Special Tips for Calculations and Liquids
In the layperson withdrawal community, people use a variety of different volumes of liquid to make their liquid mixtures or dilutions, in part depending on whether they’re tapering using a Cut-and-hold or Daily Microtaper schedule, and in part as a matter of personal preference. However, some choices can also make the handling and math calculations simpler! So here are a few tips laypeople often share with one another to help inform this decision. (For doing these particular calculations, liquid mixtures and liquid dilutions can be treated as essentially the same.)
How to choose an amount that makes the measuring and math easier
To simplify the math calculations, some people opt for a liquid volume that will make it easy to remove cuts that fall cleanly into relatively simple numbers, given their chosen taper schedule and monthly taper rate.
To figure out how to do this, we can use one of the same formulas described in ‘Doing Calculations for a Taper’, except instead of calculating how much to cut each day from a given volume of liquid, we calculate how much volume of liquid a person needs to use in order to be making a simple-sized cut each day. To do this, we can use this formula:
(Total Starting Amount X Monthly Taper Rate) / Total Number of Cuts = Initial Cut
In the ‘Doing Calculations for a Taper’ section, we put Jack or Jill’s numbers into this formula and solved the equation for the variable “Initial Cut”. This time, instead, we’ll put any desired, simple “Initial Cut” into the equation, and solve for the variable “Total Starting Amount”. So for example suppose Jill is planning a taper rate of 5% on a 30-day Daily Microtaper schedule, and she wants to make simple cuts from her liquid mixture/dilution of 0.1mL daily. What’s the “Total Starting Amount” of liquid mixture/dilution that she needs to do that? Here’s the equation:
(Total Starting Amount X 0.05) / 30 = 0.1mL
We then solve for “Total Starting Amount”:
0.05x / 30 = 0.1mL
0.05x = 3mL
x = 3ml / 0.05
x = 60mL
This means that if Jill sets the Total Starting Amount of her liquid mixture/dilution at 60mL, then she will be cutting 0.1mL per day cumulatively (i.e. 0.1mL on day one, 0.2mL on day two, 0.3mL on day three etc.). That’s about as simple as a Daily Microtaper can be!
This exact same formula can be used to calculate relatively simple liquid cut amounts for virtually any typical taper rate and any number of days. If we end up with a very large Total Starting Amount in mL, then we can simply double or triple the cumulative cut to 0.2mL or 0.3mL, which will correspondingly reduce the Total Starting Amount.
How to choose a number of days that makes the measuring and math simpler
When choosing a volume of liquid to make cuts simpler, in some cases we might end up with an odd Total Starting Amount like, say, 187.63mL, which may not be all that much easier to work with. The reason this happens is because some taper rates don’t divide easily into 30 or 31 days. So if that’s happening, here’s an extra hint for simplifying the numbers: We can slightly shorten or lengthen the number of days for the calculations using a number of days that can be divided more easily by the particular taper rate. Here’s a demonstration:
Suppose Jack wants to taper at 7% monthly, and he wants to make cuts of 0.1mL cumulatively. Here’s what the initial calculation will look like:
(Total Starting Amount X 0.07) / 30 = 0.1mL
0.07x / 30 = 0.1mL
0.07x = 3mL
x = 3mL / 0.07
x = 42.85714285mL
That’s not a simple amount of liquid mixture for Jack to work with every day! However, we know that 7 divides easily into 35, so let’s see what happens if we calculate a Daily Microtaper schedule that lasts 35 days instead of 30:
(Total Starting Amount X 0.07) / 35 = 0.1mL
0.07x / 35 = 0.1mL
0.07x = 3.5mL
x = 3.5mL / 0.07
x = 50mL
So if Jack makes his Daily Microtaper schedule last 35 days, he can do cuts of 0.1mL cumulatively from a liquid mixture/dilution of 50mL in volume. That’s clearly a much simpler amount for Jack to deal with!
How to determine reductions when taking a daily drug dose in two different forms
In previous steps, we discussed the possibility of doing partial conversions from one drug form to another during a taper—for example, taking 5 of 6 daily tablets in their original manufacturer’s form while taking a manufacturer’s/compounded liquid in place of the sixth tablet, or converting the sixth tablet into a liquid mixture. Then, as the person’s daily dose decreases, continuing by taking 4 of 5 daily tablets in solid form and taking the fifth tablet in a liquid form, and so on. In such a situation, how does a person keep track of exactly how much to cut from their liquid each day? This is a little more complicated of a situation, but not too difficult.
It's necessary to introduce an intermediate step: We must first determine both the total daily dose and the amount of dose being taken in each form. So for example, suppose Jill is wanting to reduce by 5% this month using a once-monthly Cut-and-hold schedule, and she is taking six 20mg tablets daily. That’s 6 X 20mg, or a total of 120mg of medication dose daily. A 5% cut of that would be 6mg. And suppose, after choosing an easy-to-use volume of liquid in our previous step, Jill has decided to take 20mg of her daily dose in 300mL of liquid mixture/dilution. Then what percentage of her liquid mixture/dilution does Jill have to cut to meet her 5% taper rate?
To determine this, we need to calculate how much Jill’s overall 6mg cut is as a percentage of the 20mg of medication that she’s taking in a liquid form. That formula would look like this:
Amount of Daily Dose Cut (in mg) / Amount of Daily Dose (in mg) in Liquid Form = x /100
Using our example involving Jill, we have:
6mg / 20mg = x / 100
Then solve for x:
20x = 600
x = 600/20 = 30
So to achieve her 5% total cut for her daily dose, Jill needs to cut 30% of the 20mg that she is taking in liquid form.
Once we know the percentage that Jill is cutting from her liquid mixture or dilution, we can calculate exactly how much in mL that is by converting it back into decimal form and inserting it into this equation:
Percentage Cut as Decimal = x / Total Amount of Liquid Mixture or Dilution
If Jill has a liquid mixture or dilution with 20mg of dose mixed within 300mL of liquid, then the formula looks like this:
0.30 = x / 300 mL
x = 0.3 X 300mL = 90mL
So in this example, Jill will remove 90mL from her 300mL liquid mixture or dilution to ultimately achieve a 5% cut of her total daily dose.