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Help With Weaning Cymbalta Generic: Uneven Number Of Beads


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#1 moejoe

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Posted 16 July 2016 - 05:22 PM

Hi, I am new here and having problems weaning off my generic Cymbalta by Citron. I am trying to do the bead counting method and am going very slow because I am super sensitive and have been on this med for 12 years. In another group they said you should count the balls in 3 capsules ang take the average of that. So I counted an average of 385 balls. I decided to come down 3 percent a week so in a month I came down 10 percent. I went to get my second months pills and this time my capsules are only averaging 350 balls! So that is the same amount that I had tapered down to! The other group I am I said you should count the balls you put back in, not the amount that you take out because of the uneven number of balls in each capsule. But one of the capsules only had 344 balls, so that is even less than what I had spent a month tapering down to! Is it normal to have the same generic have that much variation between the amount of balls in each capsule? This month I am removing way less balls than I did the first mont and some even came up short? I basically feel like I have just reinstated the whole dose! I am thinking maybe a scale would be more accurate. Does anyone know? I asked this question in another group and am just not getting much help.

#2 fishinghat

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Posted 16 July 2016 - 07:08 PM

This is one of the big problems with the generics. Many of these companies contract the production to off-shore facilities in Israel, Aruba and other countries. Some times they but the capsules from one facility one month and the next month they get them from a different facility because cheaper. Given the variance allowed in the manufacturing of meds and the inconsistent bead counts it makes an even slow wean very difficult, Each individual refill will have come from the same facility. To do it correctly you would have to count the number of beads in you first supply (which you did) do your drop and then before you start the next bottle of capsules calculate the mg drop (which you also did). With the next refill you would have to count the beads again and calculate how many to take out in order to get to the same dosage you have been at. Then calculate how many beads to do that 3% drop per week.

 

We had one member a few years back that went from Cymbalta (around 320 beads if I remember right) to a generic with like 117 beads. Being math challenged it was a difficult road for the person. This is one of the reasons why those on generic, in general have a harder withdrawal.


#3 Carleeta

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Posted 17 July 2016 - 09:38 AM

You know Fishinghat it's quite interesting to hear the beads being counted out and just putting a certain number in vs taking a certain number out.  I wonder if this would alleviate some of the issues like the one above stated.  hmmmm.  It has me thinking if this might be considered at times when different brands arre given instead of the consistency of one brand.  Do you think this might be another option? 


#4 fishinghat

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Posted 17 July 2016 - 04:15 PM

I agree Carleeta. That only works if you have a similar number of beads. If your brand has three hundred beads and you are taking out a hundred then what about the next month if there is only 20 beads?  A lot of math on those kind of situations.


#5 moejoe

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Posted 17 July 2016 - 04:23 PM

Thank you soo much for your replies! I have been so frustrated and just not getting any answers. So are you saying since my second months capsules averaged only 350 balls, I should take 10 percent off of that, and that would equal the 350 balls that I had tapered down to from my first months total of 385 balls. I hope this is making sense, I am not sure how to word it. But basically I would end up with 315, minus the 3 percent a week. I know my other group I am in said to count three capsules to come up with an average number of little balls. But I would have to do that every month, right? I can't believe there was such a difference from one month to the next, and this is the same generic both times!

#6 fishinghat

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Posted 17 July 2016 - 04:34 PM

Your math is correct. Next month check the number of beads again and adjust accordingly.  I was just reading an article that some of the Indian, Israeli and Aruba facilities can be as bad as + or minus 24% in dose within the same batch. The next five beads you counted might have been 385 instead of 350....in the SAME bottle. As if medicine was not enough of a hassle already.


#7 moejoe

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Posted 17 July 2016 - 04:46 PM

I obviously screwed up before so I am going to have to start completely over. I was under the impression that you put back the same amount of beads so I am at 350 balls now which is basically the full dose! Since there is such variation would it be better to count each individual capsule and then make the calculations on each pill? Even in this months pills I have averaged between 344 balls up to 369! Wow, I can't believe they can be 25 percent different! I guess that is why I have felt so awful on this med, especially since they'd switched me to generic last January! I felt like I was in withdrawal even taking the whole dose! I have ordered a scale but haven't gotten it yet so I will have to find out if that seems like a more reliable way. I talked to a compounding pharmacist and he did say he thinks weighing is more reliable, but the really precise scales cost a fortune! So I am basically back at square one and will start tapering again soon. I really appreciate your feedback! This has been so confusing! Also, I know a lot of people are just taking a certain amount of balls out of the capsule for each reduction, instead of counting all the balls and putting a certain number back in. With such a variance of total balls do you think it's better to count the balls you take out or the balls you put back in?

#8 fishinghat

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Posted 17 July 2016 - 07:15 PM

Well I just typed a reply for 15 minutes just to see it disappear.  Urggg. Basically your right but when a drug effects nearly all systems of the body including RNA and glutamate function I want to be informed ahead of time so I can make an informed decision. No surprises down the road.


#9 fishinghat

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Posted 17 July 2016 - 07:18 PM

PS - You should read that article I linked on 'Match a word' today. It is about the variation in medicine manufacturing.


#10 moejoe

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Posted 17 July 2016 - 07:30 PM

How would I find the article?

#11 emoothart

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Posted 18 July 2016 - 02:24 AM

Even in this months pills I have averaged between 344 balls up to 369! Wow, I can't believe they can be 25 percent different! I guess that is why I have felt so awful on this med, especially since they'd switched me to generic last January! I felt like I was in withdrawal even taking the whole dose!

