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Switching Generic Brand During Taper


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#151 fishinghat

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Posted 20 October 2018 - 07:22 AM

Juli's description of stable is a good one. Your body will let you know when it is ready.

 

I believe we have already talked about a 4 or 5 week tapering/crossover schedule before but if not let me know.


#152 gardenlady

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Posted 05 December 2018 - 02:42 PM

fishinghat,  Teva Pharmaceuticals is out of stock of duloxetine.  What other generic brands in the U.S. make the drug with microbeads? I may have to switch generics yet again due to non-availability.  


#153 fishinghat

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Posted 05 December 2018 - 04:46 PM


Solco - 146 - 157 beads Yes

Prasco - "Large number of beads" Yes

Teva - Approximately 315 beads Yes

Citron - Small beads, approximately 300+ Yes

Cymbalta - 250 to 350 beads Yes

* Yes indicates that this brand is available in the USA.

#154 gardenlady

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Posted 13 December 2018 - 07:34 PM

Does anyone have a 20 mg TEVA generic brand capsule s/he can weigh for me, beads only? Or, a 30 mg Citron generic capsule, beads only?

 

I am having to switch to Citron brand from TEVA brand generic because TEVA is backordered and may no longer be available. However, the weights aren't making sense. A 30 mg TEVA (beads only) weighs .264 on my gram scale. The Citron 20 mg (beads only) weighs only .124 g. I don't have a Citron 30 mg or a TEVA 20 mg to weigh, so am having to compare, proportionally. However, these proportions don't make sense.

 

20 mg is 2/3s of 30 mg. So, if a TEVA 30 mg weighs .264 g then logically, a 20 mg should weigh .174 g. However, the Citron 20 mg weighs only .124 g. Something is wrong. 

 

The bead sizes are different...the TEVA beads are larger than the Citron beads. But, the weights should be the same, or shouldn't they?  Perhaps that assumption is incorrect.

 

Can anyone help me figure this out? I need to determine how to switch from TEVA to Citron, but can't if the weights aren't proportional.


#155 fishinghat

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Posted 14 December 2018 - 10:06 AM

"But, the weights should be the same, or shouldn't they? Perhaps that assumption is incorrect."

You are not the first one to notice this type of anomaly. Many have noticed that with their version of Cymbalta that the beads in a lower dose weight considerably less than expected based on in the larger dose.

I spoke to Eli Lilley once about bead counts and bead sizes. They said this is to be expected. Once a bead is made with the right amount of medicine they are then coated. The thickness of the coat is the same on a small bead (smaller dose) as a larger bead (larger dose. Because of the smaller surface area on a smaller bead there is less coating and the bead will weight proportionally less than a bead from a larger dose. I understood what she said BUT why produce a smaller bead for a smaller dose. Just use the same size bead in all doses and simply alter the number of beads in each different dose.

Anyway, I probably confused you even more. Sorry.

#156 fishinghat

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Posted 14 December 2018 - 10:08 AM

You definitely need to read this. I think it may explain all.

https://www.cymbalta...g-beadspellets/

Also a note from a member said...

ncmom - Prasco Labs is the manufacturer and that is the same manufacturer for the previous 30 mg. and 60 mg. prescriptions that we filled and we filled it at the same pharmacy. However, I thought that I had figured there were about 6 beads per milligram in the previous capsules. For example, the 30 mg. capsule had about 185 beads as I recall. That's roughly 6 beads per milligram. But, when I opened the new 20 mg tablet it only had about 108 beads, not 120.

#157 gardenlady

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Posted 14 December 2018 - 01:07 PM

Yes, thank you fishinghat.  This writer is explaining what I already knew.....that bead counts differ widely both within and between manufacturers.  So, she suggests weighing them vs counting.  But, that's the problem, the weights differ between generics.  She doesn't address that issue.

 

How do I switch generic brands when the weights don't match up?  How do I know how much of the Citron brand to take when its weight is different from Teva brand?


#158 fishinghat

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Posted 14 December 2018 - 02:26 PM

Start from scratch.

You have been taking 30 mg TEVA (beads only) which weight .264 g on your scale, right?
How much weight have you been dropping?

#159 gardenlady

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Posted 14 December 2018 - 03:16 PM

Yes.  Current Teva dose is ~22.2 mg/113 beads/.192 gram weight. Teva has roughly 5.1 beads/mg.

Citron capsules are 20 mg/avg 116 beads/avg .122 gram weight. Citron has roughly 5.8 beads/mg.

 

I have been dropping 2.5% gram weight per week.  So, last drop was .197 gram weight down to .192 gram weight on Teva brand. 


#160 invalidusername

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Posted 14 December 2018 - 03:54 PM

Its all very well saying the enteric coating is uniform, but that cannot be the case for the generic I have seen. Some beads being half the size of others. There is also bits of coating that has chipped off and included in the capsule, so if they were weighed, this can obviously be a key issue.

 

There are a number of "dodgy" pharma companies over here in the UK however. From those that might as well be set up in a parent's basement, to those that simply outsource to India and import without any suitable checks. During my Dulox days, I am quite sure I never had the same pharma twice.


