Using a scale to weigh and measure doses

[ChessieCat]

4 hours ago, dukke said:

Where I live it's very difficult to get a liquid version of the medication prepared by a compound farmacy.

 

From Page 1 of tips-for-tapering-off-seroquel-quetiapine

 

On 09/08/2014 at 5:55 AM, mammaP said:

You could ask your doctor to switch you over to immediate release tablets and make a liquid from them as above.  Many members make their own liquid from their tablets and get on fine with it. 

 

[Gridley]

 Brassmonkey tapered all the way down from 40 mg Paxil using the Gemini 20 scale. At the very end, I believe he had to "eyeball" it.  

[brassmonkey]

I won't say that using a scale to taper is the method of choice around here, but quite a few members are doing it that way.  Gridley is correct, I used the Gemini-20 for my entire taper.  It does have some trouble at the very bottom of the range around 4mgpw so to get the last few drops I used the visual method of dividing a known amount into equal piles. Using the scales is the most accurate while being the least "scientific" method you can use.

[brassmonkey]

That's what I mean.  mgpw is the weight of the actual material from the pill.  The other designation is mgai (active ingredient) which is the strength designation on the bottle.  For me, I used 40mg paxil tablets.  So they were 40mgai, but they weighed 500mgpw each. With that information and a little algebra there is all sorts of useful information you can figure out.

[RealMe]

How do you taper using tablets?  I am stabilizing on 1/2 of 20 mg. fluoxetine tablets.  When I'm ready in a few months to taper by 10 %, how do I do it?  Do I crush and weigh the tablet?  Or could I cut or file 10% off the tablet, using the weight to figure it out?

[mona11]

I'm doing my Lexapro with cutting. I never crush my tablet. Started at 15 mg, and I'm now taking 10.38 mg and having no problem. I'm doing this really really slowly. I mean, it took me 13 months to go down from 15 to 10.38, but I don't feel anything different after the cuts. Maybe some headache for 1 day or a little anxiety for 1 day, but I feel this is the pace I can take.

I'm doing better and better the lower I go, Thank God! I hope you do it really slowly and listen to your body. 

  

[RealMe]

How do you figure how much to cut?

 

[Gridley]

Just eyeball it.  For example, if you have a 20mg tablet and you want 10mg, then cut (I use small scissors) about half then add or subtract to get the weight you want.  No need to crush.  I too am tapering Lexapro, cutting 20mg tablets and weighing.  

 

These links may help:

 

How to cut up tablets or pills
Using a digital scale to measure doses
 

 

 

 

[mona11]

I know that my 10 mg tablet of Lexapro weighs 13 mg. I do my cuts in mg of weight, not in mg of active ingredient. I don't know how to explain the process, but it's simple.  

I believe somebody will be able to explain  it better. Actually, I believe the links Gridley posted here explain the process.

 

[brassmonkey]

Multiplying your current weight, either pill weight or active ingredient weight, by 0.9 will give you a dose weight that is reduced by 10%. Multiply by 0.95 for a 5% reduction or by 0.975 for a 2.5% reduction.

 

Mona-- is your Lexapro pill weight really 13mg?  That would be a very tiny pill.

[brassmonkey]

 

Here's some of the things I've learned:

 

1. Work on a very solid surface, a heavy desk or counter top.

2. Have as little air movement as possible, no fans,A/C, and careful breathing

3. Put the calibration weight in the pan to bring the scale into the middle of it's range and press TARE.

4. Use a nail file to scoop small amounts of powder onto the pan and to scrape small amounts off to get the desired weight.

5. The readout will jump around a lot if the weight is between even mg levels, add or subtract powder to calm the readout.

6. Pour the powder into a folded Post-it note and then pour it from there into the capsule.

[mona11]

I meant 13 g, sorry. It would be definitely a very very tinny pill if it was 13 mg

[brassmonkey]

I think we're still a bit off Mona. 13 grams would be huge.  What is the exact reading on the scale? I found that little readout on the scales tricky to make out at times.

[JamesF]

Any recommendations for specific scales to buy? Willing to spend a bit. 

I have a gemini scale already and am not impressed with it's accuracy so far - I get 10% off frequently at small doses

[Hibari]

I have just switched over to the Gemini scale to help me taper at this particular time.  I want to check on something.  

