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Counting beads in a capsule versus weighing

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Lexy

I'm counting beads then weighing them on the a Gemini scale. I'm OCD weighing 3-4 times.

Idk if this has been asked before....it just dawned on me...

Do the size of the beads matter?

I have been using all the beads from the Extra Large boulder type to the tiniest ones. Do the tiny beads have enough activating substance or are they just little filler crumbles left over?

Maybe that's why I haven't been able to have many windows?!

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scallywag

The manufacturers have said that the bead contents contain the same mix of active ingredient and fillers. Several smaller beads that weight the same as a lesser number of large beads pose only one issue I've heard of -- you get more enteric coating because of the increased surface area. There's a member here who had a reaction when using smaller beads because of an allergy to an ingredient in the coating.

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ktp

Deliberately different size beads could easily figure into the extended release scheme - large jawbreakers outlast smaller ones.

And if there's an enteric coating added (is there?), can we be assured that its thickness is consistent?  it would depend on who made them and how.  Coating thickness could also figure into an XR scheme.  better please say Which mfr says What. 

 

this factoid already appears in my sig and elsewhere in this thread but it may bear repeating:

TEVA manufactured venlafaxine xr capsules contain quite uniformly sized beads each with 1mg of drug.  not perfect but very consistent - no weighing or math needed, just count.  

 

(sub mg doses? ur on your own but venla's easily water soluble so liquid should be easy to dose. but you'll have to take it 2x/day and liquid could be a pita)

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Lexy

I use Pfizer Effexor brand name. Beads come in all sizes. Should I eliminate the tiny itty bitty ones?

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scallywag

Lexy, you could save the smallest in a clean labeled container for use at the end of your taper. Some people find they need to taper from 1 bead by taking large beads, then medium beads, then small ones, then off.

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ktp

I use Pfizer Effexor brand name. Beads come in all sizes. Should I eliminate the tiny itty bitty ones?

Ask Pfizer? How much drug in a tiny bead? They won't tell even if they know.

 

Personally I think liquid is the only way to go for small doses. You just can't reliably weigh out a milligram accurately, but it's pretty easy to put 100mg in a gallon of water and know that each ounce of that has 100/128 mg of v.

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ppppp9

I'm on 3 beads Effexor XR, graduating from large, medium, small then tiny over 3-4 months.  A mild sensation on the initial drop to 3 from the last 4 beads but comfortabe.  Now almost 5-6 weeks since my drop and still feeling great.  Will hold like this probably till the New Year and then drop another bead.  My sleep is good and no anxiety to speak of.  Thought I'd share!

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WantoffVen

I am very confused by this bead thing. Hypothetically let's say I want to take ten beads. Can I just swallow those ten beads or do they have to be in a capsule? If they must go into a capsule, where do I get empty capsules? Thanks for help.

 

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ktp

> ... I want to take ten beads. Can I just swallow those ten beads or do they have to be in a capsule?

 

Capsules are merely a convenient way to swallow a hundred beads at once!   Just take the beads, you'll be fine. 

Capsules are (usually) made of gelatin (look it up) and they dissolve pretty quickly in your stomach. 

 

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Guilietta

I am considering using beads in a duloxetine/cymbalta taper - instead of the compounded liquid I have been using the past 8 months. I'm not sure how much drug I am actually getting using the liquid.

 

In looking for how to count beads - I came across this video.  Has anyone tried something like this?

 

 

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ktp
Posted (edited)

yes, but not with your drug.  see my content for gory details but the short story is

YES.  When i did it i was fortunate to discover that a 75mg cap of my med from one particular manufacturer just happened to consistently contain 75 beads all the same size so counting beads made good sense.  I got down to very small doses, then (what was i thinking?) it was going so well I proceeded to wean too quickly and triggered worse symptoms than when i started taking it in the first place.  This leaves me a strong advocate of the basic tenet here at surviving, which is "reduce your dosage by no more than 10% per month" with about a hundred !'s )  
if your med's capsules contain consitently sized beads i see no reason you can't subdivide them by counting the beads.  this makes a lot better sense than trying to weigh milligrams with any scale you can afford.

I am not a doctor and I am not a god.  Be careful with your brain!

 

Edited by ChessieCat
reworded obscenity

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Guilietta

Thank you for your prompt response and sharing. What a journey. As they used to say in naval recruiting ads, 'it's not just (ADs), it's an adventure...'

