I know the majority of the people here use the bead counting method for weaning but thought I'd share my experience with weighing the dose and dealing with generic Cymbalta, especially if you keep getting drugs made by different manufacturers. Ideally, I'd stay with the brand name Cym, but I really can't afford. Sometimes, the pharmacy can order a generic by the same manufacturer but this hasn't been the case lately so I came up with a way to be ensure that my dose stays the same when I have to switch manufacturers. Bead counting has obviously worked for lots of people here but thought I'd share this in case anyone's interested.
Note: If you are reducing by only 1 or 2 beads at a time, weighing might not work for you. I've found that between 2 and 4 beads are needed to change the weight at least 0.001g.
This is the method I came up with for weighing my dose. I read online about someone else doing it, and took their instructions then tweeked them a bit. Weighing my dose sounded intimidating at first and it took some practice but please don't let all these instructions scare you! I'll be happy to help anyone who's interested or has any questions.
1. You'll need a scale. I ordered mine from Amazon. It's a Gemini-20 Portable Milligram Scale AWS. Weighs down to 0.001g. I think it was around $25, not exactly sure. Follow the instructions when you get the scale on how to calibrate it.
2. You'll also need a calculator, pen & paper, dark colored towel (or piece of paper or cloth), and two small cups (like the kind that come with cough syrup). If you want to save your extra beads, you'll need an empty container for this as well.
3. Turn the scale on, place the small round tray on the scale and press the Tare button. This removes the weight of the small round tray. My scale came automatically set to grams but be sure that's what your unit of measure is (it will have a little "g" on the display). If it's not grams, there are instructions on how to change it.
4. If you are already bead counting, open a capsule of your current dose and pour the beads into one of the small cups. Then pour them onto the small tray on the scale. (I find it easier to pour from a small cup vs directly from the capsule, but you can try pouring from the capsule also.)
5. Note the weight displayed on the scale and write it down. This is your dose in grams. Also write down how many beads, and if this is the brand or what generic manufacturer it is. Ex: 60 beads = 0.057g - brand name Cymbalta. (made up these numbers to use as an example.)
6. Remove the tray from the scale, and pour the beads back into the capsule over your dark colored surface. This way you can see if any beads escape and you can use the tweezers that come with the scale to put them back in the capsule.
7. Now, open a full capsule and weigh the beads. Write this down and keep it as you may need it if you have to switch to a generic or switch generic manufacturers. Pour the beads back into the capsule.
A note about the scale - it will turn off after a short period of inactivity (which is annoying).
Weighing Your Dose:
(I usually weigh a week's worth of capsules at a time)
1. Turn the scale on, place the small tray on the scale and press the Tare button. The display should reset to 0.000g.
2. Open a full capsule, pour the beads into a small cup then pour then slowly onto the tray until the display reads close to your dose. Using the tweezers, add or remove beads to reach your exact dose. I've found that between 2 and 4 beads are needed to change the weight at least 0.001g. Sometimes the scale goes back and forth and you have to keep removing or and adding beads to get that right dose, which can be frustrating. I guess this happens because not every bead weighs exactly the same.
3. Try to keep the beads spread out evenly in the center of the tray. I've found this helps getting a more exact measurement.
4. Pour the beads back into the capsule.
5. I usually weigh mine twice just to be sure, so just repeat the steps above. The scale is very sensitive so even air blowing over it or breathing on it can affect the weight.
6. Pour the beads left in the small cup into your second small cup and begin weighing your next capsule.
7. If you are saving the beads, pour them into your container when you're done with all your weighing and label the container with the manufacturer and dose (20mg etc). DO NOT MIX beads from different dosage capsules or from different manufacturers.
Reducing Your Dose:
1. When you need to reduce your dose, you'll need to figure out how many micrograms you'll have to reduce it by.
2. If you were reducing by 10 beads, weigh 10 beads on the scale and see how many micrograms that is. Write it down.
3. Now, take your current dose (ex 0.057g) and subtract the weight of the beads you got in the previous step (ex 0.002g).
This will give you your new dose (ex 0.055g).
4. You can choose to reduce your dose by micrograms or you can also choose to reduce your dose by a percentage rather than number of beads. Take your current dose and times by a percentage then subtract the result from your current dose. (Ex 0.055g x 5% = 0.0275g. 0.055 minus 0.003 = 0.052g).
Changing from a Brand to a Generic or Switching to a Different Generic Manufacturer:
Ok, this truly drives me crazy! If you can, stick with the brand name or at least see if you can get the same generic manufacturer each time you fill your prescription. If you're like me and can't do either of these, here are some things I've found that may help ensure steady dosing.
Not all manufacturers have the same number of beads in a capsule, and the weight of the beads can also vary. I've discovered that some aren't even close. The beads in a 20mg capsule of the brand name weigh 0.106g. The beads in a 20mg capsule of the generic made by Citron weighed 0.124g. So if you need to switch and are weighing your dose, here's what you can do. Bear with me, this may seem complicated. It took me and my mom to figure it out, then running it by my pharmacist to be sure I was figuring it correctly. Whether you want to try this or not depends on how precise you want your dose to be. I seem to be very sensitive to any change in dose, so we came up with this to ensure the amount of medicine I was getting was consistent. If you switch manufacturers and just keep using your same dose in weight (ex 0.057g), you will probably be close to the same dose of medicine.
1. Open a full capsule of your current manufacturer and weigh all the beads. Write down the manufacturer and the weight.
2. Note your current dose in weight for this manufacturer.
3. Ex - full capsule = 0.124g = 20mg Citron generic current dose = 0.055g
4. Now divide your current dose by the weight of the full capsule (Ex 0.055 divided by 0.124 = 0.4435)
5. This translates into 44.35%. In other words, your current dose is 44.35% of the full dose.
6. Next, weigh the beads in a capsule of the new manufacturer you will be switching to.
7. Write it down. Ex - full capsule = 0.129g = 20mg Actavis generic
8. Now times that weight by the percentage. (Ex full capsule of new generic = 0.129g x 44.35% = 0.057g)
9. This weight (0.057g) will be your dose on the new generic. Again, write it down.
10. If you have to switch manufacturers again, follow these steps.
I know this sounds confusing! It still sounds confusing to me, and I've been doing this for a while!! But trust me, it does work! If anyone has any questions or suggestions, please let me know!