can manage reasonably comfortably, and our personal situations, etc. You will feel your way through this.

I also know many BB members here reduce their cut amounts as they near the lower dosages and also increase their hold times.

One or both of these options are perfectly reasonable. Though, I think there is less need for people to hold for longer at the end with Valium, as they can make quite small cuts (because of Valium's relative low potency, 0.5mg is a very small amount/cut). With a very potent benzodiazepine, particularly with a short half-life, individual cuts can hit harder, so there might be a greater need to 'hold'. Again, mileage will vary.

I would appreciate any member's experience advice or suggestions as  how to make this a successful and as painless as possible taper

 

Thanks  Rob

My advice is meant to be general. Try not to over-think this. You are taking an initial cautious approach. Good. But, unless you have attempted to taper before, there is really no reason to expect a particularly tough time of it. Your cold turkey experience is irrelevant, as most people would react very poorly in such a situation. Compound, or make discrete cuts to (Valium) tablets. Both options are perfect reasonable. Take it as it comes, and if you experience problems or have a question, post away for some feedback.

You might find this table of some help with working out percentages. Again, don't over-think this:

http://www.benzobuddies.org/benzodiazepine-withdrawal-methods/direct-taper/#tailored-taper-plans

Good luck.

Colin. On Thursday I made another .9mg cut so I was at 26.1mg on Wednesday and on Thursday I am at 25.2mg So this was a 3.45% cut.

But if I keep making the same .9mg cut every 10 days at 18mg a .9mg cut would be 5%. So each subsequent cut the percentage I am cutting would keep increasing.

I am being very cautious as you have mentioned. I can't predict if I will have severe sxs or not. I guess the trauma and very bad experience I had at the detox facility made me become this way

I am concerned that at the lower dosages I should be cutting at a lower percentage rather than cutting at a higher percentage.

I know I may be able to cut more right now than the .9mg. I guess I have extreme fear and I still have thoughts of the C/T from Klonopin.

I probably could have used pills but I could find no Dr that would even prescribe me Valium and the one I found uses compounded Valium because it is easy to make small adjustments in dosage.

If at some point I do get sxs. What is my best option updose slightly or hold my dose I am at for a longer time.

Aston had patients drop a fixed amount 1mg all the way to the end or at 5mg to reduce the dose to .5mg.

Many in the BB forum do not follow her taper schedule and consider it too aggressive

What you have written makes senses Colin. I just read it all over again. My problem was finding a Dr to prescribe me the Valium . This was my big problem. I would definitely considered using pills and cutting but I did not have this option and I was tired of looking for a Dr.

Thank You  Colin

Colin. On Thursday I made another .9mg cut so I was at 26.1mg on Wednesday and on Thursday I am at 25.2mg So this was a 3.45% cut.

How exactly are you making additional cuts? Are you getting a new compounded prescription for each cut?

But if I keep making the same .9mg cut every 10 days at 18mg a .9mg cut would be 5%. So each subsequent cut the percentage I am cutting would keep increasing.

5% cuts are not usually a problem, especially with longer half-life benzodiazepines. Many of our members make cuts of around 10 % (or even more sometimes). If and when your 0.9% or 1% cuts start to become a problem, just reduce the size of the cut.

I am being very cautious as you have mentioned. I can't predict if I will have severe sxs or not. I guess the trauma and very bad experience I had at the detox facility made me become this way

I understand your caution, but the chances are that you will taper off without experiencing too many problems. Most people would suffer very significant problems with a cold turkey withdrawal.

I am concerned that at the lower dosages I should be cutting at a lower percentage rather than cutting at a higher percentage.

To be clear, do you mean a 3% cut from your original dose of 30mg? If, however, you mean a 3% cut from your dose at the time of the cut, read on....

At lower doses, the percentage will go up. Using 'percentages' is a useful guide at higher doses. But at low doses the percentage must go up - it is just mathematics. For example, if you are taking a very low dose of Valium (0.1mg, say), this would have no appreciable affect upon you. However, if you cut this dose in half, you have made a 50% reduction. It would make no sense to expect this to be a tough cut simply because it is 50% reduction. Further, your final cut, no matter how infinitesimal small your dose might be at the time, is always a cut of 100%.