 

Bead counting is looking more and more likely in order to manage 10% decrements (I am using the BrassMonkey slide taper process) as compounded capsules look prohibitively costly. I will need to do this for another year - give or take - to get from 9.25 to 0 mg - and need all sorts of odd mcgs (if that is right) - .1 mg, .3 mg.... to make things balance out.

 

Yes - the 10% rule is important one. Listening to MDs to said to quit 20 mg duloxetine CT was a huge mistake. Dropping faster than 10% a month (I didn't realize my rate) was also a huge mistake. Not doing holds I have found to be a mistake. Lessons learned even if we want to speed things along. Patience is hard until we remember the consequences of being impatient. ;)

 

I wonder if you took your day's bead total at once or in split dosage(s)?

 

Thanks,

 

G.

 

 

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ktp

>> I wonder if you took your day's bead total at once or in split dosage(s)?

again see my content for gory details but to your question, i happened to be taking venlafaxine which was in caps containing time-release beads and the Rx was to take the caps 1 per day.  So when i was taking less than a capsule-ful of beads i took them all at once, reasoning that the time-release property was in the beads themselves.  Whether or not this applies to your med i cannot say but if the beads in your caps are consistent in size and number, I believe it does apply and YES you can count beads and do a bit of arithmetic (which was VERY easy in my case of 1bead containing 1mg of drug (and who knows or cares what else - i never needed to know how much a bead weighs)) instead of trying to weigh miniscule amounts of drug.  if the Rx for the whole cap says 1/day then 1/day for x # of beads makes sense.  

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Guilietta

Thank you - will look at the gory details shortly - trying to sort out options for compounding powder now as well as the bead bit. The beads (enteric coated to resist stomach acid) would need to be put back in an acid-resistant capsule as well. I don't know how people manage to get the cute little beads into capsules. :wacko:

 

 

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ktp

re-reading posts on this thread, I feel I should repeat that different size beads could very well be part of the "XR" (extended release) scheme.  it's been noted that some mfr's of venlafaxine have different size beads and there are posts here mentioning sorting large from small beads which seem to follow the jawbreaker theory (big ones outlast little ones) where coatings could actually be the difference in small vs large which could mean you're taking faster or slower doses without realizing it. 
With effexor (venlafaxine), the common Rx is either 2 doses per day of 'regular' or 1 dose per day of "XR".  While mfr TEVA's caps contain effectively 1mg beads and they're XR, for sub-milligram doses, "in my opinion" weighing is ridiculous and reality dictates using liquid.  so XR is out the window and you need to take it twice a day. 

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ktp

>>The beads (enteric coated to resist stomach acid) would need to be put back in an acid-resistant capsule as well. I don't know how people manage to get the cute little beads into capsules. :wacko:
1) your video shows using a little funnel to put beads back into capsules.  but that video also seems to be demoing using a milligram scale to weigh what appear to be consistently sized and thus countable beads.

2) read your drug information sheet carefully!  Are you sure your particular med's beads are "enteric" whatever that means "coated to resist stomach acid"?  and are you sure your particular med uses an acid-resistant capsule as well?  that would seem to be overkill as the beads already (allegedly.  do they really?) have this property.  

(aside: today, having finally procured a 100ml grad cylider and 120ml amber glass bottles and luer-lock bottle caps and F-to-F luer-lock adapters and 5ml LL syringes, i did my first iteration of dumping prozac powder from capsules into water and am disappointed because the powder doesn't really dissolve and seems to be mostly in sediment after the first hour.  sure i can shake it up before dispensing a dose, but it appears there may be more to the "liquid prozac" than just water and capsule powder.  such as the glycerine and ethanol that are mentioned in info sheets for liquid prozac.  some of the additional ingredients are for flavor to overcome bitterness but some may be for solubility.  more on this after i try adding ethanol and or glycerine to see what helps solubility and avoiding sticking to the glass.  maybe i'm being silly but past experience says Be careful it's your brain!

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Guilietta
1 hour ago, ktp said:

ads are "enteric" whatever that means "coated to resist stomach acid"?

 

Ah. I believe they may be coated for time-release purposes. They are manufactured using capsules that will survive stomach acid so the product may be released after passing through the stomach.

