Ripley66: weaning off Seroquel / quetiapine

[Ripley66]

Try not to make yourself throw up. I made that mistake and had cyclical vomitting where I could not stop for 24 hrs. Holding it in is actually better because it will come and go in waves but if you make yourself throw up to alleviate the nausea like I did you wont be able to stop throwing up and itll all get worse.

[Ripley66]

Hello...I would like to hear experiences from those who switched from Seroquel extended release to instant release in order to taper, since the smallest pills in XR are 50 mg and that is way too big of a jump, nor can they be cut up.

From what Im hearing, you take part of the IR in the morning, then part in the evening when transitioning.

Do you get withdrawal symptoms from the XR, even if you follow this guideline? And is it severe? I am very sensitive to withdrawal from this medication, so this switch is scaring me. What should I expect?

Are there any other ways to get off this blasted XR?

Thank you so much for your time.

[RusTW]

 no I know you're right I do hold it in and I do just get the waves I've never actually thrown up but my fear is that while I'm working it's going to get so bad that I have to run and vomit it's been awhile for me going through this nausea thing so I've kind of gotten used to it but some days it seems to be more extreme than others where I actually feel they anxiety along with it because I'm so worried

[RusTW]

 my fear my fear is that I'm going to be in for a long to drop because I cold turkey the Seroquel I was taking about 300 milligrams every day reinstating the hundred mg didn't seem to help too much I do get Windows from time to time but I do still feel the withdrawals pretty bad

[RusTW]

This

 medication was prescribed to me for insomnia at that high of a milligram ever since I started I've gained about 30 lb stop working out up until now and it's very hard to work out because of the nausea and anxiety but I'm doing a lot of walking and going to the gym I did find out though that if you overexert yourself with exercise or caffeine and you can start a wave again I think that's what started this one

[RusTW]

Have a good day today

[ChessieCat]

9 hours ago, Ripley66 said:

Hello...I would like to hear experiences from those who switched from Seroquel extended release to instant release in order to taper, since the smallest pills in XR are 50 mg and that is way too big of a jump, nor can they be cut up.

From what Im hearing, you take part of the IR in the morning, then part in the evening when transitioning.

Do you get withdrawal symptoms from the XR, even if you follow this guideline? And is it severe? I am very sensitive to withdrawal from this medication, so this switch is scaring me. What should I expect?

Are there any other ways to get off this blasted XR?

Thank you so much for your time.

 

You might be able to find this information by searching for members who are/were tapering this drug.  Some members who have changed from XR to IR may no longer be active but the information may be in their topics.  Either use the site search or google "survivingantidepressants.org seroquel quetiapine"

[Ripley66]

Hello everyone, I am still working on my horrendous taper of Quetiapine IR. 

 

I was taking 100 mg of Quetiapine XR with 50 mg IR. I tapered to just 100 mg XR and 12.5 mg IR. Because I could not go any lower on the IR due to the XR, I switched 50 mg of the XR for 50 mg of the IR, so I could make it down to 50-60 mg and then switch the final 50 mg of XR to IR to go the rest of the way. I hope this makes sense.

 

After the switch of 50 mg XR - 50 mg IR I experienced no dips in mood but very bad nausea which lasted 7-10 days and then went away completely, which was relieving.

 

I cannot seem to get lower than 100 mg in total. I dropped from 112.5 mg to 100 mg and ever since there has been mood disturbances and more nausea and a feeling of just not being myself, wanting to crawl out of my skin.

 

I did some digging and found out that you can actually get a gram scale and go down by 1 mg per day by using the gram scale (in the IR, not the XR). Can anyone verify this? Can anyone let me know if 1 mg per day is a good course of action? I read that this can reduce withdrawal symptoms dramatically. I am very sensitive and feel withdrawal even when dropping by 10%.

 

Thank you

[Ripley66]

Also, do you put it in water, and how much water is recommended?

[manymoretodays]

Hi Ripley66,

I moved your questions regarding your taper back here to your introduction.

This way we can keep track of how you are doing, and have all your information in one place.  It seems you several questions regarding your taper today. 

 

So I'll try and best address just a few of them now. 

You can also locate other Seroquel/quetiapine taperers by clicking on the tags at the top of your introduction.

 

4 hours ago, Ripley66 said:

Hello everyone, I am still working on my horrendous taper of Quetiapine IR. 

