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Reducing doses more gradually than standard capsules allow

Magpie2
Contributor

Reducing doses more gradually than standard capsules allow

I want to share this because I think it's a good idea that may help others, but also to seek good or bad experiences if anyone else has tried it. 

 

I've been prescribed and discontinued several anti-Ds, and some of the wdr/discontinuation symptoms have been awful (I'm looking at you, brain-zaps/headaches). 

 

One of my current meds, which can tend to be brain-zappy when you stop, only comes in Xmg or Ymg capsules in Australia (sorry for the algebra, I'm using no numbers due to guidelines). The capsules are enteric coated so they don't get absorbed in the stomach, so can't be split to taper withdrawal more gently. 

 

I figure it'll be a whole lot easier to reduce by [a third of the smallest available capsule] at a time. It's easy enough to buy empty gelatine capsules online/in shops, but difficult to buy the enteric-coated/acid-resistant caps online in Australia (the only Australian site I could see looked a bit sus, so I called their contact phone number and it turned out to be as sus as it looks). 

 

My specialist doesn't want me to reduce the dose (and literally refused to even read my reasons why), but my GP did thankfully give me a script to get the medication in [third-dose] capsules, so that I can reduce by that amount at a time over several weeks. 

 

When I got to the pharmacy it was going to be $111 for 100 capsules, which is big bucks on zero income. Thankfully, they could sell the acid-resistant _empty_ capsules for $30 for 100 (and without prescription), so I've split some of the capsules I have and started the gentle reduction. 

 

If you've tried this, I'd really love to hear of your experience. I feel sad when there's literally no-one to talk to about this stuff because so many mental health services apply 'privacy' in a way that means you can't talk about medications at all. 

 

If you've wanted to try this but it has been impossibly expensive or Drs have resisted it, I'd be keen to hear of that too. 

 

If you haven't tried it, capsule packing isn't rocket science when you're dividing known quantities (ie if splitting a 40mg into 4x10mg, using normal care and caution).

*I don't use micro scales, but just 'eyeball' splitting the contents into 4 (or whatever).

*The pharmacist said to ensure you have perfectly dry hands/equipment when you do it.

*There's a clear 'click' when they're properly closed.

*As a precaution, I also checked with poisons advice on what happens if I screw up and the capsule bursts, and the worst that would happen would be upset stomach and reduced medication effectiveness. (It'd be a different story if a leaky capsule caused stomach injury or greatly increased the effect of the the med). 

 

If you have tried this and it didn't turn out well, or know of a risk I haven't considered, please lmk that too. 

2 REPLIES 2

Re: Reducing doses more gradually than standard capsules allow

@Magpie2 , I haven't seen you around in ages! How are you?

Re: Reducing doses more gradually than standard capsules allow

Hey

When I weened of anti-D or anti-P it was hard

I was able to split some pills though I don't think they had hard coating

All the best

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