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Searching For A Compounding Pharmacy & Pregnancy


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#1 viola639

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Posted 12 January 2021 - 05:16 PM

Hi all, 

 

I live in seattle and am looking for a compounding pharmacy that would support my tapering. 

I went through a bad taper and went back on the full dose of cymbalta again (60mg)  :(

 

I was scared for almost 2 years to taper again, but now trying to get pregnant and i need to try to atleast try to taper from 60 - 30mg as an initial try. 

 

P.S. Will being pregnant on 20 or 30mg of cymbalta be very risky ? 


#2 fishinghat

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Posted 12 January 2021 - 05:45 PM

Welcome Viola

 

When you tapered before did you try bead counting?

 

All the medical research concerning Cymbalta use during and after pregnancy can be found in our ebook (Free!!) It is the pinned link right above this thread in the Medical Support section. If you have any problems locating the information just let us know.

 

I can tell you there is a lot of research in the medical journals that link autism to the use of antidepressants. There is still some debate about that though.


#3 viola639

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Posted 12 January 2021 - 05:53 PM

Thank you @fishinghat :). That was really helpful, i didn't know about the ebook. 

 

I was using an asian version of duloxetine and couldn't bead count, i went down 10 mg at a time :(

 

But this time, i wanted to make sure i had support from a pharmacy. 


#4 invalidusername

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Posted 12 January 2021 - 06:35 PM

Hi Viola and welcome...

 

As Hat said, plenty in the eBook which is here in case you couldn't find it;

 

https://www.cymbalta...tion-the-ebook/

 

10mg at a time is a risky withdrawal strategy! 60 to 50mg isn't too bad, as that is about a 15% drop, but 20 to 10mg is a 50% drop... so you are better off dropping by fixed percentages rather than fixed mg, as the drop changes each time. 

 

The pregnancy/anti depressant thing will forever be open to debate, but I would err on the side of safety as much as you can.

 

If you need help with the withdrawal math - please do not hesitate to ask and we will help!

 

IUN


#5 viola639

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Posted 12 January 2021 - 06:45 PM

@invalidusername thank you :)

 

I would definitely need help with that. Unfortunately i'm scared to drop below 20mg, i become highly unstable. Hence was wondering if it would be ok to take a small dose. 

 

Also, i tried searching through the posts to see if anyone had a recommendation for a compounding pharmacy, would you have a link to point me to it ?


#6 invalidusername

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Posted 12 January 2021 - 09:33 PM

You became unstable after 20mg as this was your highest drop. Lets have a look at the maths to see how your withdrawal went;

 

60-50 = 17%

50-40 = 20% (+3%)

40-30 = 25% (+5%)

30-20 = 33% (+8%)

20-10 = 50% (+17%)

10-0 = 100% (+50%)

 

So as you can see the first drop was 17%, so not too bad, then you went to 20%, 25%, 33%... tolerable perhaps. but then a massive jump to 50% after the 20mg. Your withdrawal was +17% based on the previous, so no wonder you felt the sting at that point!!

 

Apologies if I am losing you here with the maths. I have been doing some research analysis tonight which involved crunching lots of data, so you are lucky I don't attach a graph to this... maybe I should... no, calm down IUN!!

 

If you are happy counting the beads, you will not need a compounding pharmacy, but ideally should be sticking to the same pharma for the length of the withdrawal as different manufacturers have different amounts of beads in the capsules. For example, Teva 20mg might have 120 beads, but Eli Lilly 20mg might be 180 beads per capsule. So the math worked out would need to be re-written to suit the change. Personally I would prefer to do it myself to know that it was done correctly. But whichever choice you go with, we will help you along the way.

 

I am in the UK, so all I know about Seattle is the Seahawks and Fraiser :)


#7 fishinghat

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Posted 13 January 2021 - 08:46 AM

I am afraid that I am not familiar with the Seattle area as well but when I was looking for one in my area I just called a local pharmacy and they immediately knew which pharmacies in the area could do compounding.


#8 invalidusername

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Posted 13 January 2021 - 10:51 AM

Kelley-Ross Compounding Pharmacy, 805 Madison St #702, Seattle, WA 98104

206-622-3565

Open 9-5pm Mon-Fri

 

Cha-ching!


#9 viola639

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Posted 15 January 2021 - 05:24 PM

@invalidusername thank you :). Do you think they would know about compounding cymbalta?, i asked around a local compounding pharmacy in Kirkland here, they didn't :(. I'll call them today and try. 

 

The reason i'm scared to count beads is mostly because of inflammation in my fingers, they are now extremely rigid. This started happening after my first unsuccessful taper :(, lots of side effects. 


#10 invalidusername

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Posted 17 January 2021 - 03:35 PM

I would imagine so - it is quite a popular drug. How did it go?

