Counting Beads in a Beaded Capsule

Beaded capsules are dosage forms that contain up to hundreds of tiny beads or pellets inside two shelled halves – a narrower “body” and a wider “cap”. The beads/pellets within a capsule are sometimes identical in size and shape, while on other occasions they may be beads/pellets of varying different sizes, or even ones that look more like “chips” of inconsistent shape and size. This taper method involves manually twisting open the beaded capsule, pouring out its beads and then removing a calculated number of beads in accordance with a planned cut. The basic gear required for counting beads are new, empty capsules and an aid for moving and counting beads such as a nail file, mini-ruler, or tweezers.
 

Pros

• If the particular drug has a lot of beads in each capsule, can allow for reasonably precise reductions.
• Some find the repetitive, rhythmic motion of counting to be soothing, and that this method can become a daily meditation like counting prayer beads.
• Does not necessarily require the support of a prescriber, as there is no need for a new, changed prescription.
   

Cons

• Can be very time-consuming.
• Requires a high degree of fine motor coordination.
• Different beaded capsules can hold beads that come in different sizes, have inconsistent numbers of beads, or have beads of similar sizes with different amounts of active drug; it is essential to do supplemental research about how the drug is manufactured, and to consult with a well-informed pharmacist, when considering counting beads as a taper method. People sometimes report that counting beads, pellets or “chips” that are irregularly sized and/or shaped has led to an uptick in problems given that active drug amounts can vary across them. (In these situations, they often report that weighing beads/pellets/chips on a digital scale instead feels less disruptive to their withdrawal process.)
• At especially low doses, it becomes more difficult to reduce at a slow, responsible rate using this method.
   

Which taper schedule it can work with 

• Cut-and-hold
• As long as the number of beads in a dose is still relatively large, a Daily Microtaper is possible