How Can I Accurately Cut A Pill
March 28, 2009 7:18 PM   Subscribe

CuttingPillsFilter: I am super-sensitive to anti-depressants, but having found one that works, I'm now trying to hit the right dosage. The pills in question are round and scored in half so creating halves or quarters is easy with a Rite Aid pill cutter, but if I wanted sixths - or even better, 12ths - how could I do this? The pills I get are 15mg (lowest dose) so the only thing I can think of is a professional scale which, for that accuracy, cost $$$.

The drug in question is Remeron/ Mirtazapine. After 6 months use I reckon my ideal dose is between a quarter/ 3.75mg and a sixth/ 2.5mg - let's say 3.1mg (like I said - super-sensitive).

I know this sounds a bit mental, and there's probably a ton of folks who'll want to say OMG I take 60mg, how can you think half a milligram will make a difference? Maybe it won't. But I find a quarter too strong, and a sixth not enough. That's all I got. (And yes, my Dr knows I'm experimenting with dosage.)
posted by forallmankind to Health & Fitness (14 answers total)
How much is each pill? Maybe you could just factor in some extra doses.

Like instead of trying not to waste any part of a pill, just cut them into quarters, and shave a bit off. You'll figure out exactly how much to shave off with a little practice.
posted by barnone at 7:28 PM on March 28, 2009

How much would you be willing to spend on a scale?
posted by barnone at 7:35 PM on March 28, 2009

I have a friend who tapered himself off antidepressants by dissolving them in water (the exact amount of water each time) and drinking successively smaller amounts of the dosed water each day, tapering down the amount over the course of 6 weeks or so. I believe this would be easier to accomplish if you spoon out more water and drink what's left in the glass each day.

The system would probably have a detrimental effect on any time-release aspect the pills had, and you'd want to stir or shake the solution like crazy to dissolve/suspend the particles as evenly as possible.

YMMV, but said friend has a background in medicine, and it seemed to work for him... maybe something like this would work in your situation?
posted by pseudostrabismus at 7:37 PM on March 28, 2009 [1 favorite]

Here's a scale that can go to 0.002g (2mg). It's $80. Here's another for $100. I'm sure there are others - maybe it's not accurate at that small amount, but I can't imagine they'd publish that as the minimum if it's not accurate to a higher threshold.
posted by barnone at 7:46 PM on March 28, 2009

I think this one might work too - can anyone verify?
posted by barnone at 7:52 PM on March 28, 2009

You could try dry dilution as well. If you ground a pill in a mortar and pestle along with a known volume of some inactive substance (say, sugar), you might find it easier to split the resulting larger volume of powder into the doses you're after.
posted by flabdablet's sock puppet at 7:52 PM on March 28, 2009

Best answer: Maybe instead you can talk to a pharmacist at a compounding pharmacy???
posted by St. Alia of the Bunnies at 8:00 PM on March 28, 2009

Best answer: A local compounding pharmacy might be your friend.
posted by holgate at 8:02 PM on March 28, 2009

Response by poster: I had no idea that such a service was available: sounds perfect - thank you.

barnone - I believe a scale that measures accurately so low would cost $100s. I expect an $80 scale with a purported 2mg accuracy would bottom out at the higher end, but thanks for the suggestions.
posted by forallmankind at 8:27 PM on March 28, 2009

One of the problems with cutting pills even into 1/4s is the active ingredient isn't necessarily evenly distributed within the pill. Crushing the pill and weighing eliminates this problem.

Deal extreme has a couple of 0.001g resolution scales starting at $24 with free shipping. I order stuff from them every couple of months and never had a problem with them.
posted by Mitheral at 8:28 PM on March 28, 2009

They seem to work for drug dealers... and jewelers. So they can't be too far off. But a compounding pharmacy might be a good bet too. Good luck!
posted by barnone at 8:46 PM on March 28, 2009

Best answer: Your own biochemistry will vary from day to day depending on what you ate and drank, how recently, how much exercise you've done, your sleep patterns, moods etc etc. You may get different responses on a daily basis from the same level of medication. Talk to your doctor and pharmacist about this; it may be wasted effort to try to fine-tune your dosage below 15mg increments (or even higher), without paying equal fine attention to all of these factors and more.
posted by aeschenkarnos at 8:53 PM on March 28, 2009

How long is the half-life of the drug? If it lasts longer than 24 hours, you could take double the dosage every other day.
posted by radioamy at 10:39 PM on March 28, 2009

pseudostrabismus has the answer. I do this with loprazam, since I only need about 1/4 of a 5 microgram tablet to be effective (p.r.n.), and loprazam is strongly addictive.

After I started this practice, I checked with my doctor at my next visit. He approved.

Loprazam has a very low solubility in water, so I really get grainy water slurry. To fix this, I shake vigorously before doling out my single dosage from the bottle.

Remember, you don't need to measure out 25.00% +/- 0.005% to make a one-quarter dose.
posted by IAmBroom at 7:33 AM on March 29, 2009

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