#161 gardenlady

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Posted 14 December 2018 - 04:41 PM

Its all very well saying the enteric coating is uniform, but that cannot be the case for the generic I have seen. Some beads being half the size of others. There is also bits of coating that has chipped off and included in the capsule, so if they were weighed, this can obviously be a key issue.

 

There are a number of "dodgy" pharma companies over here in the UK however. From those that might as well be set up in a parent's basement, to those that simply outsource to India and import without any suitable checks. During my Dulox days, I am quite sure I never had the same pharma twice.

Yes, that's unfortunately the case.  But I have to figure out a way to work with what I have. 


#162 fishinghat

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Posted 14 December 2018 - 05:51 PM

Yes.  Current Teva dose is ~22.2 mg/113 beads/.192 gram weight. Teva has roughly 5.1 beads/mg.[/size]
Citron capsules are 20 mg/avg 116 beads/avg .122 gram weight. Citron has roughly 5.8 beads/mg.[/size]
 
I have been dropping 2.5% gram weight per week.  So, last drop was .197 gram weight down to .192 gram weight on Teva brand. [/size]


If you go straight to Citron  20 mg (full capsule) that would be to big a drop at once. The last drop on the Teva was a 0.005 gram drop or about 0.56 mg dose of medicine. If you go straight to the 20 mg Citron that would be a 2.2 mg drop and that would be too much. So you are going to wind up taking a 20 mg Citron (20 mg of Cymbalta) plus a little mote. A 22.2 mg dose of Citron would be a full capsule and 2.2 mg more. 2.2 mg would be 12.7 beads of Citron.

 

So...I would do a 20 mg Citron plus 13 beads to start with and then continue to drop from there.


#163 gardenlady

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Posted 14 December 2018 - 06:58 PM

If you go straight to Citron  20 mg (full capsule) that would be to big a drop at once. The last drop on the Teva was a 0.005 gram drop or about 0.56 mg dose of medicine. If you go straight to the 20 mg Citron that would be a 2.2 mg drop and that would be too much. So you are going to wind up taking a 20 mg Citron (20 mg of Cymbalta) plus a little mote. A 22.2 mg dose of Citron would be a full capsule and 2.2 mg more. 2.2 mg would be 12.7 beads of Citron.

 

So...I would do a 20 mg Citron plus 13 beads to start with and then continue to drop from there.

Thanks, fishinghat!  That's just what I needed to know.  Fortunately, I have hundreds of loose beads of both Citron and Teva brand beads.  I've kept them in separate plastic snack bags.  So, I have plenty of each to bridge me.  Thanks again for being such an angel, as I realize you're suffering like rest of us.  You are a dear man!!!


#164 fishinghat

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Posted 15 December 2018 - 09:23 AM

Thank you for the kind words Gardenlady. Always glad to help.

#165 gardenlady

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Posted 06 September 2019 - 11:43 PM

fishinghat, Just checking in with you as I am now down to 44 beads/8.5 mg and cutting 1 bead per week.  It's been pretty brutal without easing up of symptoms.  The main ones are existential doom, dread, despair, depression, fear, terror, insomnia and akathisia (both internal and external).  I've had to isolate myself completely as it's just too hard to be around people....even casual conversation with people I know well is difficult.  My personality is unrecognizable from what it was prior....I'm negative, whiney and overall unpleasant.  I'm not able to go anywhere where there are crowds such as church or other group-type settings.  Casual chit chat conversation is nearly impossible.  It's odd as I really need to be around people, but cannot.  The isolation is doing something to me that's hard to explain...nothing positive.  

 

I do take hydroxyzine, but have to use it judiciously, otherwise it begins to lose its effect and doesn't give relief.  So, I can't take it every day for that reason.  Because of the very slow taper rate that my symptoms dictate, I have perhaps another two years of tapering ahead of me....I'll probably need to slow to 1 bead every two weeks at some point and then perhaps go even slower after that.  It's hard to imagine bearing up under these dreadful symptoms for that long not to mention post-taper healing that will be required.  

 

As you've been observing people tapering for many years now, is it usual for the doom/dread symptoms to remain all the way down to the end of the taper?  My guess is that this will be my case as I've had no let-up since I began.  Just wondering if it will ever ease as it's hard to have any quality of life feeling this way all the time with no break.  Do people ever get over it?


#166 invalidusername

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Posted 07 September 2019 - 12:41 PM

Wow this is harsh GardenLady - my sympathies are with you. In my darker times I can certainly empathise as I too find social chat invasive and all I want to do is locked myself away from the world. Crowds for me are right out as well. Were even before this latest episode. You need to find some confidence in something to bring you out of the hole a little. My wife is slowly coming out of her place which is a diluted version of your own since she stopped Lexapro. She is going forward with a combination of talking therapy, occasional benzos and daily doses of Kratom. This is the best she can hope for at the moment and she is seeing some glimmers of hope. 