Right now I am halving my pills because of the dosage I am on. I was at 12.50 mgs and used to split my tablets in half. 

 

I just moved down to 11.25 mgs, which I do by splitting the 12.50 tablet in half to get 6.25mgs and then combine it with a 5mgs tablet to equal 11.25. 

 

Here's my question.  Right now I weigh a 25mg pill, get whatever weight it is on the scale. Most times it weighs about 79gms = 25mgs. Then I divide that in half to get a weight of 39.50gms=12.50mgs and then in half again to get a weight of 19.75gms =6.25mgs.  I then take 19.75gms with a 5mg pill.  This should give me a total of 11.25mgs of medication. 

 

I am using the scale weight to  make the same cuts I would if I were simply cutting the pull with a razor or pull cutter.  

 

Just want to make sure that this method of halving the weight on the scale is correctly duplicating what I was doing before.  I am only doing for this point in the dosage.  God I hope I make sense. 

[brassmonkey]

Yes you are making sense, and that is the correct dose.  But... the weight of the pill itself is also measured in mg not in grams as you have it indicated.  A pill that weighed 79 grams would be larger than a quarter and very hard to swallow.   for future reference it would be better to refer to the weights  like this:

 

weight of the actual pill or the measured weight of the dose  xxmgpw  milligrams pill weight

strength of the desired dose xxmgai  milligrams active ingredient

 

Might I also suggest that you start figuring your dose using the average pill weight instead of calculating each pill individually. The minute differences in the pills won't make a difference in the dose, it also allows you to crush several pills at one time and just measure out the amount of powder you need at any one time.  You can then do a progressive calculation using the mgpw of the previous dose to calculate the weight of the new dose instead of starting over each time. For a 10% reduction you would multiply the previous mgpw by 0.90 to get the new dose weight.  This greatly reduces the chance of making a math error.

[Hibari]

Thank you Brass.  I will read through what you have written and then ask any follow ups if neccesary.

 

Thank you for taking the time.

 

H

[tacomaprime]

On 7/5/2011 at 10:13 PM, JoLe said:

Admin note:
Measure precise amounts for controlled tapering with a digital electronic scale
 
The basic digital scale method:
 
To calculate your daily dosage, you need to know the weight of the beads or powder in one capsule.

 

The number of beads in a capsule varies from manufacturer to manufacturer and from dosage to dosage. There will even be a little variation in the number of beads among the capsules in one prescription vial.

 

This method will require you to keep notes about what you're doing.

 

At the beginning, for convenience, instead of weighing the contents of each capsule each day, I would take an average weight from several capsules and work with that.

• Have large empty gelatin (or vegetarian) capsules handy into which to  put the beads.
• Empty one capsule at a time and weigh the beads or powder. Note the weight on a piece of paper.
• Put the beads or powder back in a large, empty gelatin capsule.
• Add all your weights together and divide by the number of capsules you've weighed. This is the average weight of the contents of a capsule for that prescription vial.
• If you wish to taper by 10%, multiply the average weight by 90%. This will give you the amount you need to weigh out for your first stage of tapering. Example: If you have been taking 100mg, multiply the weight by 90% to find the weight equivalent to 90mg.
• For the next stage, subtract the prior decrement from the weight and then multiply the result by 90%. Example: You've decreased from 100mg to 90mg, now you want to take 90% of what the 90mg weighed. To find this, subtract the weight of 10mg from 100mg, then multiply by 90%.
• And so forth. The amounts of the decrements should keep getting smaller as your dosage decreases.

 

So do I have to use an average.  What I was going to do was just spend a saturday night weighing 4 weeks worth of capsules (28).  I'm currently taking the 37.5mg capsules of venlafaxine.  I was going to open each capsule and empty the contents onto the scale, weigh each one and then multiply the weight by the percentage of that months drop as indicated on the spreadsheet that is here - https://docs.google.com/spreadsheets/d/1pw4tjImAJ92OIVyRvZoZYjqxiKMk7wvp-ljiIi1olRo/edit#gid=0   

So for example first capsule weighs .122g, I'd multiply that by 90% and then weigh out .1098g and put it back into the capsule.  Then capsule 2 i'd weigh and it's .134g I'd multiply that by 90% and then weigh out .1206g and put it back in the capsule.

