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Guilietta

Perhaps I might have added in the above post (unwitting omission) why I am using compounded liquid as opposed to compounded powder capsules. 

 

After contacting 2 local reputable compounding pharmacies in my state - the best they would do is repackage beads in amounts of 5 mg per capsule. In addition to the lack of flexibility - and in dosages I knew wouldn't work for me - it was prohibitively costly.  Neither would compound from a powder.

 

Finally - I was referred to the currently used compounding pharmacy, whose process for compounding is to suspend the drug in an oil base. I have an extremely sensitive nervous system and the liquid would allow me to make very small changes - but I didn't appreciate/understand that it was immediately released into the blood stream (and hence shorter half-life?).

 

 

 

 

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Guilietta

Updated dates, dosages and symptoms

 

Summary for 8/10-8/12 - symptoms were pretty much the same and at the same times. Total duloxetine each day was 9.6 mg - split evenly at 6.30 and 1.30/2.

 

6.30 a.m. Awoke and ate breakfast.

6.30 a.m. Took 300 mg gabapentin, 2.5 mg lisinopril, 10 mg crestor, .5 mg clonazepam, 4.8 mg liquid duloxetine (1.6 ml)

12 p.m. Ate lunch

1.00 p.m. Took 300 mg gabapentin

1.30-2ish Took 4.8 mg liquid duloxetine (1.6 ml)

4 p.m. Anxiety, Tinnitis, Jitteriness (1.5 - 3 hours depending on 10th, 11th or 12th).

6 p.m. Ate dinner and took 600 mg lamotrigine XR

10 p.m. Took 400 mg gabapentin & 1.5 mg clonazepam and went to bed

 

Awaken around 3-4 in the morning - and back to sleep without sleep aids

 

August 13 (originally posted last night but copied) - this is the first day of a cut (9.25 down from 9.6 mg)

 

6.30 Ate breakfast

6.30 Took 4.25 mg liquid dulox (1.5 ml), 300 mg gabapentin, 2.5 mg lisinopril, 10 mg crestor, .5 mg clonazepam

12 p.m. lunch
1 p.m. 300 mg gabapentin

1 -1.30 p.m. 5 mg liquid duloxetine -  anxiety (1-2 hours)

1.30 - 4 p.m. mild anxiety

5 pm anxiety, tinnitus and jitters (3.5 hours)
6 p.m. Ate dinner Lamotrigine XR 600 mg.
9 pm 400 mg gabapentin and 1.5 mg clonazepam and bed

 

Awakened at 1 and back to sleep without sleep aids

 

August 14 (today)  - thus far doing well!

 

6.30 Ate breakfast

6.30 Took 4.25 mg liquid dulox (1.5 ml), 300 mg gabapentin, 2.5 mg lisinopril, 10 mg crestor, .5 mg clonazepam

12 p.m. lunch
1 p.m. 300 mg gabapentin and 5 mg liquid duloxetine
6 p.m. Ate dinner Lamotrigine XR 600 mg.
9 pm 400 mg gabapentin and 1.5 mg clonazepam and bed

 

 

 

 

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Guilietta
1 hour ago, Guilietta said:

August 14 (today)  - thus far doing well!

  

6.30 Ate breakfast

6.30 Took 4.25 mg liquid dulox (1.5 ml), 300 mg gabapentin, 2.5 mg lisinopril, 10 mg crestor, .5 mg clonazepam

 

Edit to the above - Awoke initially around 5.45 with anxiety.

 

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Guilietta

Hi there.

 

How would I use the BrassMonkey technique with compounded capsules and a decrease of 10% over 4 weeks and minimize the number of capsule sizes needed? 

 

Does one have to have a week's worth of capsules made up at a time (for example, Week 1: 4.6 mg bid, Week 2: 4.5 mg bid, etc.)?

 

Thanks,

 

G.

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brassmonkey

Hi Guilietta-- Trying to do a Brassmonkey Slide using compounded capsules would be a major pain in the ...... As you surmised above you would have to have the capsules made up in batches of 14 (2bid) for the first three weeks of the taper and then a batch of 42 (2bid) for the last week and the two week hold period. This would be prohibitively expensive, not to mention that your would require a new prescription for each batch.  So you would have to add doctors visits on top of that.

 

The Brassmonkey Slide method is designed as a do-it-yourself sort of thing.  That way you have control over the dosing, the timing, the reduction rate and can maintain some control over the cost.  

 

If you would like to try a Brassmonkey Slide then we will need some more information about your medication.  For a starter:

 

Do the capsules contain beads or powder?

 

What is the listed strength of a capsule as listed on the bottle?

 

Do you own a scale such as the Gemini-20?

 

What is your current dose and how often do you take it?

 

This information will help get us started, but there will be more questions.  I am sitting in a hotel room in the wilds of New Mexico ATM, and will be heading into the outback for the next week or so.  The connectivity can be really poor at times but I will check in as best as I can to help get things going.

 

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Guilietta

Thank you for the expert input on powder compounding. Your facts support my hunches.

 

11 hours ago, brassmonkey said:

Do the capsules contain beads or powder?

 

What is the listed strength of a capsule as listed on the bottle?

 

Do you own a scale such as the Gemini-20?

 

What is your current dose and how often do you take it?

 

To answer your questions:

 

Duloxetine capsules contain beads.

 

The listed strength on the generic's bottle is 20 mg per capsule. This is the lowest dose capsule.

 

I do not own a scale.

 

My current dose is 9.25 mg (which I am taking as compounded short-acting liquid since December 2018). I am taking this in a split dose - so roughly 4.6 mg at 7 a.m. and 1.30-2 p.m.

 

This idea is really a stroke of genius. It has made a huge improvement in my QOL.

 

Enjoy your trip throughout NM. It's a gorgeous place I am told by a friend who traveled there twice a year marveled at its beauty.

 

Thanks again,

 

G.

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brassmonkey

I'll have to look things over, but we should be able to work out a Brassmonkey Slide using the counting beads method.  Using scale and weighing things seems to be the easiest method for most people, but at least in the beginning counting beads should work.

 

In general how sensitive are you when making changes? Do tiny changes cause great affect?  It will be best if there is some wiggle room in dosing if we want to count beads.

 

If splitting doses during the day is a good thing for you, then we will incorporate it into the slide.

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