 

I know there is some doubt over Kratom, but it is legal and used for medicinal purposes in your state. Given the place where you are, I would like to suggest a trial of it, but that is all I will say as I understand everyone's opinion. Have a read of the latest from the AKA here;

 

https://www.american...rg/science.html

 

If you would like any further help regarding this at all, please ask me as I went through a LOT of information before I tried it. My wife and I have been taking it since December and we both agree we would be nowhere like where we are if it wasn't for the support of it...

 

Wishing you all the very best - and no doubt Hat will be along later with his sage advice.

 

IUN


#167 gardenlady

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Posted 07 September 2019 - 06:57 PM

Thanks, IUN, for your response.  I am staying away from any substance such as Kratom as it has the potential to only pour gasoline on the fire.  I've read too many horror stories of people trying to get off of it once they got hooked on it.  I truly hope this won't be the case for you and your wife. 

 

I'm hoping that fishinghat will respond as his visibility over the long term watching people get off this dreadful drug is so rare and valued.  


#168 fishinghat

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Posted 07 September 2019 - 07:20 PM

High gardenlady. I have been wondering how you have been doing.

"is it usual for the doom/dread symptoms to remain all the down to the end of the taper?"

Mine lasted 9 months past the last dosage but that is very rare. Normally 2 to 4 months past the last dose with a slow fade during that time. If it takes 2 years so be it. There is no need to rush.

God bless

#169 gardenlady

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Posted 07 September 2019 - 07:44 PM

Thanks, 'hat!  I was afraid you'd write what you did, but, that's just the way it is.  I'm surviving by just trying to get though each day, but I must say that at this age (66), it's pretty depressing thinking of what a long road I have ahead of me seeing that I'm already in the fourth quarter of life.  God bless you, too, kind friend.


#170 invalidusername

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Posted 07 September 2019 - 07:56 PM

I fully respect your opinion GardenLady, and being only too aware about the dangers of addiction, which is why I only use Kratom medicinally and not recreationally. I should also state for the record for anyone reading this that if one is of a addictive disposition it is far better to avoid purely for the reason you said...

 

Again, I am so sorry to hear of your ongoing saga with the described troubles. I really hope there is some hope for you on the horizon. Time is a good healer, and the plasticity of our gray matter will ensure that things do improve. Meanwhile, it is the kindness of people such as our Hat and our strength through faith that we are able to continue.

 

Please keep in touch.


#171 gardenlady

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Posted 07 September 2019 - 11:23 PM

Oh, my.  Of course I knew that you were using the Kratom only for medicinal purposes for your withdrawal.  However, just like benzos and ADs, it can still cause physical dependance -- differentiated from psychological addiction-- resulting in difficult withdrawals.  It's all too common to become physically dependent yet not psychologically addicted to benzos and ADs (as was the case with me) in addition to Kratom, Lyrica, gabapentin, opiates and many other such drugs.  It doesn't require a predisposition to addiction to still have a problem with physical dependence resulting in severe withdrawals.  I've read about many such cases with Kratom on Benzo Buddies from people who took it for relief in benzo withdrawal.  However, you may be one of the fortunate ones to not have such difficulties with physical dependance resulting in a difficult withdrawal and I certainly do hope that's the case!

 

I have no addictive predisposition and was never psychologically addicted (as in cravings/abuse) to benzos or ADs, yet my withdrawals have been and are as fierce and gruesome as that of anyone who was.  My physical dependence on these prescribed drugs has wrecked my life as thoroughly as if I had been psychologically addicted even though I wasn't.  And, that is certainly the case for everyone on this forum who is battling Cymbalta withdrawal.  Unfortunately, our bodies don't know or care whether our intention in using a drug is for medicinal or recreational purposes....they will react as they will and we must deal with the fallout.

 

I write all of this with the utmost respect and do hope for nothing than the very best outcome for all of those suffering the ravages of Cymbalta withdrawal.  This site is a wonderful help to those of us on this painful path and I'm grateful for the kindness and sympathy of all involved with it. 


#172 invalidusername

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Posted 08 September 2019 - 08:23 AM

"Unfortunately, our bodies don't know or care whether our intention in using a drug is for medicinal or recreational purposes....they will react as they will and we must deal with the fallout."

 

Some truly wise words if they were ever spoken...

 

Thank you for your message - and once again you are absolutely right. With regards to the Kratom, I take it maybe 3 times a week, but I can take it or leave it. From what I know of the use, this level of dosing it very unlikely to cause a dependence. However, it is, as you say, just like any other medication that can become dependent. In my eyes however, it is far better than turning to benzos or similar. This is how I found it in the first place; I wanted an alternative to the benzo. By comparison, Kratom is like a walk in the park to stop than a benzo, and given that I have been through my fair share of withdrawals and cross-tapers, it does not worry me. I will continue taking it for as long as I feel I need. If that is another week, another year... it matters not. If it helps me recover, then it is a good thing - provided I keep the dependence/addiction in the forefront of my mind.

 

I echo your words about all those suffering, and once again, my every sympathy - I will remember you in my prayers.





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