 

I was taking 100 mg of Quetiapine XR with 50 mg IR. I tapered to just 100 mg XR and 12.5 mg IR. Because I could not go any lower on the IR due to the XR, I switched 50 mg of the XR for 50 mg of the IR, so I could make it down to 50-60 mg and then switch the final 50 mg of XR to IR to go the rest of the way. I hope this makes sense.

 

After the switch of 50 mg XR - 50 mg IR I experienced no dips in mood but very bad nausea which lasted 7-10 days and then went away completely, which was relieving.

 

I cannot seem to get lower than 100 mg in total. I dropped from 112.5 mg to 100 mg and ever since there has been mood disturbances and more nausea and a feeling of just not being myself, wanting to crawl out of my skin.

 

I did some digging and found out that you can actually get a gram scale and go down by 1 mg per day by using the gram scale (in the IR, not the XR). Can anyone verify this? Can anyone let me know if 1 mg per day is a good course of action? I read that this can reduce withdrawal symptoms dramatically. I am very sensitive and feel withdrawal even when dropping by 10%.

 

Thank you

 

I don't know anything about the 1mg/day method of reduction.  It may be too much over time is my best guess?  Like when you get to the smaller doses. 

 

I was taking 100 mg of Quetiapine XR with 50 mg IR. I tapered to just 100 mg XR and 12.5 mg IR. Because I could not go any lower on the IR due to the XR, I switched 50 mg of the XR for 50 mg of the IR, so I could make it down to 50-60 mg and then switch the final 50 mg of XR to IR to go the rest of the way. I hope this makes sense.

 

Have you considered crossing over to all IR before the next taper?  Rather than waiting until you are all the way down to 50 mg?

 

You posted your last post as "Urgent"........and my guess is that you may be having W/D symptoms now?  I used to think the cure for W/D symptoms was further tapering......only I found out that it was the opposite......sometimes the symptoms felt urgent because, I had gone too fast. 

 

 

What was the date of your decrease from 150 mg quetiapine to 112.5 mg?  And then to 100 mg.

Could you update your signature to reflect this.

It will be helpful to get a time frame on your reductions.      

We generally recommend a 10% reduction, which is based on each previous dose.  Some taper by even less, depending on symptoms. 

Why taper by 10%

And then a hold period of 4-6 weeks between reductions.  So I kind of would like to see where you are at in that time frame now.
Keep it simple, slow, stable

 

Tips for tapering off Seroquel

This ^ might answer some of your questions as well. '

You might decide to switch over all the way to IR too, before continuing your taper. 

Weighing may be a good option for you OR liquifying (with the IR).  I think it's best to liquify with enough water, so that you can do accurate, and consistent measurements with your oral syringe.

 

It's great to be planning ahead for your tapering.  Hopefully we can help you avoid too many W/D symptoms that way.

  

 

What are your present symptoms? 

Are you keeping notes at this point?  If you can keep notes on paper and then share here it's very helpful for us.

Keeping daily notes on your drugs and symptoms

Include any supplements used, and symptoms throughout the day, as well as your sleep. 

Keep it simple for us when sharing here.  Time on the left.  Drug.  Dosage.  Symptoms.  Etc.

 

I'm a bit hesitant to have you taper much more right now as you did a fairly quick taper down already.  Often we get a misguided notion that quicker tapering will solve W/D symptoms.  And often it's the opposite.  So I want to be able to see if a longer HOLD might be in order, or possibly even an updose if symptoms have worsened.

It's a lot easier to prevent withdrawal symptoms sometimes than it is to wait out the stabilization process.  Our CNS(central nervous system) really likes stability.

 

All for now,

Love, peace, healing, and growth,

mmt

 

 

 

 

Edited September 8, 2018 by manymoretodays
edit on tags comment

[Altostrata]

On 9/8/2018 at 5:26 AM, Ripley66 said:

I was taking 100 mg of Quetiapine XR with 50 mg IR. I tapered to just 100 mg XR and 12.5 mg IR. Because I could not go any lower on the IR due to the XR, I switched 50 mg of the XR for 50 mg of the IR, so I could make it down to 50-60 mg and then switch the final 50 mg of XR to IR to go the rest of the way. I hope this makes sense.

 

After the switch of 50 mg XR - 50 mg IR I experienced no dips in mood but very bad nausea which lasted 7-10 days and then went away completely, which was relieving. 