I know I may be able to cut more right now than the .9mg. I guess I have extreme fear and I still have thoughts of the C/T from Klonopin.

That's understandable. Later, perhaps, when you feel more confident you might decide to increase the size of cuts. If not, an 11 month taper plan from 30mg Valium does not strike me as at all unreasonable.

I probably could have used pills but I could find no Dr that would even prescribe me Valium and the one I found uses compounded Valium because it is easy to make small adjustments in dosage.

Well, just managing to get hold of Valium in the States is achievement enough. Probably overkill to have it compounded, but it will certainly do you no harm.

If at some point I do get sxs. What is my best option updose slightly or hold my dose I am at for a longer time.

So long as you have been tapering sensibly, there is not normally any need to reverse a cut. If you feel an upsurge in withdrawal symptoms, I suggest stabilising your dose for a while. When you feel better, continue where you left off. This is what most members do and is what is recommended by Prof. Ashton.

Aston had patients drop a fixed amount 1mg all the way to the end or at 5mg to reduce the dose to .5mg.

At higher doses, Ashton normally had her patients make cuts larger than 1mg. Typically, from your starting dose, 2mg cuts all the way down to 10mg. However, her protocols are for the purposes of guidance; they are not law, just a sensible suggestion.

Many in the BB forum do not follow her taper schedule and consider it too aggressive

BB tends to attract tougher cases. Often, members have already experienced problems tapering. Sometimes, no doubt, they have read overly pessimistic advice elsewhere (or sometimes here from well meaning members). We are a self-selecting group - this will distort the stats. Some people experience greater difficulties withdrawing than the general population. These people are far more likely to join BB and similar sites. All these people together can give a distorted picture of to expect. Unless you have already experienced problems quitting via a sensible taper plan, there is no reason for you to expect that your experience will be anything but 'average' from the general population of benzodiazepine users. The 'average' around here is different from the general population.

What you have written makes senses Colin. I just read it all over again. My problem was finding a Dr to prescribe me the Valium . This was my big problem. I would definitely considered using pills and cutting but I did not have this option and I was tired of looking for a Dr.

 

Thank You  Colin

Well, in which case, maybe the old idiom of if it ain't broke, don't fix it should apply.

Colin, I get a bottle of compounded Valium with a graduated syringe. Right now the bottle is 6mg/ml. There are 100 graduations on the syringe. But the large graduation marks go from .05 .1 .15 .2 .25 all the way up to 1.0ml. So I am now at 25.2mg per day of Valium. I take 3 equal doses 8 hours apart so each dose is 8.4mg or 1.4ml. The bottle contains enough compounded Valium for 30 days. So I can make 3 cuts before I get my next bottle. My next dose will be 1.35ml or 8.1mg for a total daily dose of 24.3mg. So there are 20 large marks that are easy to see  of the 20 marks would be .05ml or .05 X6MG =.3mg

The compounding pharmacy can change the dilution ratio at any time. For example 2mg/ml or 1mg/ml. There is no making up a new batch every day. I get a consistent dose every time and keep an even level of Valium in my blood over 24 hours

After 30 days I get a new bottle and syringe enough for 3 cuts pf .9mg for each cut.

The Dr had wanted me to start at 5% of 30 mg or 1.5mg per cut. The per cent is based on the starting dose and the cut amount would not change. I had a bad experience from the klonopin and felt it would be easier to start slower than start too fast. So I asked him To start at 3% for 10 days instead of his suggestion of 5% over 7 days. That is how I got to the .9mg cut every 10 days,

He told me he could change the cut amount and hold time if I started to have sxs but I should let him know as soon as the sxs got worse. He knows about Ashton but he thinks 3 times a day even dosing would be better even when Valium has a longer half life. He had calculated a 10 month taper but I am not sure if it was based on his 1.5mg cuts every week or my .9mg cut every 10 days. He said if I based the per cent always on the preceding dose it would take a very long time to get off of the Valium. Some BB members keep the per cent always the same and based on the preceding dose.

