Using a scale to weigh and measure doses

[brassmonkey]

Considering that you have just started to taper the small variations in pill weight shouldn't make any difference for quite some time.  If you are doing a 10% Brassmonkey Slide you should be getting down to 15mgai in about nine months.  When you get to that level you will need to be paying closer attention to the small variations, but even then two or three milligrams pill weight shouldn't make much difference.  I'm not saying to be sloppy in making up your doses, but rather to not obsess over it quite yet.

 

So we can do some quick calculations what is the average weight of one of your pills? We usually use 10 pills to determine the average weight. I am assuming that the 30mg is the strength listed on the package.

[PerAsperaAdAstra]

On 3/29/2020 at 9:01 AM, brassmonkey said:

Considering that you have just started to taper the small variations in pill weight shouldn't make any difference for quite some time.  If you are doing a 10% Brassmonkey Slide you should be getting down to 15mgai in about nine months.  When you get to that level you will need to be paying closer attention to the small variations, but even then two or three milligrams pill weight shouldn't make much difference.  I'm not saying to be sloppy in making up your doses, but rather to not obsess over it quite yet.

 

So we can do some quick calculations what is the average weight of one of your pills? We usually use 10 pills to determine the average weight. I am assuming that the 30mg is the strength listed on the package.

 

Sorry for my late reply! Haven't seen you've replied until now. You're right about the 30 MGAI being the amount on the package. I started with that amount on 28 March.

I also read your advice about taking the average of 10 pills instead of 1, which I've applied.

 

According to the calculations in Excel I will be at 15,94323 MGAI at the beginning of December. At that moment I'm sort of 8,3 months tapering already. 9 months and 15 MGAI would therefore make sense. This reassures me I'm properly doing the Brassmonkey Slide. Thanks for providing these metrics to gauge I'm not doing any stupid things.

 

I've heard that below 20 MGAI (or somewhere thereabouts) one would need to be a little bit more careful because of the exponential effects tapering a certain amount has, right?

[brassmonkey]

If you look at the SERT Occupancy chart http://www.mediafire.com/view/opcitwztcu1x3sb/5HTT_occupancy_curve_-_clomipramine_and_fluvoxamine.jpg it really brings the taper into prospective.  Any dose over 20mgai is pretty much wasted as it has very little affect. Between 20 and 10mgai there are noticeable differences with each reduction and from 10mgai on down things happen quickly with each reduction.  Our recommended 10% reduction plan and the Brassmonkey Slide have a reduction rate that pretty well matches the same curve. 

 

Because of this curve it is quite important to do reductions on  a percentage basis instead of by a set weight.  The set weight would give a straight line instead of a curve and an accelerating amount of reduction. The percentage base taper will match the curve and give a smaller decrease each reduction cycle making things much easier on the body.

 

In theory on can reduce a bit faster between 20mgai and 10mgai has to slow up a bit from 10mgai to 5mgai and then take things very carefully below that.  In practice it works better to take it slow and steady the entire way.  Even though the occupancy rate can be matched there are a lot of other things going on that need time to heal also.  If these are rushed then they have a bad tendency to build up and eventually cause a crash.  That crash can take months to stabilize and frequently leaves a person sensitized so they have to proceed with even more caution.

 

What is the average weight of one of your tablets? Who is the manufacturer?

[PerAsperaAdAstra]

19 hours ago, brassmonkey said:

If you look at the SERT Occupancy chart http://www.mediafire.com/view/opcitwztcu1x3sb/5HTT_occupancy_curve_-_clomipramine_and_fluvoxamine.jpg it really brings the taper into prospective.  Any dose over 20mgai is pretty much wasted as it has very little affect. Between 20 and 10mgai there are noticeable differences with each reduction and from 10mgai on down things happen quickly with each reduction.  Our recommended 10% reduction plan and the Brassmonkey Slide have a reduction rate that pretty well matches the same curve. 

 

Because of this curve it is quite important to do reductions on  a percentage basis instead of by a set weight.  The set weight would give a straight line instead of a curve and an accelerating amount of reduction. The percentage base taper will match the curve and give a smaller decrease each reduction cycle making things much easier on the body.

 

In theory on can reduce a bit faster between 20mgai and 10mgai has to slow up a bit from 10mgai to 5mgai and then take things very carefully below that.  In practice it works better to take it slow and steady the entire way.  Even though the occupancy rate can be matched there are a lot of other things going on that need time to heal also.  If these are rushed then they have a bad tendency to build up and eventually cause a crash.  That crash can take months to stabilize and frequently leaves a person sensitized so they have to proceed with even more caution.