1 hour ago, ktp said:

sure i can shake it up before dispensing a dose, but it appears there may be more to the "liquid prozac"

The liquid duloxetine which I have been using requires I shake it well to distribute the drug product before taking a dose even it has been well mixed at the pharmacy. It has been prepared in an oil-based suspension.

 

I hope you get your liquid prozac sorted out.

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ChessieCat
2 hours ago, ktp said:

weigh milligrams with any scale you can afford.

 

Many members are successfully using the Gemini20 scale.  using-a-digital-scale-to-measure-doses

 

BrassMonkey used this scale for his taper except for the very last extremely tiny doses, when he weighed an amount and then divided it up manually.

 

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ktp

the point I'm making, as well as the point I find in your reply, and in the thread to which you refer:

"when you're down to a low dose, you'll probably want to count beads instead of weighing."

"...tiny doses, when he weighed an amount and then divided it up manually."

 

even the pharm manufacturers don't try to weigh tiny amounts like this.  instead they make a big batch and divide it.  measuring milligrams with your gemini 20 is ridiculous even though it claims .001 sensitivity.  hmm was that .0015 or .0005?  to accurately measure a milligram you need .0005 precision or better.  now repeat your measurement 10 times and see how consistent you can get.  no breathing, no air circulation at all.  good luck!  but don't take my word,

https://www.google.com/search?q=accurately+measuring+a+milligram 

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ChessieCat
On 8/15/2019 at 1:04 PM, brassmonkey said:

I used my scales for my entire taper.  I reached their limit when I got to 4mgpw and had to resort to visual dividing the dose to get it small enough. 

 

 

4mg = 0.004g

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ktp
Posted (edited)

Exactly!  that's 4mg or .004g.  Assuming perfect accuracy of your gemini 20 scale, it's actually anywhere from .0035g to .0045g.  Fortunately this doesn't matter so much at 4mg as it does at 1mg. 
I'd be a lot happier with a scale that 1) at least pretends to measure .0005g (.5mg) and 2) comes with a calibration weight of something on the order of precision we want - not 10g, not 1g, maybe .1g but more like .01g to have half a chance of 1mg accuracy.

Edited by ktp

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Guilietta
1 hour ago, ChessieCat said:

Many members are successfully using the Gemini20 scale.  using-a-digital-scale-to-measure-doses

 

BrassMonkey used this scale for his taper except for the very last extremely tiny doses, when he weighed an amount and then divided it up manually.

 

Thanks to you both for the information and insightful thinking. It is clear that one needs to count the beads as one gets closer to tiny doses.

 

When I cracked open a 20 mg generic duloxetine tablet 8 months ago (I have some still) - I counted about 100 beads. At my current dosage (9.25 mg) this may be ~45 beads. For a 10% a month decrease in beads that is a reduction of one bead per week (plus the 2 week hold). At this rate - in 7 months I would still be counting 25 beads per day.  😕

 

1 hour ago, ktp said:

Assuming perfect accuracy of your gemini 20 scale, it's actually anywhere from .0035g to .0045g.  Fortunately this doesn't matter so much at 4mg as it does at 1mg.  

 

Well - both of you have a pleasant evening. And thank you. Tomorrow is another day.  My head is spinning....

 

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brassmonkey

My head is spinning too!!!

 

There is so much more involved in measuring a dose that the difference in accuracy between an affordable scale and a laboratory balance is insignificant. The affordable scale is quite capable of measuring out doses in the microgram range, if they are used correctly.  Which is not difficult.  If a person is more comfortable spending several thousand dollars for a tool that does the same job as one that costs $25. Well that's their choice.

 

Guilietta -- It would be best to continue discussing the details of your taper on your intro thread so you will have a better record of the information.

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ktp

>>"The affordable scale is quite capable of measuring out doses in the microgram range,"  

I'm sure you meant to say milligram (not microgram) range, even though you were quoted in this thread as saying the scale became less than adequate at doses below 4"mgpw" which i assumed meant 4 milligrams.  what's the "pw" mean?

 

correct me if i'm wrong, please: I understand that the Gemini20 will measure milligrams, but not very accurately.  anything from .0035g through .0045g will simply measure as .004g.  so when you're trying for 1mg, you're as much as 50% off either direction with no indication at all.  

 

 

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ChessieCat
11 minutes ago, ktp said:

below 4"mgpw" which i assumed meant 4 milligrams.  what's the "pw" mean?