Ashton kept a constant 1 mg cut for under 20mg of V and 2 mg for over 20 Her table started at 40 mg V. I only saw  a reduction at 5 mg down from 1 mg to .5mg her hold times were 1 to 2 weeks . So I guess with Ashton the percentage would go way up as the dose dropped until 5mg where it would go back down

Colin I do regret that I could not find a Dr to prescribe me Valium pills but if I did I would prefer mostly 5mg and even more 2mg pills. I would still prefer even dosing 3 times a day. I think it may help any interdose W/d sxs

Rob

I have not posted in a long time because my taper has been going well. But lately I have been getting slammed with sxs. The Tinnitus has increased and the burning sensation have also become worse. Should I stay the course with my Taper and get it over with. I don't want to updose but I worry about prolonging the taper by slowing down.

Does anyone have an opinion?

Rob

Rob, you got truly excellent advice from Colin back in January. Have you had the opportunity to go back and read it?

There are a couple of things to keep in mind as you taper.

One is that practically no one gets through this without symptoms. If your only symptoms are increased tinnitus and burning skin, I'd say you're pretty lucky.

The other thing is to watch the percentage of cuts. Try to stay below 10% as you go down.

Good luck,

Flip

Flip, I have been keeping my cuts under 10%. I do know taht other BB member have much more and severe sxs. I understand this. I did a C/T of Klonopin in a detox place and i had much more severe sxs. I am just hoping that I don't get any new or more severe sxs with this taper than I already have. My PMC Dr wanted me to speed up my taper significantly. My complaint to him was I was having severe headaches to which he replied Valium W/D could cause these sxs. I was kind of shocked because I never heard a Dr acknowledge taht there was such a thing as W/D sxs.

But the Dr who prescribed the compounded Valium advised me to keep on schedule and not to speed up the taper. Since he has experience with benzos I have followed his advice. I guess I want answers but I find that it is not possible to predict what will happen or what will help. It seems it is trial and error. My hunches on what to do always seem to be wrong.

Rob

There is probably no "right" way. Most of us have found we made it through by doing what your doing, staying below 10% and making the cuts every 10-14 days.

I also CT Klonopin in a detox. However, I reinstated on Valium within a few days. Still, my whole taper was brutal.

I'm feeling good now, though, so take heart!

Flip

my symptoms have increased significantly, my plan to lower my cut to 13.5mg are derailed. I know from past experience when I cut using pills that even increasing the hold time to one month did not make the symptoms less severe. I have done a trial to see if a updose would help reduce the symptoms. It has so I went back up from 13.5mg to 15.3 mg. The symptoms are slowly easing up. It may take a while but when I am stable and the symptoms have decreased significantly, I will decrease my cut amount. Right now I am thinking of changing the cut amount from .9mg to .45mg. I don't know if I can cut .45mg and hold for 5 days and then cut another .45mg and hold for 5 more days. It would still be a .9mg cut but I would have made 2 (.45) mg cuts with a hold in between. The other plan would be just to make a .45mg cut and hold for 10 days. I still would dose  3 times per day.

So the total cut of .45 mg would be divided by 3 =.15mg reduction per dose. Right now I am at .9mg. So each of the 3 cuts is .3mg per dose.

It just seems that I can't predict what will happen and that I just have to try something and learn from the results. But lowering the amount that I cut should help me to avoid getting worse symptoms during this taper. As Colin had said a .5mg cut in Valium should not be that noticeable because of Valiums long half life.

I think at a dose of 15.3mg a .45 mg cut would bring on less symptoms.

Rob

my sxs were intolerable going from significant at cut from 15.3mg to intolerable at 13.5. I updosed as from my past experience holding for an extended time did not relieve sxs. I have now changed my Taper rate from 3% to 2%. The 2% is based on my current stable rate of 15.3mg. I dose 3 times per day. each dose is 5.1mg so my dose will go down to 5mg or 15mg per day and my amount dropped will go down from 2.7mg to .9mg. So If I am starting at 15.3mg I will be at 14.4mg after  30 days which is a 6% drop instead of a 18% cut. Did anyone in this forum face a problem when going from 30 + mg down to under 15mg? Any one care to give any advice. I should get better again with the slower taper rate. I never expected I would run into the problem at 15 mg. I think I was on the conservative side of the Ashton schedule when I started out.