 

What is the average weight of one of your tablets? Who is the manufacturer?

 

Massive thanks for the information brassmonkey! This is of great help! 🙂

I am now even more resolved to do it by the book, easy as she goes. But good to know where I need to start paying extra attention to reductions. I sure want to prevent stuff from building up too much, thereby sensitizing the CNS.

 

The tablets are from Aurobindo. One pill (30 MGAI, based on the average of 10 pills) weighs somewhere between 0,3663 mg and 0,3684 mg. The measurements differ however, but slightly.

[brassmonkey]

Thanks for the numbers Per they really help.

[PerAsperaAdAstra]

I'm pretty lucky I'm not in serious withdrawal atm and can wrap my head around your instructions easily. 

(and it helps I'm well versed in Excel :-P)

[phillyfan24]

@brassmonkey

quick question regarding crushing the pills and using the scale. I am using trintellix, which has a film coating. Is this something to worry about? I am obv not getting the same amount of coating in each capsule. Should I avoid the coating all together when filling my capsules? I really want to make sure I’m doing things consistently. I am at the high dose as of now and think it may make more of a difference as I get lower 

[brassmonkey]

Consistency is a major key to a successful taper. The actual dose doesn't matter, but rather getting as close to the same dose as possible each time. Does the coating grind to a powder when you crush the pills?  If so try to mix it in as best as you can and not worry about it.  If it stays in big sheets then try to remove as much of the powder as possible from each piece and then discard the pieces of film.  The physical weight of the skin will be so small it's not going to change the dose unless you get big chunks of it at one time.

 

When working with powder/crushed pills and scales the weight of original pile of powder doesn't matter, It is basically a stockpile that you draw a specific weight out of. The weight you are measuring on the scale is the important one. I usually rushed up three or four pills at a time in one pile so I would have enough to work with.

[Timberline]

Hi @brassmonkey...just started crushing pills to get ready for taper. I weighed 20 pills and got a weight of 2.581 grams. I divided that number by 20 and got .129 grams as an average weight per pill. I crushed up one pill and weighed the powder and got a weight of .089. With my first 10% cut, I will need a weight of .116 of powder. It seems as if I'll run out of my RX quicker, if it takes about 1 and 1/2 pills to get the correct weight of powder for 1 dose. Am I looking at this correctly?

 

Thanks!!

[brassmonkey]

Interesting.  I can see a few milligrams being lost, maybe four or five, but 40 is quite a lot. The crushed tablet should have the same weight as the whole one. Have you tried it again and gotten the same result? How are you crushing them?

[Timberline]

Thanks @brassmonkey... I'm using this: https://www.amazon.com/gp/product/B01MZ04NWS/ref=ppx_yo_dt_b_asin_image_o07_s00?ie=UTF8&psc=1

It's crushes it in to a very fine powder and some gets left behind when I pour the powder out on to the scale. It's impossible to scrape the film of powder left behind. Maybe I should crush with a spoon instead?

 

I didn't want to try it again until I heard some suggestions... didn't want to risk losing another dose!

[brassmonkey]

Yea, I'd try the two spoon method. Work over a piece of paper to catch any that falls and put a small piece of paper with a fold in it on the pan of the scales. The spoon method can leave things a little course, I just would put it on the paper and crush it some more with one spoon against the table top. When you measure out the dose be sure to save the leftovers, you end up getting "a free dose" that way.

[Bruci]

Milligram scales

I am looking for a reasonably priced milligram scale to weigh out my crushed pills. Does anyone have recommendations?

 

Edited September 20, 2020 by ChessieCat
added topic title

[Gridley]

6 hours ago, Bruci said:

Does anyone have recommendations?

The scale most commonly used here is the Gemini-20 scale available on Amazon. It's not expensive.  I've used it for several years now with my Lexapro taper and also to weigh my Imipramine and Ativan doses.  

 

The GEMINI-20 Scale

[Nomansland]

Hello @brassmonkey!

 

I have a question about my doses...iam not sure if someone can help me.

 

My mirtazapine tablets weight from 148 mg to 158 mg, right now iam taking 10 mg to stabilise.

I weight every tablet on its own and file to get to 10 mgai.