 

I cannot seem to get lower than 100 mg in total. I dropped from 112.5 mg to 100 mg and ever since there has been mood disturbances and more nausea and a feeling of just not being myself, wanting to crawl out of my skin.

 

Hi, Ripley. When did you decrease to 100mg?

 

Yes, you could dissolve a 50mg IR tablet in (for example) 50mL water and take 2mL (2mg) to updose a little bit. That might help settle those symptoms.

 

Are you able to get a prescription for liquid quetiapine? That would be easier for you. You could take 50mg of your dose in ER form and the rest in liquid for a while, until you get down to 50mg Seroquel ER, then you'd switch to all liquid to complete your taper.

[Ripley66]

Thanks so much! I will ask for liquid form at my next apt. But I ordered a milligram scale as well in case they do not have it. Do you think 1 mg per day is too fast Altostrata? 

[Altostrata]

Given your recent difficulty going down to 100mg, I would wait quite a while before making any more reductions.

 

A reduction of 1mg per day amounts to about 30mg per month, which at your current dosage is a 30% reduction. So that seems too fast, you've already had withdrawal symptoms. A reduction of 10% per month would be 10mg, or about 2.5mg per week.

 

If you use the liquid, you could reduce by any amount per day, week, or month. Rather than reducing every day, I might try 2mg per week for a while, until you get down to to a dosage of 80mg, where you'd have to make smaller reductions to maintain a rate of 10% per month.

 

I would ask your druggist if quetiapine liquid is available by prescription in Canada and if insurance covers it.

[manymoretodays]

Hi Ripley,

Here is the link to get to your signature so you can update that for us.  

Signature instructions and updating signature instructions

Presently, it appears(on your signature) that you are on 125 mg of Seroquel.  Although your narratives differ.  This will help us quite a bit so we are aware of your particular situation at a glance.  Thank you.

 

On 9/9/2018 at 2:47 PM, Altostrata said:

Hi, Ripley. When did you decrease to 100mg?

 

Yes, you could dissolve a 50mg IR tablet in (for example) 50mL water and take 2mL (2mg) to updose a little bit. That might help settle those symptoms.

 

Please keep us updated .........and let us know if you are able to get the pre-made pharmacy liquid form of quetiapine as well.

 

See Alto's most recent post to you as well.  It's right above, posted last Sunday. 

 

Love, peace, healing, and growth,

mmt

 

 

Edited September 11, 2018 by manymoretodays
clarity

[Ripley66]

I was unable to get the liquid Quetiapine. I (with the help of my husband) tried crushing the tablets to put into water as suggested but they are so hard to crush...is there an easy way to do this? I was concerned over how much of the pill was sticking to the things we were crushing it with...and had no idea how to compensate for this. It was extremely daunting. It was also sticking to the glass! So I know the measurements were just not accurate using this method. 

I was on 100 mg in total which happened I think one month ago, 50 XR 50 IR.

I have managed to go down by 6.25 mg of the IR every 7 days. I am now at 87.5 mg. For whatever reason I have not felt any withdrawal symptoms at all. Perhaps I was not fully stabilized after the drop to 100 mg, which I had tried in the past and that drop always seemed to be the hardest for me.

Im going to hold for another couple of weeks then go down again by 6.25. I am trying to listen to my body and what it can handle and if I feel any changes I will hold longer.

[Carmie]

Hi Ripley, 

 

I crushed the seroquel tablets for many years n water titrated them. I used a mortar n pestle n had no problems. Just recently I got the pharmacy to make me a compounded 7.5mg capsule as I got the 25mg tablet down to 7.5mg. 

 

Changing over caused waves though as measurements can be different, which I found out once when I used a different brand syringe. Anyway, when I stabilise I’m going to start tapering. It’s easy now as I just open up the capsule. Someone was saying though that compounding capsules can be off by a small percentage.

 

All the best with your continued tapering💚

[Ripley66]

I apologize if this is not the right place to post this, I wanted to add this to my old thread so all of my information was attached from a few months back but I am having a hard time finding it and navigating this site.

I'm ok now, but coming out of a 2-3 week steady drop into what felt like relapse until I realized this was possibly medication related. Can someone please tell me where it could possibly have tipped the scales?

I have been very, very slowly tapering Quetipaine XR and Quetiapine IR for one year. 

My original dose was 175 mg, divided into 100 mg XR and 75 mg IR. 