 

That is a huge variance!  I wonder if that is why I had such awful "side effects" when I tried a generic?  I could only take it for a week and then had to get my doctor to write a script for brand!


#12 fishinghat

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Posted 18 July 2016 - 08:19 AM

Here it is Moejoe...

http://safemedicines..._inequality.pdf


#13 Carleeta

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Posted 18 July 2016 - 10:21 AM

How would I find the article?

On the main page you will find :Nutritional Support.....click on this and go to the forum called Mind Support; Drop a Word add a Word.....there you should find what Fishinghat has posted for you.....and for us....lol lol lol


#14 moejoe

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Posted 18 July 2016 - 03:51 PM

Wow, this article just makes me sick! I was on brand name Cymbalta for 12 years and then all of a sudden my doctor refused to pay for it because it came out in generic. My doctor even tried to write a letter specifying mu prior suicide attempts when switching drugs and they still refused! So I am stuck on this awful generic that I feel terrible on so that makes the withdrawal so much worse.

#15 Carleeta

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Posted 18 July 2016 - 07:49 PM

MoeJoe, yes it's horrible. It's bad enough we were prescribed Cymbalta, and the to go from the original to the generic.  It's ironic Fishinghat posted this article as I just had this conversation with my doctor about about a month ago.  My psychiatrist was a pharmacist prior to even becoming a MD then a psychiatrist. The story he explained to me was just eye opening.  It doesn't even end there because as the new generics come out they could even with less of what the last generic had.  It's horrible.  Just try and stay with the same generic you have been using.  Check all pharmacies before filling your prescription and make sure it's the same company you are currently using.... 


#16 moejoe

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Posted 18 July 2016 - 11:55 PM

Carleeta, My pharmacy did try to suddenly switch to a different generic and I had a fit so then they said they could order the same one in. I am thinking of hiring a compounding pharmacist to make up my doses but he uses the Teva generic and I am scared to switch again. He is far away so I would have to have it mailed to me. I hate how pharmacists and doctors say the generic is the same thing as the brand name! Bad thing is my husband believes it too! He just thinks I'm being paranoid. And he doesn't believe anything he reads on the Internet.

#17 fishinghat

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Posted 19 July 2016 - 08:09 AM

I don't know about other places but here in Missouri it is law that a pharmacy must inform their patients if they change brands. I don't know if it helps much but at least it puts us on alert for any issues that develop.


#18 Carleeta

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Posted 19 July 2016 - 09:31 AM

MoeJo and Fishinghat, here in NYS the pharmacist has to tell you also.  They actually tell you once it's in your prescription has been refilled.. they did tell me prior to paying for it.  At that point I didn't have much of a choice but to take it...... 


#19 fishinghat

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Posted 19 July 2016 - 10:02 AM

Here you can refuse a prescription at time of pick-up as long as you don't open it.


#20 Carleeta

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Posted 19 July 2016 - 10:41 AM

Oh yes here too Fishinghat.  Although, if it's something you need and the prescription can't be forwarded somewhere else like a controlled sustenance, valium or ambien, you sort of have to take it.  NYS is very strick on their controlled substances.  We are the worse here.  It's a good things for some who abuse the medications and it's bad for the person who needs it filled every 30 days on the dot.  You can't get it a day early at all.  Just right on the day.  So if the pharmacy decides to carry another generic brand you sort of 'don't have a choice' but to take it.  Dr's here will not write out another prescription because of the controlled laws.  It can be frustrating......  


#21 fishinghat

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Posted 19 July 2016 - 12:51 PM

Valium and Ambien controlled substances in NY? Really?  They are not here. Only the narcotics are controlled substances.


#22 moejoe

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Posted 21 July 2016 - 12:17 AM

Here I Idaho they don't inform you if they switch generics. I only found out by looking at the fine print. Of course the pharmacists say they are all the same.

#23 Carleeta

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Posted 21 July 2016 - 09:19 AM

Yes Fishinghat, Valium, Ambien xanax, darvon, darvocet, ativan, tramadol, and other and considered a controlled substance here nys.  Therefore we have to have get a drs.prescriotion (new one) every 30 days on some and others medications can have a dr write 2 refills on them, although they can only be dispensed every 30 days and the state has records of this and the pharmacies are hooked up to NYS regulations.  The drs prescribing the medication need to send their copies into the state.  It's not easy to get medications here in NYS especially if you are one who abuses them....

 

Moejo, they don't even tell you when they are handing it to you? 


#24 moejoe

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Posted 23 July 2016 - 04:55 PM

No, they don't tell you when they are switching generics. They didn't even inform me when the generic first came out and they tried to switch to the generic. For some reason my insurance still paid for the brand name for a year but then I got a letter from my insurance company saying they wouldn't pay for the brand name anymore. My doctor tried to write a letter to the insurance company telling them I need to have brand name. She explained to them that the last time I tried to get off Cymbalta I tried to commit suicide twice. They still wrote back and said they wouldn't cover it unless I tried 3 other antidepressants first and they failed. One was Effexor, one was Pristiq. I can't believe they still said I should just switch when I had such a horrible reaction before to switching or changing doses of this med! It's just infuriating!

#25 Carleeta

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Posted 23 July 2016 - 05:24 PM

MoeJoe, It's horrible what the insurance company is doing to you.  It's just not fair.  At lease you have a dr. which will keep trying for you.  Thank God you are not in NYS the doctors here won't even try.  





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