 

My concern is that if a have a tablet which weights 148mg...i have to file it down to 99mg (uprounded) to get 10 mgai.

And with a 158 tablet its 105 mg.

 

When i make the average of ten pills (made it and it would be 152,5) i would have to file all tablets down to 102 mg for 10mgai.

BUT the tablet with original weight of 158 mg , filed down to 102 mg, would give me a dose of 9,68 mgai. The 148 mg tablet,

filed down to 102 mg, would give ma a dose of 10,33 mgai. Thats too much of a variation i think. And with the normal inconsistency of the 

gemini scale it could be even worse...right now my CNS would react to that i guess.

 

I have thought about some options...:

 

- continue with weighting each tablet (also i feel i could need a change, improvement, hence why i ask)

- leave out the upper and lower end tablets, obviously i dont know how much there will be in one container

- sort the tablets and only use the average from tablets which (for example) differs 5-6 mg in weight, and use another 10 tablets next time with the same conditions

  (the last method seems kind of useful to me and came to my mind right now...)

 

Ive read the average weight is only used once (if there arent any other changes), but with a variation of 10 mg(pw) and possible doses changes of 9,68 to 10,33 mgai

per day it seems to much right now.

 

Greetings

 

Nomansland

[brassmonkey]

The actual dose is not as important as taking the same dose consistently. I would calculate the average weight for the tablets (you already did at 152,5) and use that to determine the dose weight required. (you already did at 102mg). Instead of trying to adjust each individual tablet by filing it down I would crush several of them into powder and use that as a "stock pile" to remove just the amount needed for each dose. It would be best to get a supply of size  "0" gel caps to put the powder in. This will lead to much more consistent dosing and a lot less work. I would allow six weeks after starting this method to get use to the change in format, then you could resume your taper by calculating your new dose as a percentage of your current dose.

 

I see you just flagged me in a post so I need to go and read that.

[Nomansland]

Thanks for you answer brassmonkey!

 

Well, i did a too fast taper and right now i want to stabilise.

So iam not even thinking of beginning to taper, sadly.

 

Also iam unsure if a change right now would be the best for my destabilised CNS...

but on the other hand a consistent dose is sooo important. Damn it.

 

I will read the powder and capsule thread again i guess...switching from

tablets to powder is usually not so drastic then changing to DIY liquid, right?

 

Always thought the "cut each tablet on its own and file it" was the most accurat way of dry cutting...

beside powder.

 

Greetings!

[ChessieCat]

I think the consistency is more important.

 

Generally we suggest doing a cross over when changing form of a drug because it is is gentler on your system.  Do each combo for 3-7 days holding longer if needed: 3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4

 

Note for members:  Do not make a reduction at the same time (Nomansland has already stated they will not be reducing)

[nautical]

Hi there! I am using a pill crusher and a scale and make sure the powder is very fine. But I am worried that perhaps the different parts of the powder (filler vs active ingredient) are not well mixed, leading me to fill up my gel capsule with just filler or just active ingredient rather than taking equal proportions of filler vs active ingredient. I assume this risk is also getting higher  the smaller the amount of powder is needed each time. What do other members do to make sure that they "stratify" filler and active ingredient to sample proportionally for both? Do you shake the powder each time to make sure all substances are equally distributed? Is there a way to tell whats filler and whats active ingredient and then sample proportionally from both? Thanks for your help!

[Gridley]

3 hours ago, nautical said:

What do other members do to make sure that they "stratify" filler and active ingredient to sample proportionally for both?

I did the powder method for my 4 year Lexapro taper.  I gave the pill a very good crush between two spoons then stirred the powder well before measuring a portion out into my capsule and it worked fine for me.  

[brassmonkey]

@nautical  Have a look at this thread:

https://www.survivingantidepressants.org/topic/22065-myths-about-your-drugs/?tab=comments#comment-463989

 

[ryan1982]

Hey guys!

I’ve been struggling a bit and wanted to check out my scale and make sure it’s still good. I have my trusty old Gemini-20 and purchased a new one to compare weights. 
 

I calibrated both of them with the weights tonight and the weights were +/- .002 or .003 different each and every time. The old scale has much more trouble settling. My dose weighs .025 and I take it twice a day.

 

Thoughts on what I should do? I’m afraid the old one is dying (I’ve replaced batteries) and the new one is great but weighing heavier. Appreciate it very much!