Month 2 I'd take out the first capsule, weight it, say it's .130g I'd multiply that by 81% and then weigh out .1053g and put it back in the capsule.  The capsule 2 say the weight is .128g I'd multiply that by 81% and then weigh out .1037g and put it back in the capsule.

 

Will that be accurate?  I want to be as accurate as possible, so I thought weighing each one would be better then taking an average.  

 

[brassmonkey]

That would be a perfectly fine way to do it.  Be sure to save the excess powder so you can collect your "free dose". The further you taper the quicker the excess adds up.  I did the last two years on my taper on a one months supply of the original tablets.

 

Frankly I quite shocked that there is a 12mgpw difference in weight between the two capsules.  To me that indicates sloppy manufacturing practices.  I roughly calculate the Active Ingredient Concentration at 1mgai/ 3.25mgpw. That would give a difference in dose of 3.65mgai between capsules which is basically 10% of the original dose.  This has a lot of implications for people tapering these types of capsules.  Before I get upset about this would you please do me a favor?  When you make up the months supply would you please record the weights of the powder from each capsule and either post it here or PM me with the numbers. I would really appreciate that.

[tacomaprime]

11 hours ago, brassmonkey said:

That would be a perfectly fine way to do it.  Be sure to save the excess powder so you can collect your "free dose". The further you taper the quicker the excess adds up.  I did the last two years on my taper on a one months supply of the original tablets.

 

Frankly I quite shocked that there is a 12mgpw difference in weight between the two capsules.  To me that indicates sloppy manufacturing practices.  I roughly calculate the Active Ingredient Concentration at 1mgai/ 3.25mgpw. That would give a difference in dose of 3.65mgai between capsules which is basically 10% of the original dose.  This has a lot of implications for people tapering these types of capsules.  Before I get upset about this would you please do me a favor?  When you make up the months supply would you please record the weights of the powder from each capsule and either post it here or PM me with the numbers. I would really appreciate that.

 

Sure, no problem!  I'll report back when I do it.  

So my math is ok?  I just want to make sure that weighing each individual capsule is ok vs weighing say 7 and taking an average.

[brassmonkey]

Yes, weighing each capsule would be fine. In fact until we sort out the differences in weight I think it would be a good idea.  Until now all of the pills I have run into have varied by only about 3mgpw and have an AIC of .08mgai so the small difference in pill weight makes very little difference in the actual dose.  With the difference in weight you are showing it makes it so you could be skipping doses with out knowing it.  Skipping doses is not a good way to taper, as it can cause a lot of different problems. It looks like you are already doing it, but be sure to follow a 10% reduction of the previous dose when calculating the new dose.  The progression is very important to maintain.

[tacomaprime]

On 2/2/2018 at 11:57 PM, brassmonkey said:

That would be a perfectly fine way to do it.  Be sure to save the excess powder so you can collect your "free dose". The further you taper the quicker the excess adds up.  I did the last two years on my taper on a one months supply of the original tablets.

 

Frankly I quite shocked that there is a 12mgpw difference in weight between the two capsules.  To me that indicates sloppy manufacturing practices.  I roughly calculate the Active Ingredient Concentration at 1mgai/ 3.25mgpw. That would give a difference in dose of 3.65mgai between capsules which is basically 10% of the original dose.  This has a lot of implications for people tapering these types of capsules.  Before I get upset about this would you please do me a favor?  When you make up the months supply would you please record the weights of the powder from each capsule and either post it here or PM me with the numbers. I would really appreciate that.

 

Here's my 1 month worth of weights.  These are the 37.5mg weights of the arbudino brand capsules. 

90% 37.5mg dosage.xlsx

[tacomaprime]

Another question I thought of.  Will the oils on my fingers break down the gelatin capsules I bought to put the new dosages in?  I assumed no but wanted to make sure.

[brassmonkey]

Hey Tacoma-- I can't get you link to open. Lets try it again. 

 

No, there should be no problem with handling the capsules, just don;t get them wet.

 

Another question, is the material in the capsules a fine powder or small beads?  Everything I'm finding indicates the they don't make then with powder, and that would make a big difference.

[tacomaprime]

1 hour ago, brassmonkey said:

Hey Tacoma-- I can't get you link to open. Lets try it again. 

 

No, there should be no problem with handling the capsules, just don;t get them wet.

 

Another question, is the material in the capsules a fine powder or small beads?  Everything I'm finding indicates the they don't make then with powder, and that would make a big difference.

