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2 Failed Tapers. Very Sensitive To Drops. Advice Please.


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#271 Noush

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Posted 12 August 2019 - 12:52 AM

You are absolutely correct IUN. In order to have 50 beads less the beads would have to be larger in size to stray within the 10% dosage limit.


I'm confused now. So are you saying that even though the capsules have 50 beads less, the dose is the same, as the beads will be bigger?

If this is the case & I am counting 375 beads still, I will have gone up in dose to approx 48mg. Is this right?

#272 invalidusername

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Posted 12 August 2019 - 07:00 AM

"I'm confused now. So are you saying that even though the capsules have 50 beads less, the dose is the same, as the beads will be bigger?"

 

Yes - if you had 60mg in 200 beads, each bead would have 0.3mg.

 

If you had 60 mg in 100 beads, each bead would be 0.6mg, so you would need half the amount of beads from this capsule to get the same dose as you would from the first capsule.


#273 Noush

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Posted 12 August 2019 - 08:12 AM

How can this be the case? Then surely the bead counting theory wouldn't work? If for example I was weaning at a rate of 1 bead per day & I finished a pack on 375 beads but then my next pack has only 355 bead in but equates to the same mg as the previous 375 bead pack, you wouldn't been bead counting down to 374, then 373??? Very confused now!

#274 invalidusername

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Posted 12 August 2019 - 08:19 AM

If you are doing a bead per drop, then no, this wouldn't work as you would in effect need to split a bead in half... which of course you cannot do. 

 

The only way is to get the same pharma as before to ensure you are dropping at the same rate. If you have less beads and still drop 1 bead, then yes, you will be doing a larger drop than before.


#275 fishinghat

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Posted 12 August 2019 - 09:11 AM

If brands are switched by your pharmacy then you have to count the beads in the new brand and do some math to figure out a 'bead equivalence'.

#276 Noush

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Posted 12 August 2019 - 09:37 AM

Ok. So I think you may both have the wrong end of the stick here. May be I wasn't very clear. The brand hasn't changed at all. I have it on my prescription that it must always be the same. It is only the AMOUNT of beads within the capsules that differ per pack. So last month's pack had on average 375 beads per capsule & this month's pack has on average 325 per capsule. As I have been wanting to stay on the exact same amount if beads to be stable, I have stayed at 375 beads per capsule since January. Therefore, this month I have had to add approx 50 beads to each capsules.

So by what IUN is saying, by adding 50 beads, I have just increased my dose by approx 8mg??? Surely this wouldn't work in the case of bead counting?

#277 invalidusername

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Posted 12 August 2019 - 09:54 AM

Right I am with you now. So it is the same brand, but just new pack. New pack has a different amount of beads. This is where we would have to assume that they are going by weight and that the amount of medicine in each bead is the same regardless of how many beads there are in a capsule.

 

Therefore, if you have added beads, then I would say you have indeed added to the amount you were taking before. 

 

See what Hat has to say on the matter too...


#278 Noush

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Posted 12 August 2019 - 09:55 AM

FFS!!!

#279 fishinghat

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Posted 12 August 2019 - 11:52 AM

I would like to know what brand you use. Some brands have more than one facility that produces their meds. So you may be going along great and then suddenly the number of beads change even though the overall dose does not. That is unusual though and I have only heard of it one time before. (Teva brand).

#280 Noush

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Posted 12 August 2019 - 12:08 PM

I would like to know what brand you use. Some brands have more than one facility that produces their meds. So you may be going along great and then suddenly the number of beads change even though the overall dose does not. That is unusual though and I have only heard of it one time before. (Teva brand).


The brand is Yentreve.

#281 fishinghat

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Posted 12 August 2019 - 12:33 PM

Yentreve is the name of the drug. I would like to know the manufacturer's name if you can find it. It should be on your prescription bottle somewhere. If you can't find it that's Ok too.

#282 Noush

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Posted 12 August 2019 - 12:41 PM

I will check in an hour once I get home. But I have a feeling it is TEVA that is on the foil packaging of the capsules. It is is really important that I figure this out, as I am so sensitive to the dosage changes.