 

4mgpw = 4 mg pill weight, not active ingredient.

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brassmonkey

I meant exactly what I said.

 

There is much more involved with weighing a dose than just measuring the pill weight or the weight of the powder you place on the scale.  To calculate the dose weight or the milligrams of active ingredient (mgai) you have to factor in the Active Ingredient Concentration. Which is the ratio of the weight of the active ingredient to the weight of the powder reduced to 1. A typical medication has a ratio of about 0.08 to 1 or smaller.  This is well into the MICROGRAM range for the dose weight, which is the one that counts.    

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Guilietta

Thank you all - I am just as confused - and neither a mathematician or chemist. :wacko: So many brilliant people on this website who do get it.

 

BrassMonkey - I will take a look at my intro.

 

G.

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drugged
On 8/16/2019 at 3:07 PM, ktp said:

>>The beads (enteric coated to resist stomach acid) would need to be put back in an acid-resistant capsule as well. I don't know how people manage to get the cute little beads into capsules. :wacko:
1) your video shows using a little funnel to put beads back into capsules.  but that video also seems to be demoing using a milligram scale to weigh what appear to be consistently sized and thus countable beads.

2) read your drug information sheet carefully!  Are you sure your particular med's beads are "enteric" whatever that means "coated to resist stomach acid"?  and are you sure your particular med uses an acid-resistant capsule as well?  that would seem to be overkill as the beads already (allegedly.  do they really?) have this property.  

(aside: today, having finally procured a 100ml grad cylider and 120ml amber glass bottles and luer-lock bottle caps and F-to-F luer-lock adapters and 5ml LL syringes, i did my first iteration of dumping prozac powder from capsules into water and am disappointed because the powder doesn't really dissolve and seems to be mostly in sediment after the first hour.  sure i can shake it up before dispensing a dose, but it appears there may be more to the "liquid prozac" than just water and capsule powder.  such as the glycerine and ethanol that are mentioned in info sheets for liquid prozac.  some of the additional ingredients are for flavor to overcome bitterness but some may be for solubility.  more on this after i try adding ethanol and or glycerine to see what helps solubility and avoiding sticking to the glass.  maybe i'm being silly but past experience says Be careful it's your brain!

The capsule in Effexor XR is not an enteric coating.  It dissolves very quickly in the stomach.  You can take the beads out and toss the capsule (info from a friendly pharmacist).  This is what I do.

 

The amount of coating on the beads determines the length of time a given bead lasts in your GI tract before the active ingredient is released.  Each bead has the same amount of active ingredient.  When considering the half-life of the XR you have two factors to consider:  one is the absorption half-life (the time in which it takes the beads to be released from the enteric coating) and the metabolic half-life.  These are ~15 hours +/- 2 hours and ~5 hours +/- 2 hours.  Smaller beads have less enteric coating i.e. shorter half-life, larger beads have more enteric coating i.e. longer half-life.  

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drugged

I have a question about how to report what dose I'm at while a taper using the counting beads method.  I'll be continuing to taper off 75mg capsules of venlafaxine ER.  I guesstimate that I'm currently taking a total daily dose of 112.5mg, divided.  I take one 75mg capsule in the early morning. 

 

To get the other 37.5mg I took a 75mg capsule, opened it and emptied the beads into a shallow dish.  I divided them in 2 approximately equal size amounts then counted how many beads were in a 1/2 a capsule and came up with 115 beads.  That's how I get the ˜37.5mg afternoon dose.  

 

To continue tapering I'll reduce the number of beads by X amount every other week or so until I'm down to a daily dose of 75mg once a day.  That was the dose that I'd been on for 3-4 years prior to this summer.  

 

When I begin to taper that remaining 75mg I plan to start by removing a certain number of beads for each step of the taper but this doesn't give me an exact dosage to report.  So what would be the way to report that?  

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CharlieBrown
On 9/3/2019 at 10:17 AM, drugged said:

When I begin to taper that remaining 75mg I plan to start by removing a certain number of beads for each step of the taper but this doesn't give me an exact dosage to report.  So what would be the way to report that?  

 

Hi, Just popping in. I tapered by removing various size beads from 100mg Sertraline XR. Pouring them all onto a piece of paper. Then removing more each day until they were gone.