 

Hmm.  I screenshotted it instead.    The material is beads.  I originally was going to count beads, like starting out taking 90 beads and taking them.  But the number of beads varied from 93 to 106, so I figured I wouldn't be getting an accurate dose.  So instead I weighed all the beads in each capsule, then weighed out 90 percent of that.   Everyone said that would be way more accurate.

[brassmonkey]

Thanks Tacoma that's what I needed, and to find out that it it little beads and not powder.  I think weighing each capsule and calculating the dose weight would be a good way to go.

[Raye]

On November 13, 2011 at 3:58 PM, Altostrata said:

NOTE: If you a looking for a digital scale that measures milligrams, it must measure to at least .001g. A milligram is 1/1000 of a gram. A scale that measures to only 0.1g will not measure milligrams accurately.

 

Im confused with my scale because my pill is a 25mg and when I weigh it it says its 0.130 grams. Is this inaccurate because shouldn’t it be 0.025mg? 

[ChessieCat]

10 minutes ago, Raye said:

 

Im confused with my scale because my pill is a 25mg and when I weigh it it says its 0.130 grams. Is this inaccurate because shouldn’t it be 0.025mg? 

 

25mg is the dosage of the drug in the tablet (mgai = milligram active ingredient).  The tablet weighs 130mg (mgpw = milligram pill weight).  The tablet contains fillers.

 

Here is an example.  I've shown your own tablet and dose in green (however please double check that my calculations are correct).

 

On 14/02/2018 at 2:27 PM, brassmonkey said:

Hi Gardenlady--  Trying to make sense of the numbers can be really frustrating, especially when we are worried that any little slip up could cause a lot pf pain.  For the sake of our other readers a "microtaper" is achieved by doing reductions that are very small, frequently less than 1%.  This is often done using the liquid version of the drug in question, but can be done very nicely using the scales that we are all use to using.  A microtaper done using the scales can not be as finely tuned as one done with liquid, but with a little care surprisingly small reductions can be achieved.

 

The key to doing a microtaper with scales is to use the Active Ingredient Concentration as the basis for your calculations.  The Active Ingredient Concentration is the weight of the pill divided by the strength of the full dose.

 

If we use the numbers that Gardenlady provided above it would look like this;

 

411mgpw / 48.3 mgai = 8.5  (it's best to use the weight of a whole pill and the listed strength from the bottle, but this will get us surprisingly close.)

(so for Raye that would be 130mgpw / 25 mgai = 5.2)

 

This means that for every 8.5mg (Raye: 5.2mg) of pill material you get 1mg of active ingredient.  To take it one step further, we divide that 1mgai by 8.5 mgpw and get 0.12 (divide 1mgai by 5.2 mgpw  = 0.1923). Which means that every 1mgpw contains 0.12mgai (0.1923mgai).  That's just over 1/10 of 1mgai or written out in long form 0.00012mgai.  However you write it, there's not a whole lot of active ingredient in 1mgpw of pill material.

 

This is telling us that the small fluctuations in the scales accuracy don't make a whole lot of difference in the actual dose that you weigh out.

 

You can figure out the weight of a specific dose using the Active Ingredient Concentration.  Again  I will use the numbers Gardenlady provided above for an example.  Say she wants to do a 1/2% drop for her next taper.  She is currently taking 48.3mgai for her dose. We would multiply that by .995 to get the new dose.  48.3mgai X .995 = 48.0mgai

 

We then multiply the new dose by the Active Ingredient Concentration of 8.5.    48.0 X 8.5 = 408  So the weight that we measure out on the scale for the new dose is 408mgpw. The only tricky part now is manipulating the little beads to get the correct weight.

 

Hope that helps.

 

Brassmonkey

 

[brassmonkey]

Recently there have been several questions about how to read milligrams using the Gemini-20 scale.  This is the reply I gave to one such question:

 

The display on the Gemini-20 will show either four or five digits depending on how much an object weighs. The scales do not have a milligram setting, but rather rely on the decimal point on the gram setting.  The maximum is 20grams which shows as 20.000.  The calibration weight should give a reading of 10.000.  Anything weighing less will give a reading of  X.XXX.  Even if the decimal point is hard to see, which it can be, the three digits on the right of the display will be the milligrams.  So a display of 0123 or 00123 is going to be 123mg.