I began tapering small amounts, and let myself adapt, would monitor how I felt and would taper by 6.25 mg - 12.5 mg, based on how my body felt and coped. 

To get below 100 mg, and then 50 mg, I had to swap the 50 mg tabs of XR for 50 mg of the IR, because the IR can be split and the XR cannot.

About 6-8 weeks ago, I can't exactly remember when, I swapped 50 mg XR for 50 mg IR, and was on a total of 62.5 mg IR. 

After about 2 weeks, I was feeling ok, so I tapered to 56 mg (a 6.25 mg drop). 

Another week and I was ok, so I was brave and went to 50 mg even. 

Around here I started having depressive symptoms, nothing extreme, but it was noticable. I also started having stomach problems. Acid reflux, nausea. 

I was still mentally ok though, so I went to 37.5 mg. Then everything went crazy. I suddenly started having really terrible acid reflux, nausea, derealization and bad bad symptoms.

I absolutely panicked, and tried reinstating 50 mg of the XR. I lasted three days before I had to stop, as I was having start up symptoms from the XR, worsening head pressure, derealization and dream-world state anxiety and it was very scary. 

So that night I stopped the XR, reinstated to 75 mg of the IR only.

Nothing seemed to change for a few days, but yesterday was a tad better. My main symptom was severe anxiety, restlessness. Not panic but a restlessness and inner agitation, like something was wrong. It was very unnerving.

Im on day 4 post reinstating the 75 mg IR and I still have acid reflux but my mind feels stable. I feel like I am levelling out, and feel like the past 2 weeks were some sort of really bad dream or something, it was all just very bizarre and strange, but now I feel fine.

I found it would hit in waves.

I would be really bad in the morning, it would waver in the afternoon, and every couple of hours I would feel completely normal. Only to have a wave come back with a vengence and hit me again and throw me into an anxious state. The an hour or so would pass and I would be totally normal.

Another thing I noticed quite vividly was I would get a throbbing pressure headache at the exact same time every single day for 5 straight days. They would start at 5 pm and let up around 8 pm. Like clockwork, these headaches happened in the same way, at the same time, every day. 

I'm ok now, I think Im finally coming out of whatever that was, but I would like to know where I went wrong, as to not make the same mistake next time.

Do you think the symptoms were withdrawal from the XR, or the IR?

 

Thanks!

[RusTW]

1 hour ago, Ripley66 said:

I apologize if this is not the right place to post this, I wanted to add this to my old thread so all of my information was attached from a few months back but I am having a hard time finding it and navigating this site.

I'm ok now, but coming out of a 2-3 week steady drop into what felt like relapse until I realized this was possibly medication related. Can someone please tell me where it could possibly have tipped the scales?

I have been very, very slowly tapering Quetipaine XR and Quetiapine IR for one year. 

My original dose was 175 mg, divided into 100 mg XR and 75 mg IR. 

I began tapering small amounts, and let myself adapt, would monitor how I felt and would taper by 6.25 mg - 12.5 mg, based on how my body felt and coped. 

To get below 100 mg, and then 50 mg, I had to swap the 50 mg tabs of XR for 50 mg of the IR, because the IR can be split and the XR cannot.

About 6-8 weeks ago, I can't exactly remember when, I swapped 50 mg XR for 50 mg IR, and was on a total of 62.5 mg IR. 

After about 2 weeks, I was feeling ok, so I tapered to 56 mg (a 6.25 mg drop). 

Another week and I was ok, so I was brave and went to 50 mg even. 

Around here I started having depressive symptoms, nothing extreme, but it was noticable. I also started having stomach problems. Acid reflux, nausea. 

I was still mentally ok though, so I went to 37.5 mg. Then everything went crazy. I suddenly started having really terrible acid reflux, nausea, derealization and bad bad symptoms.

I absolutely panicked, and tried reinstating 50 mg of the XR. I lasted three days before I had to stop, as I was having start up symptoms from the XR, worsening head pressure, derealization and dream-world state anxiety and it was very scary. 

So that night I stopped the XR, reinstated to 75 mg of the IR only.

Nothing seemed to change for a few days, but yesterday was a tad better. My main symptom was severe anxiety, restlessness. Not panic but a restlessness and inner agitation, like something was wrong. It was very unnerving.