[Nomansland]

Hello everyone,

 

iam having a question.

 

I know about the stock pile and that it doesnt matter in the end for a taper (if you use powder)!

Its just about the pills.

 

So...i have a tablet that weighs 148 mgpw and one that has 158mgpw. Both should be Mirtazapine 15 mgai.

Had a conversation with a friend. He told me that BOTH of them have 15mgai Mirt inside, while i told him

that the mgai is different because of the weight.

 

What we know about the process how tablets are made and assuming that everything is well distributed in a tablet,

is it more likely that the active ingridient in these tablets is DIFFERENT or the SAME?

 

Greetings

 

Nomansland

[PerAsperaAdAstra]

Hi @Nomansland! I think it's difficult to give a precise answer to this. When I started my taper and tried to figure out the pill weight versus the active ingredient the fact I got different weights for individual pills quite bothered me.

But then I read the advice here it's better to take the average of 10 pills for the calculation so differences between pills become negligible.

 

But my hunch would be that every pill has the same amount of active ingredient. Seems to me that's one of the most important metrics in the production process.

[Nomansland]

Hello @PerAsperaAdAstra,

 

so, i read alot about uniformity in the tabletting process. Here is an interesting link: https://www.gmp-compliance.org/gmp-news/causes-for-weight-variations-during-tableting

 

"Weight variations of the tablets produced is a relatively common problem of the tableting process. But each tableting process aims at producing tablets with a constant weight. The actual cause for this problem is the lack of weighing systems that are sufficiently fast to weigh or dose the required weight for each single tablet. Since this is not possible, each tablet press doses a certain amount of powder into the die and this powder is then pressed into tablets by the upper and lower punch. This means that a volume is dosed, but the quality requirement is the weight. Hence, weight variations in a limited extent are quite normal due to variations in the density of the powder material and to a partially incomplete filling of the dies.

The pharmacopoeias specify the acceptable level of weight variations. If the weight variations are too high the level of active ingredient in each tablet might be too high or too low and then the tablets don't comply with the specifications any more."

 

Then i checked for the tests that manufacturer has to make and what weight variation are allowed and found this pharmacopoeias : https://apps.who.int/phint/pdf/b/7.5.3.5.2-Uniformity-of-mass-for-single-dose-preparations.pdf

 

It states that for tablets which weigh from 80 to 250mg (my has an average of 153), the variation allowed is 7.5 % in weight (which fits in my weighting variation of 148 to 158).

 

Then we have the "even distribution" topic, which is true for my tablets, because they can be scored into 2 equal amounts.

 

As far as i know the weight of the tablet is the most important test that is done in tableting after they come out of the machine. At least for these simple coated tablets without extended release.

 

With the even distribution in mind and the allowed variations of weight and how the base material for making tablets (a big, mixed "mass" with a given ratio of filler and active ingridient) is made. Iam REALLY sure that these tablets (148mgpw and 158mgpw) have different contents of active ingredients. It may not be much, but they do (depends on the base material ratio of the manufacturer).

 

One tablet that comes out of a tableting machine has NOT a different ratio (active ingredient : filler) then the next one.

But they are allowed to have a slight variation of pill weight, because of manufacturing processes.

 

Pill weight differs  =  Active ingredient differs -> When its evenly distributed, which iam sure it is.

 

At least these are my thoughts. Brassmonkey is right to give the advice to get the average weight and then the AIC.

[Nomansland]

Hello everyone,

 

i also read through all of the (german) package inserts and technical informations of the normal coated mirtazapine/remeron tablets (about 10 different manufacturers) Some of the tablets can be split into two equal doses and some cant. A score line does not always indicate equal dose splitting.

 

I would recommend that you read through YOUR package insert or google to get the information of your manufacturer.

 

If it says it can not be split into two equal doses, i would NOT recommend to split it with a pill cutter (of course) and

NOT file down a single tablet to a certain weight. Otherwise it would be no problem.

 

-> Instead, use powder to get to the pill weight you need or suspend them into liquid!

 

This is just MY opinion of course, but i think its very important. Dont know if you can find this information here in the forum.

 

Also, this should apply to every other drug tablet (if its not extended release or some other "special" form of medication). Remember, not every medication can be made into a liquid and some extended release meds will get immediate release if you break them.