 

I can well understand your concern over counting the beads.


#11 viola639

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Posted 26 January 2021 - 02:21 PM

@invalidusername thank you :), they don't compound cymbalta. I reached to another pharmacy and they do. But the compounding pharmacies charge exorbitant amount of money (100$ for 28 capsules). That just seems really high :(. I'm not left with probably trying to create capsules myself. 

 

Would you have a recommendation for a brand that would be best & easy to self create capsules ? I'm at my wits end trying to decide. 


#12 invalidusername

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Posted 26 January 2021 - 07:32 PM

Unbelievable... why do people not compound these meds?!

 

And that is stupidly high costs. Goodness, if we knew that would be the going rate, Hat and I would be millionaires by now!!

 

95% of the brands that are on the market are the small bead. The pharmacy that you currently get your prescription filled will be using the big bead pharma as they are giving them the best deal, but if you go to any other pharmacy, or switch to online, you are sure to get the smaller bead capsules.

 

Once you have these, it will make things better in terms of the withdrawal (although longer to count out) but it means that you can get your taper down to far less than 10mg at a time which is our aim here.

 

There is a list of brands with bead counts somewhere on the site here, but I have done a 14 hour day, it would be like trying to find a fart in a Jacuzzi at the moment for me...

 

Hat - can you remember where that is in our little forum?!


#13 fishinghat

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Posted 27 January 2021 - 09:31 AM

It is in the ebook. I will find it and copy it here in a few minutes.


#14 fishinghat

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Posted 27 January 2021 - 09:33 AM

Bead counting data
Lupin - 7 -12 large beads Yes*
Solco - 146 - 157 beads Yes
Prasco - "Large number of beads" Yes
Teva - Approximately 315 beads Yes
Breckenridge - Unknown Yes
Citron  - Small beads, approximately 300+ Yes
Devo - 150 beads Europe
Apotex - various size beads in each capsule as well as various number of beads. Yes
Cymbalta - 250 to 350 beads Yes
Tixal - 60 mg - 88 beads
Andepra AN  - 30 mg - 56 beads
Ajanta Pharma - 70 beads 
Cymgen - 569 beads
 
* Yes indicates that this brand is available in the USA. 

#15 viola639

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Posted 27 January 2021 - 06:47 PM

Thanks a lot @invalidusername and @fishinghat. This is really helpful information :)
Yes i do wish they don't exploit folks that are suffering and actually want to get better. 

 

I'm going the non-compound pharmacy route, trying to see if i can my brother's help in making the capsules for a month in advance at a time. 


#16 invalidusername

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Posted 27 January 2021 - 08:05 PM

Sounds good viola...

 

Let us know how you get on and if you need any further help in your withdrawal schedule and/or maths...

 

IUN


#17 viola639

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Posted 28 January 2021 - 08:06 PM

Thank you @invalidusername :), i'm going to try and order capsules now and slowly titrate better. Is there something you recommend getting for the process ?


#18 invalidusername

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Posted 28 January 2021 - 09:11 PM

Well the first thing to note is that you will need more capsules than supplied with the prescription, so you need to source some, and they need to be enteric coated to prevent the capsules dissolving in the stomach.

 

Regarding the counting, there is no easy method, it is a pain in the ass whichever way you look at it, but the best way as reported from members is to use a black t-shirt or similar as you can clearly see the beads and the friction of the fabric stops them rolling around as they would if you tried using a plate for example.

 

It starts off quite tedious, but you get into your stride eventually. I would also recommend that you get a weekly pill box as is you make the capsules in advance as most people do, there is no way of knowing which has got any given amount of beads, unless you are sticking to the same amount between drops. But the time will come when you need to drop down by a few beads at a time and you don't want to get the capsules mixed up on different days!


#19 frog

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Posted 29 January 2021 - 05:49 PM

Not sure if this was already mentioned, apologies if this is redundant, but with the small beads you want to empty the capsule out and put back the amount of beads you need (as opposed to only removing some amount of beads each time). Each capsule from a manufacturer has a different amount of beads so if you're only taking out then you could be ending up with very different amounts left in each capsule. 

 

Personally I weighed my beads rather than counting them. IDK if that was a good decision or not since cold turkeying threw everything to hell anyway, but weighing the beads is also an option if you are having too hard of a time with the counting. You can get some scales off of Amazon that are able to measure small increments like this. Supposedly weighing is a bit less precise because the amount of coating on each bead varies, but unless you're SUPER sensitive I feel like it should be ok? And certainly better than nothing!