 

I have taken Venlafaxine. Is it possible to talk to your Dr., and get a prescription for 37.5mg capsules? That would make the separation of beads easier. Along with the counting and tapering accuracy.

 

As for how to report the dose you are taking. Since you are removing beads that are not exactly the same, there is no way to accurately pinpoint the exact MG you are taking. You could do some math. Count the beads per capsule and divide by the Milligram count. That would give you an average of how many Mg are in each bead. Once you have that number you multiply it by how many beads you are taking. This is still an approximation.

Edited by CharlieBrown
How to report

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drugged
On 9/2/2019 at 2:15 AM, Altostrata said:

drugged, I am sorry you are so uncomfortable.

 

 

 

 

 

 

One thing that strikes me is that you are clearly at risk for all kinds of drug-drug interactions as well as adverse reactions to any individual drug, you feel worse after you take batches of drugs, and yet you seem to think you have medical illnesses that need treatment with these drugs.

 

FYI, trazodone releases an active metabolite that can cause muscle tightness and pain. If you take trazodone at night, this metabolite, m-CPP peaks during the day -- and it can interact with other drugs you take then. It can make you feel quite ill.

 

As I understand it, over the last few months you've been taking 10mg diazepam per day, yet you decided to stabilize on 15mg per day -- a dosage escalation. Is that correct?

 

You also seem used to adjusting or remixing your drugs and dosages when you feel it's necessary, is that so?

 

15 hours ago, CharlieBrown said:

 

Hi, Just popping in. I tapered by removing various size beads from 100mg Sertraline XR. Pouring them all onto a piece of paper. Then removing more each day until they were gone.

 

I have taken Venlafaxine. Is it possible to talk to your Dr., and get a prescription for 37.5mg capsules? That would make the separation of beads easier. Along with the counting and tapering accuracy.

 

As for how to report the dose you are taking. Since you are removing beads that are not exactly the same, there is no way to accurately pinpoint the exact MG you are taking. You could do some math. Count the beads per capsule and divide by the Milligram count. That would give you an average of how many Mg are in each bead. Once you have that number you multiply it by how many beads you are taking. This is still an approximation.

I've got about a six month supply of the 75mg capsules.  I don't want to toss them, they were quite expensive.

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drugged

The reason that the beads inside a capsule of venlafaxine are different sizes is because each head has more or less slow release coating on it.  If you take beads out of the capsule and weigh out, say 10mg worth of beads that isn't  giving you 10 mg of active ingredient!  Weighing beads gives you the weight of the inert coating + active ingredient.  

 

Again, the beads are different sizes due to the amount of delayed release coating around an equal amount of active drug.  

 

If you sort out beads by size and take only the smallest beads you are essentially selecting the immediate release beads.  If you only take the largest beads you are selectively taking beads that will release the drug some time later.  

 

This probably doesn't matter a whole lot with the drugs that have a longer half-life but it can make a big difference with a drug like venlafaxine.  One thing my psychiatrist did see fit to warn me about was to avoid the immediate release tablets.  

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ChessieCat
10 hours ago, drugged said:

One thing my psychiatrist did see fit to warn me about was to avoid the immediate release tablets.

 

Depending on the drug's half life, immediate release tablets would generally need to be taken at least 2 times a day, or possibly 3.

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drugged
12 hours ago, ChessieCat said:

 

Depending on the drug's half life, immediate release tablets would generally need to be taken at least 2 times a day, or possibly 3.

Yes, and with venlafaxine having a half-life of ~5 hours, when you get down to extremely small doses that's difficult to do.  I have read case histories of people who've counted beads all the way down to one bead per day then dropped to zero.  

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CharlieBrown
On 9/5/2019 at 8:51 AM, drugged said:

 

I've got about a six month supply of the 75mg capsules.  I don't want to toss them, they were quite expensive.

 

Understandable. No need to waste money and pills.

 

Due to the shorter half-life of Venlafaxine, and the various thickness in XR coating on the beads. Try to keep a log/journal of the number and size of beads you have removed each day.

 

When I was removing the Sertraline beads, there were different sizes. I did something similar. Taking one "Large and two small," each time I reduced beads.

Sometimes I would wait a few days to stabilize, before continuing to take more beads away. (I.E. spend 4-7 days taking out the same number of Large beads and small before continuing my reduction.)

 

I counted my beads all the way down to zero.

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drugged

Thanks Charlie Brown.  

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