 

 

Greetings

 

Nomansland

[Jakebob]

Hello, 
I have a question about tapering my mirtazapine. So I have orally disintegrating mirtazapine tablets (Mirtor) 15mg. 
Each tablet weighs 100mg. 

I think it's this one -> https://www.drugs.com/imprints/a-36-14498.html
I wanted to start tapering by shaving those tablets (with sandpaper) and weighing them on my scale.

The question is if I shave let's say 10% of the tablet weight, will I be getting my mirtazapine dose smaller by that 10%?
If I shave the tablet to the weight of 90mg will I be getting 13.5mg of active substance?
Maybe there is some outer coating that doesn't contain the substance? Can this be even checked?

 

I know I can make a liquid from those tablets, but I wanted first start with this method as I'm a little scared of moving to the liquid version. 
Sorry if my English is a bit messy. Not a native speaker.

[Gridley]

15 minutes ago, Jakebob said:

f I shave the tablet to the weight of 90mg will I be getting 13.5mg of active substance?

There's no way to tell about manufacturing standards in terms of distribution of active ingredient.  That's why it's better to crush the tablet between two spoons into a very fine powder and give it a good stir with a nail file to ensure the active ingredient is evenly distributed.  Then transfer the the weight of the powder you need onto the scale to get the weight dose you want.

 

You could use tweezers to add/subtract the powder.  

 

I don't know if you get Amazon.com in Poland.  If you do, Google "powder measuring spoon" and you'll see several varieties.  This is good for stirring and also from transferring powder from spoon onto the scale.

[Jakebob]

Thank you, Gridley. That's what I was afraid of. I'll try to find some measuring spoon on Amazon and do some testing with it and tweezers to see if this works for me. Although with my clumsy hands it's gonna be messy. I think the biggest challenge would be to take that powder off the scale to my mouth or capsule and not scatter it. Also, the leaflet says that the tablet shouldn't be crushed. So this leaves me very confused.

[indario55]

Thinking of buying a scale...I see many use Gemini 20 but there seems to be several with similar names... Which of the three is proven to be most precise and reliable?

 

American Weigh Scale Gemini Series Precision Digital Milligram Scale Gemini 20

American Weigh Scales GEMINI-20 Portable MilliGram Scale

Smart Weigh GEM20 High Precision Digital Milligram Jewelry Scale

 

[Gridley]

2 hours ago, indario55 said:

Thinking of buying a scale...I see many use Gemini 20 but there seems to be several with similar names... Which of the three is proven to be most precise and reliable?

 

American Weigh Scale Gemini Series Precision Digital Milligram Scale Gemini 20

American Weigh Scales GEMINI-20 Portable MilliGram Scale

Smart Weigh GEM20 High Precision Digital Milligram Jewelry Scale

 

I think they are all the same, just with different names.  The most recent one I  bought from Amazon is the 3rd in your list, called Smart Weigh.

[indario55]

19 hours ago, Gridley said:

I think they are all the same, just with different names.  The most recent one I  bought from Amazon is the 3rd in your list, called Smart Weigh.

 

Thanks. I was thinking of buying the second on the list, since it appears most users have it (Portable). But it says it's unavailable.

 

Is the first one worse than the ''portable named'' version? Anyone with experiences? I've also read somewhere that these 3 are all very similar but some get much worse reviews than the other, so bit confused there.

[Nomansland]

Hello @indario55,

 

i own the AWS Gemini-20 and the SmartWeigh Gem20.

 

Both measure exactly the same, there are no differences in the accuracy. I also have an analytical scale (0,1 mg) and can confirm that these versions of the Gemini-20 are on point when you weight carefully and with the tips here in the thread. There is one little difference. The Smartweigh version has the option to turn off the Auto-Off function, which can be really useful. But apart from that, i cant see any differences.

 

Greetings

 

Nomansland

[Gridley]

4 hours ago, indario55 said:

 

Thanks. I was thinking of buying the second on the list, since it appears most users have it (Portable). But it says it's unavailable.

 

Is the first one worse than the ''portable named'' version? Anyone with experiences? I've also read somewhere that these 3 are all very similar but some get much worse reviews than the other, so bit confused there.

I think they're all the same.  Earlier versions had different names.  I'd get the Smartweigh as (I think) it's a recent model.

[Josef]

Hey guys! I wanted to ask if I need to calibrate the Gemini20 with or without the bowl? Thanks in advance!

[Artistic1]

My directions say to calibrate it without the bowl, using only the small weights that came with it.