#20 invalidusername

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Posted 29 January 2021 - 08:18 PM

Well therein lies the problem Frog as the caps are also determined by weight which is why some caps contain different numbers of beads. So whether you are taking out, or emptying and putting back in, you still have the same conundrum. Very difficult situation and weighing is a better way to go, but not always an option for all. 

 

That said if the withdrawal is dropping 10 beads every week rather dropping 1, 2, 3 etc over a period of days, the above isn't so much of a concern. But we will always have this issue, but until the pharma employees sit there counting out the beads like we have had to do (!), it ain't gonna happen!! :)


#21 viola639

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Posted 01 February 2021 - 02:23 PM

Totally agree with this. I wish pharmacies offered compounding as a service covered by insurance. My capsule has 70 beads in it. Even if i reduce by 5% of the original dose every month, i'll still be a long way from completely stopping the drug. 

I do wish i could use a pipette or something to funnel the beads inside :(


#22 invalidusername

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Posted 02 February 2021 - 06:09 PM

No easy way unfortunately. And there are always those times when it gets too much and wish that someone else can do it for you, but alas we need to be strong. I will never forget sitting there every Sunday tipping my capsules out and counting the beads for the week. 


#23 viola639

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Posted 05 February 2021 - 07:24 PM

@invalidusername, that is totally right. It needs to be done, no other way. Started today by removing 10% off the evening dose 30mg. My aim is to get to half the dose by year end. No matter how slow it goes. Wish me luck :)

 

I'll keep checking into this topic to update and keep reporting my state of mind. A full time job and evening classes with this taper schedule is going to be a not so fun journey. 


#24 invalidusername

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Posted 07 February 2021 - 09:41 AM

Well I do indeed with you luck. Try not to have goals, rather than plans. We never know what life is going to throw at us. It is a case of going at the pace that our bodies decide for us. I was meant to be half way through my citalopram withdrawal by now, but the covid has put pay to that. It has really hit hard over here now and despite the falling levels, they are not letting up at all. We are still under national lockdown and it is really damaging to mental health. I really wish they would consider more support for those of us suffering. With all respect, Covid is a 2 week ailment at best, whereas mental health can be far long and damaging.


#25 viola639

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Posted 09 February 2021 - 01:14 PM

@invalidusername i totally understand the covid impact on this :(. I personally switched jobs (was laid off from the first one (thereby paying out of pocket for cymbalta for a few months :(, searched and finally got the new one). If the government empathized even a little bit with our problems, they would be making withdrawal known to folks, instead we get stuck in this vicious circle. 


#26 viola639

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Posted 11 February 2021 - 01:04 PM

Update: 3 days on 10% reduction on 60mg, feelings of pain in my fingertips, leg extremities and back. I hope the feelings go away. I never had neuropathy symptoms before i got on this, but a few years on this and i have insulin resistance and weight issues :(. For perspective (i used to be underweight and anemic ;)). Now mild neuropathy. 

 

P.S why can't i take omega-3 supplements without it causing anxiety in me  :(). 


#27 fishinghat

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Posted 11 February 2021 - 01:55 PM

Most people can take omega 3 without developing anxiety as long as it is epa and dha types and at 3000 mg/day or less. What brand omega 3 are you taking?


#28 fishinghat

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Posted 11 February 2021 - 01:59 PM

I just looked at the FDA data and 1.9% of the people taking omega 3 report anxiety as a side effect. That is more than I expected.


#29 viola639

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Posted 11 February 2021 - 02:34 PM

@fishinghat, i'm taking the nordic naturals omega3. So, a bit of a background, i used to take it regularly before my 1st taper without issues. After my first failed rapid taper, i have not been able to take omega 3 or b12 :(. Could this be a side effect of a sensitive gut from the first failed taper ? 

 

Also i changed to a US generic capsule from india based tablet, for better tapering. I feel as if the US due to quality control is stronger, have you ever experienced this ?

 

P.S. I can't do caffeine either since the first failed taper. I used to be a massive coffee person (4/day), now i can barely do 1/day. 


#30 frog

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Posted 11 February 2021 - 03:10 PM

I feel like for months after my cold turkey from Cymbalta when I was the most messed up, I was really sensitive to a lot of pretty normal things, Benadryl was one. Made my heart beat out of my chest the one time I tried to take it to sleep. Idk if it's so much about a sensitized gut as it is about your entire system being sensitive to any changes as it's trying to rebalance things after with the withdrawal. The sensitivity should eventually die down. 

 

I wasn't a huge caffeine drinker ever, but my anxiety would spike if I had a latte or anything in those months too. Caffeine is obviously a stimulant. Be mindful that you may have a bit of a caffeine withdrawal too if you were drinking that much and then had to stop. Are you able to tolerate anything caffeinated that has a lower amount? Like a green tea maybe? That could be helpful so you don't completely have to cold turkey from caffeine





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