 

Most of the other scales people use here are going to be clones of the Gemini-20 and should read in a similar manner.  

[DMV64]

I am wondering what to do as I taper  down from a 1.2 mg sublingual dose. As I get into single digits I can’t go any smaller with the cuts. Help 

[mia]

On 12/18/2013 at 7:54 PM, areyouthere said:

If you want to decrease 70 mg of doxepin by 10% you first have to figure out what 10 % of 70 mg is. To do this you multiplply 70 mg by .10 or

 

70mg X .10 = 7mg      so  10 % of 70mg is 7mg.      To decrease by 10 %, then , you need to take 7 fewer milligrams of doxepin than you are now or…. 70 mg - 7 mg = 63 mg doxepin.

 

 

Another way to think about it is that 63 mg is 90 % of 70 mg. So if you take 63 mg of doxepin you will have decreased you previous dose of 70 mg by 10 %.

 

63 mg of doxepin would be your new dose assuming you want to decrease your previous dose ( 70 mg ) by 10 % ( or 7 mg). 

 

Hope this helps.

 

RU

 

 

To prove this …. 63mg / 70 mg = .90 X 100 ( for 100 %) =  90 %.  

Can you please tell me how you came out with 63mg,what math did you use please?

[brassmonkey]

Hi DMV64  Would you please give us some more information about how you are working your taper currently.  Are you using a scale? What is the weight of a whole tablet? What dose weight are you currently taking? How are you making up your dose, cutting the tablets, crushing them etc? Would you object to making and using a liquid? I have several ideas but need some input to figure which to suggest.

[brassmonkey]

Hi Mia-  the easiest way to get the 63mgai is:  Previous dose times .9.  Using the numbers above that would be 70 X .9 = 63

[mia]

2 hours ago, brassmonkey said:

Hi Mia-  the easiest way to get the 63mgai is:  Previous dose times .9.  Using the numbers above that would be 70 X .9 = 63

Thank you.

 

Edited February 26, 2018 by ChessieCat
removed duplicate post

[Hibari]

On 11/4/2017 at 11:20 PM, ChessieCat said:

 

You will need to use gram because this is what mg (milligrams) is.

 

The tablet contains 25mg of the drug Lamictal (lamotrigine).  The tablet will weigh more because it has fillers in it.  To get a more accurate weight of a single tablet, weight a larger quantity of tablets and then divide the number of milligrams by the number of tablets.

 

Please do not use the figures below, they are an example only:

Once you have the weight of one tablet you will need to divide that by 25mg.  So as an example if the tablet weighs 30mg and the dose of the tablet is 25mg, divide 30 by 25.  Each 1.2mg of tablet weight will contain 1mg dose of drug.  Now multiply 1.2mg (tablet weight) x 15 (wanted dose) = 21.6mg tablet weight that you need to measure on the scale. 

 

Tapering Calculator - Download

HI Chessie, this was so helpful to me and I just want to double check something.  I've been trying to use the 10mgs soluble tablets but I never (and have written about the before) feel they contain the same amount of meds that regular tablets do.  (this could be my obsessive withdrawal brain but so be it). 

 

I now want to go back weighing and cutting from my 25mg tablets. 

 

Using your formula above, could you check my calculations?

The average weight of my 25mg tablets are 40mgs.   I divided 40mgs by 25mgs and got 1.6.  Each 1.6mg of tablet weight has 1mg of the drug.   I then multiply 1.6 by 10 (current dose)  which = 16mg tablet weight on my scale. 

 

Would that be correct? 

 

Thank you. 

[brassmonkey]

That would be correct Hibari. If you are going to switch from one form of pill to another it would be a good idea to make the switch and then hold for a few weeks before attempting to taper further.  This will allow your body to adjust to any differences between the two types of pills before it has to adjust to a new dosage.

 

For everyone reading this, we are trying to start using clearer weight notations on the measurements we are writing down.  It makes it a  lot easier to keep track of what is being talked about.  So for the weight of the active ingredient, i.e. the strength on the bottle or the strength of the dose we are using "mgai" as the unit of weight.  This would make the tablets Hibari is talking about  25mgai in strength.  Then we are using "mgpw" for the actual weight of the tablet or powder that is measured on the scales.  The tablets mentioned above would weigh 40mgpw and the dose he measured would be 16mgpw.