Posted by bleauberry on May 1, 2008, at 17:13:29
In reply to Pdocs crazy strartup dosage on Cymbalt-help, posted by slinky on May 1, 2008, at 10:25:59
I keep trying to pursuade myself that doctors know what they are doing. I know some of them are a lot more competent than others.
30mg per day is the official starting dose. The halflife is too short to extend it two days. The halflife is short enough that it barely makes one day if that.
I believe the halflife is 12 hours. If so, then 12 hours after a 60mg dose, it is 30mg. 24 hours after the 60mg dose it is 15mg. 36 hours it is 7.5mg. 48 hours it is 3.25mg. If the halflife is shorter, as I've seen it stated at 8 hours in some references, then the situation is even more compelling.
But more importantly, the idea is to get a steady blood level, which is done with overlapping halflives from previous doses. Kind of hard to do that with an every other day dosing schedule. The blood level would be up and down like a roller coaster.
Anyway, forget the math. I think it makes sense to follow the normal label instructions which is daily 30mg. If it were me, I'm sure I would be having some withdrawal type symptoms during that day without the dose if I followed your doc's instructions.
poster:bleauberry
thread:826572
URL: http://www.dr-bob.org/babble/20080430/msgs/826652.html