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Multiple Doses

CAUTION: The information contained in this document comes from the personal experience of laypeople and is not intended to constitute medical advice. Do not attempt to stop or taper benzodiazepines without first consulting a doctor.

Water Titration Multiple Dose Directions

MULTIPLE INTER-DAY DOSES 

When taking benzodiazepines with short half-lives it may be desirable to take doses at different times of the day. 

Multiple doses can be taken as part dry and part liquid or entirely in liquid form.   Taking your dose as both dry and in liquid form allows for the maximum dilution of the medication using the least amount of water and is the preferred method using the materials recommended. 

Method 1 – One large titration:

Advantages: Relatively easy to understand.  Use just one schedule.  Provides for even dosing throughout the day.

Disadvantages: Requires the use of additional equipment such as large home blender or large Tupperware container, and additional smaller containers to store multiple doses. 

This method works by diluting your entire daily dose into one large volume of water.  You would then split the “drink” portion of your liquid into equal amounts throughout the day by pouring them equally into multiple small capped containers. 

Here’s how you do it…

Combine your entire daily dose and dissolve all of it with water.

In the “dry dose” header portion of the spreadsheet you would enter a value of 0 (zero).

In the “dilute dose” on the spreadsheet header you would enter your entire daily dose. 

Here is an example for someone on a 3mg Ativan daily dosage using 1mg tablets titrating the entire daily dose.

 

Medication

Ativan

Valium Multiplier

10

Original Dose

3

Current Dose

3

Start Date

January 1, 2006

Dry Dose

0

Dissolve Dose

3

Water in ML

300

ML Increments

1

Display Dates

Yes

 When water titrating large “dilute doses” it is not uncommon to have to use more water in order to dilute the medication to offer you a slow enough taper.  To accomplish this it will likely be required that you enter water amounts that exceed the capacity of the 250ml cylinder and exceed the capacity of the 450ml blender. 

Water capacities that exceed the 250ml cylinder are not difficult to measure because you would use the 250ml cylinder multiple times to measure the entire water amount. 

If water capacities exceed the 450ml blender capacity, then it would be necessary to obtain another method of suspending the medication in the water such as a large home blender or a large milliliter graduated Tupperware container with a screw on top so that you can shake the water rather than blend it. 

After mixing your “drug water” in whatever device you decide to use, you would then measure out equal amounts of the “drug water” splitting it into smaller containers to be consumed at various times throughout the day.


Method 2 – Multiple titrations through out the day:

Advantages: Can use existing 250ml cylinder and 450ml wire whisk blender, gives even taper through out the day.

Disadvantages: Complicated, must keep track of multiple schedules, must hand write in date. 

Here is an example for someone on a 3mg Ativan daily dosage using 1mg tablets

When taking three doses throughout the day, three schedules would be required.

 MORNING            

Medication

Ativan

Valium Multiplier

10

Original Dose

1

Current Dose

1

Start Date

January 1, 2006

Dry Dose

0

Dissolve Dose

1

Water in ML

100

ML Increments

1

Display Dates

no

 

  NOON                  

Medication

Ativan

Valium Multiplier

10

Original Dose

1

Current Dose

1

Start Date

January 1, 2006

Dry Dose

0

Dissolve Dose

1

Water in ML

100

ML Increments

1

Display Dates

no

 

NIGHT 

Medication

Ativan

Valium Multiplier

10

Original Dose

1

Current Dose

1

Start Date

January 1, 2006

Dry Dose

0

Dissolve Dose

1

Water in ML

100

ML Increments

1

Display Dates

no

 Notice that the dry dose is 0 on all schedules.  This is because all medication will be water titrated.  No medication will be taken in dry form. 

Divide the total daily dosage of into equal portions though out the day.  In this example 3mg has been divided out into three schedules: morning, noon, and night. 

Set the Display Dates value to: No – This is so you can write in the dates on each schedule which is necessary when using this multi-dose scheduling technique. 

Print out all three schedules and label them “Morning”, “Noon”, and “Night”. 

This method tapers one dose per day and changes which dose is tapered each day in order to maintain an even drop in the medication through out the day. 

Here is a sample of how you would taper using the three schedules:

 

Day 1:  - 1ml drop                                                                                           Day 3: - 3ml drop

Morning Schedule:  Measure 100ml water, blend, toss 1ml, drink 99ml      Morning Schedule: Measure 100ml water, blend, toss 1ml, drink 99ml

Noon Schedule:      Measure 100ml water, blend, toss 0ml, drink 100ml    Noon Schedule:      Measure 100ml water, blend, toss 1ml, drink 99ml

Night Schedule:     Measure 100ml water, blend, toss 0ml, drink 100ml    Night Schedule:     Measure 100ml water, blend, toss 1ml, drink 99ml

 

Day 2:  - 2ml drop                                                                                          Day 4: - 4ml drop

Morning Schedule:  Measure 100ml water, blend, toss 1ml, drink 99ml      Morning Schedule: Measure 100ml water, blend, toss 2ml, drink 98ml

Noon Schedule:      Measure 100ml water, blend, toss 1ml, drink 99ml      Noon Schedule:      Measure 100ml water, blend, toss 1ml, drink 99ml

Night Schedule:     Measure 100ml water, blend, toss 0ml, drink 100ml    Noon Schedule:      Measure 100ml water, blend, toss 1ml, drink 99ml

 

Notice that only 1ml is being extracted per day which keeps the taper rate at a constant amount.

Important! Do not make more than one reduction in your dose per day. 

The information contained in this document comes from the personal experience of laypeople and is not intended to constitute medical advice. Do not attempt to stop or taper benzodiazepines without first consulting a doctor. 

 

 

Disclaimer:  The information contained in this website was not compiled by a doctor or anyone with medical training. The advice contained herein should not be substituted for the advice of a physician who is well-informed in the subject matter discussed. Before making any decisions about your health or treatment you should always confer with your physician and it is always assumed that you will do so.

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Last updated 22 July 2015