#283 Noush

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Posted 12 August 2019 - 01:42 PM

Yentreve is the name of the drug. I would like to know the manufacturer's name if you can find it. It should be on your prescription bottle somewhere. If you can't find it that's Ok too.


Eli Lilly are the manufacturer. Produced in the Netherlands according to the box???

#284 fishinghat

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Posted 12 August 2019 - 02:01 PM

Understandable. Eli Lilley had 6 different manufacturing facilities the last time I researched it. Each facility must follow the patent but it only specifies a range of sizes so some facilities produce smaller beads than others.

#285 Noush

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Posted 12 August 2019 - 02:11 PM

Oh bloody hell, really?

#286 Noush

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Posted 12 August 2019 - 02:17 PM

So what does that mean I should be doing? I have been bead counting 375 beads every day, to stay at the exact same dose of 40mg for the past 7 months. Usually the capsules only differ 15 - 20 beads +/-. However the last 2 boxes I have had much less beads, with the last box averaging only 325 beads per capsule.

Any advice would be much appreciated.

#287 invalidusername

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Posted 12 August 2019 - 02:32 PM

Are these 60mg capsules that have 325 beads in?

 

If so 216 beads will give you 40mg...


#288 Noush

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Posted 12 August 2019 - 02:36 PM

No. I have the 40mg capsules. My current 40mg capsules have 325 beads in. Last month's box of 40mg capsules had 375 beads in.

#289 Noush

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Posted 12 August 2019 - 03:13 PM

Understandable. Eli Lilley had 6 different manufacturing facilities the last time I researched it. Each facility must follow the patent but it only specifies a range of sizes so some facilities produce smaller beads than others.



So what would you recommend that I do going forward Hat? I have been bead counting 375 beads every day, to stay at the exact same dose of 40mg for the past 7 months. Usually the capsules only differ 15 - 20 beads +/-. However the last 2 boxes I have had, have had much less beads, with the last box averaging only 325 beads per capsule.

#290 fishinghat

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Posted 12 August 2019 - 04:35 PM

I hate to say this but each new batch you will have to do a bead count and use some math to adjust the number of beads you take. It is no wonder so many people have so much trouble when weaning at low doses.


#291 Noush

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Posted 12 August 2019 - 04:41 PM

So if I am extremely sensitive (as we know I am), could this be the reason that I have had issues when only dropping 18 beads? Because every time I get a new pack the bead count is different? But I have been assuming I need to work on the same amount of beads?

As I have only been on this pack around 3 weeks, how quickly would you drop back to the amount if beads in the current capsules Hat?

#292 invalidusername

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Posted 12 August 2019 - 04:43 PM

But if they are marked up as 40mg, then there is nothing for you to do. By counting the beads to get the same each time, you could be messing up the gross weight of the duloxetine inside each pellet.

 

Am I missing something? I don't see an issue with taking them as they are.

 

If you go count each of the new ones to get 325 beads thinking it will help, then do so, but as said before, you could be making things worse.


#293 Noush

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Posted 12 August 2019 - 04:59 PM

Well here I am, wide awake after only 3 hours sleep, with my heart pounding again, unable to sleep, even though I am exhausted! My sister kindly counted the number of beads in a capsule out of my current pack for me which was 354 beads. Before I reinstated, I had dropped down to 358 beads!!! My capsules at the time had between 370 & 380 beads in. Therefore, it seems that I've probably done a 5% drop in beads pretty much over night! Bingo! Looks like I have found the reason for the racing heart & insomnia again. Yo-yoing up & down in beads. So I'm going to bead count my capsules to 375 to see if that resolves matters.


This was my post from earlier in the year IUN & then you agreed that counting 375 beads in each new capsule was a good idea going forward. No mention of the change in number of beads being due to the size of beads or the weights. Therefore, that is what I have been doing ever since. Not at any point has anyone ever mentioned that when starting a new pack, I would need to take a new average of beads. So I'm even more confused now.