Im on day 4 post reinstating the 75 mg IR and I still have acid reflux but my mind feels stable. I feel like I am levelling out, and feel like the past 2 weeks were some sort of really bad dream or something, it was all just very bizarre and strange, but now I feel fine.

I found it would hit in waves.

I would be really bad in the morning, it would waver in the afternoon, and every couple of hours I would feel completely normal. Only to have a wave come back with a vengence and hit me again and throw me into an anxious state. The an hour or so would pass and I would be totally normal.

Another thing I noticed quite vividly was I would get a throbbing pressure headache at the exact same time every single day for 5 straight days. They would start at 5 pm and let up around 8 pm. Like clockwork, these headaches happened in the same way, at the same time, every day. 

I'm ok now, I think Im finally coming out of whatever that was, but I would like to know where I went wrong, as to not make the same mistake next time.

Do you think the symptoms were withdrawal from the XR, or the IR?

 

Thanks!

HI Ripley66 sounds like your tapering waay too fast hold for a while.it takes time for things to catch up.under 50mg go slower.im still at 37.5 holding for next taper in may or june.my last taper took a few months to hit. 

[Ripley66]

Thanks for the reply, do you think the XR did this or the IR? I definitely went to fast between 60-30 mg and things went crazy at some point during those tapers. I'm definitely not making any changes for a while. 

[RusTW]

It's hard to tell because the extended release stays in your system while you're taking the instant release so it could have a delayed effect. I take instant release so I can gauge on how long it last in my body. If I take my tablet at 10 p.m. it will generally wear off by 6 a.m. fully. I would work on transitioning over to the instant release. Hold for a month or two at least and then switch over if you can

[RusTW]

When I cold turkey The Seroquel it took three weeks for with withdraws to hit. I would be careful with Seroquel tapering at this point. This is a very potent drug and tapering it is not easy maybe at higher dosages but not at lower dosages.

[BfromNJ]

12 minutes ago, RusTW said:

When I cold turkey The Seroquel it took three weeks for with withdraws to hit. I would be careful with Seroquel tapering at this point. This is a very potent drug and tapering it is not easy maybe at higher dosages but not at lower dosages.

I take Seroquel, 25 mg a night for sleep.  you scare me with this statement.  I fear the day a go of off this one.  :/   

[Ripley66]

11 minutes ago, BfromNJ said:

I take Seroquel, 25 mg a night for sleep.  you scare me with this statement.  I fear the day a go of off this one.  😕

Just do not ever go off cold turkey. Withdrawal off this drug is powerful and terrifying.

[RusTW]

5 hours ago, Ripley66 said:

Thanks for the reply, do you think the XR did this or the IR? I definitely went to fast between 60-30 mg and things went crazy at some point during those tapers. I'm definitely not making any changes for a while. 

I wouldn't  once you go down that path its very hard to undo.Stay there and deal with the fast taper.i would taper 5% from now on for a while when you eventually do.below 50 is brutal and takes time to hit.

That's a tough one taking long acting and short .I would work on getting on one only.then you take out that variable. I would wait though until your stabalizing ok

[Ripley66]

23 minutes ago, RusTW said:

I wouldn't  once you go down that path its very hard to undo.Stay there and deal with the fast taper.i would taper 5% from now on for a while when you eventually do.below 50 is brutal and takes time to hit.

That's a tough one taking long acting and short .I would work on getting on one only.then you take out that variable. I would wait though until your stabalizing ok

Im fully off the XR now. I had to drop from 100-50 mg back in like August I think. I had no withdrawal except nausea and intense energy. I think I was hypomanic. But going from 50-0 was crazy. Mainly the energy and adrenaline, it all culminated into a panic attack then went away.

I thought reinstating Xr would help but I lasted three days and it made me feel way too bizarre so Im just on 75 mg IR right now, no XR. Im feeling way better today, the only lingering symptom is bad acid reflux which I cant seem to kick.

[RusTW]

Good hold that dose for a while.ive got reflux and gi stuff also. You've tapered a lot.take it easy now.this drug is scary.

[Altostrata]

11 hours ago, Ripley66 said:

fter about 2 weeks, I was feeling ok, so I tapered to 56 mg (a 6.25 mg drop). 

Another week and I was ok, so I was brave and went to 50 mg even.  

Around here I started having depressive symptoms, nothing extreme, but it was noticable. I also started having stomach problems. Acid reflux, nausea. 