Rob

I had to update my experience with using compounded valium. It did allow me to taper down from 30mg to around 15 but that is where my problems started. I am now experiencing burning sensations. I did updose from 13.6mg to 15.3mg again, The symptoms are now less severe but I still am having constant Tinnitus and burning which is milder nut not as severe.

It is easy to make small dosage changes either up or down with compounded V. That is a nice advantage. But I decided to cut my Taper rate to 2% of my last stable dose of 15mg. So now I am cutting .3mg every 7 days. Or 1.2mg every 4 weeks.

The only worry I have is if I am going too slow. I have read about Benzo Toxicity.

I am worried about this I have posted 2 topics in the general taper section writing about this. I hope someone will chime in and respond. I don't know if any BB member has experienced this paradoxical reaction to benzos,

birdie, I had attempted a taper before just using pills and a pill cutter and I failed but again the number I failed at was 16. It seems it is different for many BB  people where they run into a wall. My problem area happens to be somewhere in between 16 or 15. It may have something to do with genetics or my past use of other drugs or the combo of meds I am taking. Not everyone has the same circumstances. But my wall is around 16mg. So I need to plan ahead because I can use compounded V or I can use pills and cut and weigh them and I will always have the problem here. So I need to change my Taper strategy maybe slow down the taper rate way before I get down to my danger zone.

Rob

birdie, I had attempted a taper before just using pills and a pill cutter and I failed but again the number I failed at was 16. It seems it is different for many BB  people where they run into a wall. My problem area happens to be somewhere in between 16 or 15. It may have something to do with genetics or my past use of other drugs or the combo of meds I am taking. Not everyone has the same circumstances. But my wall is around 16mg. So I need to plan ahead because I can use compounded V or I can use pills and cut and weigh them and I will always have the problem here. So I need to change my Taper strategy maybe slow down the taper rate way before I get down to my danger zone.

 

Rob

Or when you get to the danger zone  HOLD HOLD HOLD

Rob,

Have you considered a micro (daily) taper?  It is easier on the system and very adjustable for those of us who are highly sensitive to tapering. 

I micro tapered all the way down from 20mgs and the last bit took a long time.  Throughout my taper, I held, updosed, reduced my taper rate etc, much like Bart here did. 

Diaz-Pam has a link in her signature which is a good method for a liquid daily taper.  I used a slightly different method with Ora Plus diluted half and half with water as the liquid medium and it worked well, pretty accurate!

Hang in there - hitting walls is difficult but with a careful approach, you can make progress, even if that is slower than you would have liked to go.

FWIW many here, including myself, found Ashton impossibly fast....please try not to set a schedule for reducing - it's much better to stay as functional as you can and take your time with this. (Opinion only of course!). 

love gts

getting there, I only have one Dr who I found that would prescribe me valium, Where I live it is almost impossible to find any doctors to prescribe benzos. So I am stuck with the Dr I have and he uses compounding. I did change my taper rate. I will now be cutting .9mg every 30 days. .3mg every 10 days. I hope the 10 day holds and smaller cut amounts will help also I am dosing every 8 hours. That is 3 times a day. So when I cut I will be only dropping .1mg off my single dose. Now I am at 4.8mg but I am holding here for 2 weeks before I make my next cut to 4.7mg.

I hope that my new taper rate of 2% will help. I just think I did not change my yaper rate soon enough I could handle 3% or 4% but 5% or over is where I am having problems. So I am hoping a smaller cut in percentage with a 10 day hold may work.

Thanks for your advice

Rob

update, i held at 14.4mg for 12 days, sxs did get less. So I made a cut of .3mg on 7-12 now at 14.1mg. Plan on holding here for 2 weeks. I am hoping my healing will get back in sync with my taper rate.

Has anyone found when they over tapered and tried what I have that it worked?

Rob