#294 invalidusername

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Posted 12 August 2019 - 05:38 PM

The problem here is that we do not know. This is why in both replies I have said it could be, and the first reply would be an experiment. Hat, Vin and myself have been discussing this at length about the use of sieves in the process. It is very complex. 

 

Either way you approach this could be better than the other - this is what we have since learnt - but you would have done no harm in counting the beads before this. If counting the same amount of beads has worked for you in the past, the stay with this - but you could try not counting and due to the variance in bead size and coating, there may be no difference. 

 

Poor Vin is down to 2 beads and trying to get just these 2 beads to have the same content - he is also that sensitive. We have concluded that, like the situation here, is not possible to be 100% sure.

 

I am truly sorry if I have confused you, but both Hat and myself are constantly learning about this stuff for the benefit of everyone else. So what I said in first reply still may be right, but then the sieves they use may be well calibrated and the weights might be very close indeed, but this is impossible to tell. All we know is that it has to be within 10%. So you can try either method, but in both cases, they will be an experiment.


#295 Noush

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Posted 13 August 2019 - 01:10 AM

10% of what IUN? 10% of the amount if beads or weight of the capsule? If it was bead count then it us definitely out of the 10% tolerance, as that would've been 37 beads +/-.

I know you're both still learning as you go, me too & I have been on this stuff for 6 years now! So I should be a vet!

Oow I haven't seen Vin's posts. Is he as sensitive as me?

#296 invalidusername

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Posted 13 August 2019 - 07:50 AM

The 10% goes on the weight, which is why some people choose micro scales during their withdrawal.

 

VinPin is extremely sensitive - you can find his thread here;

 

https://www.cymbalta...ff-my-last-2mg/


#297 fishinghat

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Posted 13 August 2019 - 09:03 AM

"could this be the reason that I have had issues when only dropping 18 beads? Because every time I get a new pack the bead count is different?"

It could be and a 18 bead drop is a huge drop. Most only drop 1 or 2 beads at a time.

OK, lets step back and take this one step at a time. Your previous supply was 375 beads and your new one is 325 beads per capsule. Both are 20 mg doses right?

#298 Noush

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Posted 13 August 2019 - 09:26 AM

"could this be the reason that I have had issues when only dropping 18 beads? Because every time I get a new pack the bead count is different?"

It could be and a 18 bead drop is a huge drop. Most only drop 1 or 2 beads at a time.

OK, lets step back and take this one step at a time. Your previous supply was 375 beads and your new one is 325 beads per capsule. Both are 20 mg doses right?


No Hat. They are 40mg capsules. One pack had 375 beads per cap one pack had 325 beads per capsule. Both packs are 40mg.

When I weaned I was weaning 1 bead per week. When I got to week 18 (18 beads down in total) I got horrific withdrawal.

#299 fishinghat

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Posted 13 August 2019 - 11:09 AM

Sorry, I have got it. So if you went down 18 beads from 375 mg capsule then that was equal to a 4.8% drop.

So if you remove 15.6 beads from the 325 mg capsule that would be a decrease of 4.8% as well. I would suggest you do a 16 bead drop (obviously you can not drop 15.6, lol) and when stable continue to drop at the one bead rate.

I am sorry about the confusion. I not only deal with a lot of similar scenarios here but also in my PMs. Don't ever be afraid to correct me or challenge me. That is OK.

#300 Noush

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Posted 13 August 2019 - 11:54 AM

Sorry, I have got it. So if you went down 18 beads from 375 mg capsule then that was equal to a 4.8% drop.

So if you remove 15.6 beads from the 325 mg capsule that would be a decrease of 4.8% as well. I would suggest you do a 16 bead drop (obviously you can not drop 15.6, lol) and when stable continue to drop at the one bead rate.

I am sorry about the confusion. I not only deal with a lot of similar scenarios here but also in my PMs. Don't ever be afraid to correct me or challenge me. That is OK.


Sorry Hat, I'm not following. Are you saying that in your opinion the capsule with 325 beads in & the capsule with 375 beads in, will both still equate to 40mg?

Please bare in mind that I am not weaning at present. I have been on 375 beads (40mg) since January & planned to stay at that until the end of the year to give my brain a rest.



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