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How To Taper With The 20 Mg Duloxetine Scored Tablets?

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#1 SheriJ



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Posted 05 May 2022 - 03:16 PM

Hi everyone!      I am new and hopeful that I too will find some answers and finally get off this medicine.  Over the last 9 years I have gone from 60mg to 30 mg to 20 mg and now at 10 mg (for the last 6 months).   Besides the many current (but barely tolerable) side effects of the medicine, my pressing problem with reducing any further is that the 20 mg capsule does not contain beads but 1 scored oblong tablet that can be broken into quarters (5 mg each).  Recently, I tried a 5 mg quarter but immediately went back to 10mg half within a couple days because I couldn't take the withdrawal (dizziness, nausea, brain zaps, insomnia, etc. Can anyone suggest how to reduce the scored tablet so I can begin my 10% reduction.  10% of a quarter tablet is very difficult to be consistent.  I feel I am in a good place now (after 6 months) and would like to continue the slow tapering but don't know how.  I asked my pharmacist if he could only order me capsules with beads and he could not, so I don't want to start tapering with beads and then continue with tablets and so on.  Please, anyone, I want to be a success story and help others taper but I'm so confused on how to proceed.  

#2 fishinghat


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Posted 05 May 2022 - 03:57 PM

Welcome Sheri


First of all I think your pharmacist is just being lazy. Many members on here have had similar situation as you do and their pharmacists were happy to help. Moving on. Some of our members had Cymbalta with a big bead inside. This makes withdrawal much harder. The nest method I have seen in this situation is to buy a mg scale from  Amazon. The one most commonly used is ...


Amazon.com: GEMINI-20 Portable Precision Digital Milligram Scale 20g x 0.001g (Silver), GEMINI-20: Digital Kitchen Scales: Home & Kitchen


You then take 5 or 6 of the beads inside your capsule and weight them and figure out how much they weight on average. You then set up a schedule to reduce the weight a very small amount each day so that you will be weaned off in about a year. At least this would be a good start. Let me give you an example; Lets say your average bead weights 180 mg. This means you would need to drop 1 mg every other day to be weaned off in a year. These tablets can be "trimmed" by using the edge of a knife or a razor blade to slowly remove material each day to get to the weight you need. Some have also used a fingernail file to "sand" off small amounts to achieve the desired weight. If you decide to go this route let me know as there is a few tips you will need to make this more accurate. I have used this method on other meds and had good success.

#3 invalidusername


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Posted 06 May 2022 - 06:46 AM

Welcome Sheri and thank you for sharing your story thus far - it sounds like you have done so well.


I do feel for you if you have only the big bead available to you for reducing your dose and as Hat said, it does sound like your pharmacist just can't be bothered.


It can all depend on where you live and the system. For example here in the UK, we pay a single fee of £9.65 (goes up every few weeks) for each med. The government pay the pharmacist a certain amount of money for each med, depending on what it is and the fee goes directly to the government. 


So for example, some you win, as if it is a new drug on the market, it could cost around £50+ so paying £9.65 is a good thing, but then my 28-pack of Valium costs about 40p to produce, so I pay way over the odds and the government MAKE money, so to say that the NHS is a good thing is not true as most drugs cost less than this prescription charge. And this is PER ITEM. So because I have valium AND citalopram, I have to pay £19.30. This all goes to the government who get the pills for about £2-3 at the most, so we do end up paying for our meds which is where a lot of the world have got it wrong.


Then the pharmacist will be paid, for example, £3 for my valium and £4 for my Citalopram. It is up to the pharmacy where they source the drugs. Every time I get new pills, they are from a different pharma because the pharmacist buy from the cheapest at the time - that way they maximise their profit. Usually they are OK, but sometimes, you get some really bad pharma types and they simply don't do their job.


The pharmacies also save money in buying stock which is nearly out of date. For example, a couple of months ago (March 2022), I got some valium that expired in January 2022!! They just didn't shift them in time. They clearly got a good deal on a batch that was nearly out of date, but I called them on it and they gave me some that were in date. But this just shows you what pharmacies can be like!!


I feel like I should "out" the government over here in the UK with a sticky on the forum. The amount of times I explain this to people. 


But just to make one thing absolutely clear, the NHS (the doctors, nurses, admin etc) are, for the most part, amazing people. It is the government who do not allocate the funding appropriately (thus causing pharmacies to source cheaper pills), nor do they pay the "blue-collar" workers - nurses, cleaners, clerical staff nearly enough. The PEOPLE are amazing and I support them 100%. It is our government that is corrupt.


Bit of a divergence from your topic, but it just gives you a back-story to what can be an issue for the pharmacies.... 

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