I was still mentally ok though, so I went to 37.5 mg. Then everything went crazy. I suddenly started having really terrible acid reflux, nausea, derealization and bad bad symptoms.

 

That decrease to 37.5mg was too big.

 

Do you get worse symptoms at any particular time of day?

 

You may need to take IR twice a day. What times of day do you take it?

 

I would not have increased to 75mg, but 25mg IR twice a day.

[RusTW]

9 hours ago, BfromNJ said:

I take Seroquel, 25 mg a night for sleep.  you scare me with this statement.  I fear the day a go of off this one.  😕

B you were lucky to get your Rx at 

25mg.I was prescribed 10 mg of zyprexa then switched to 300mg seroquel for sleep??

Lower doses are used to sleep it sedates.over 100 mg is for Mental issues. Low sedation .you will be ok .taper slow very slow

[Ripley66]

7 hours ago, Altostrata said:

 

That decrease to 37.5mg was too big.

 

Do you get worse symptoms at any particular time of day?

 

You may need to take IR twice a day. What times of day do you take it?

 

I would not have increased to 75mg, but 25mg IR twice a day.

Unfortunately I can only take the IR before bed, I cannot tolerate the sedation if I took it in the morning, and have to look after young kids. Should I just keep doing the 75 before bed? Or lower do you think

[Ripley66]

Im feeling much better today, it does seem as though the worst has passed, CBT helps me cope with residual lingering gastro issues. 

My symptoms when I had postpartum depression last year began in my stomach. Severe acid reflux, nausea.

Withdrawal from seroquel does the same.

There is a supplement called Restore for gut-brain health. I am wondering if this could potentially interact with Seroquel. I am wary to take anything with this drug but am so desperate to help my stomach.

[Altostrata]

What is your daily drug schedule now? Do your symptoms follow any daily pattern?

 

What are the ingredients in Restore?

[Ripley66]

I have only ever taken my dose at night at 8 pm. I have been taking just 75 mg IR, for four nights. Mornings there is some anxiety, between 9-11 no symptoms, then around 1 pm mild anxiety and bad acid reflux. No symptoms in evening 5-11 pm.

I copied this from the Restore website,

RESTORE ingredients for gut health are comprised of purified water, a soil-based mineral supplement, Terrahydrite(TM) (Stabilized Lignite Extract), trace soil amino acids and minerals.

[Altostrata]

I wouldn't take Restore, they're not being candid about their ingredients.

 

Are you doing anything about noon that might be causing the gut symptoms? Lunch? Caffeine?

 

If something you're ingesting at lunchtime is not causing your gut symptoms, Seroquel IR has a short half-life, only 6 hours, so by noon, you've probably got a substantial dip of the drug in your blood level at about noon. What you might do is take 70mg Seroquel IR at night and 5mg around 10 a.m. to bridge you over until your evening dose.

 

I would try this over weekend, in the unlikely case that 5mg causes you to be drowsy in the daytime.

 

[Ripley66]

46 minutes ago, Altostrata said:

What is your daily drug schedule now? Do your symptoms follow any daily pattern?

 

What are the ingredients in Restore?

 

18 minutes ago, Altostrata said:

I wouldn't take Restore, they're not being candid about their ingredients.

 

Are you doing anything about noon that might be causing the gut symptoms? Lunch? Caffeine?

 

If something you're ingesting at lunchtime is not causing your gut symptoms, Seroquel IR has a short half-life, only 6 hours, so by noon, you've probably got a substantial dip of the drug in your blood level at about noon. What you might do is take 70mg Seroquel IR at night and 5mg around 10 a.m. to bridge you over until your evening dose.

 

I would try this over weekend, in the unlikely case that 5mg causes you to be drowsy in the daytime.

 

Perfect, I will definitely try that. It has to be 6.25 mg as I can only split these tiny pills into quarters. Should I take the 6.25 mg off of my evening dose? Or just continue the 70 mg.

[Altostrata]

1 hour ago, Ripley66 said:

 

Perfect, I will definitely try that. It has to be 6.25 mg as I can only split these tiny pills into quarters. Should I take the 6.25 mg off of my evening dose? Or just continue the 70 mg.

 

I'd take the 6.25mg off the evening dose.

[Ripley66]

3 hours ago, Altostrata said:

 

I'd take the 6.25mg off the evening dose.

Awesome thanks so much. Ill post updates