Capsule Dose Reduction Schedule Planner

Plan a multi-phase dose taper using a mix of commercial and compounded capsules. Define each reduction step, specify which commercial strengths are available, and let the optimiser determine the minimum compounded capsule strengths needed — or specify your own.

Disclaimer: This tool is provided for informational and educational purposes only. Results should always be independently verified by a qualified healthcare professional before use in clinical practice. Compound Direct accepts no liability for errors or clinical decisions made based on these calculations.

One row per dose level. The starting dose is shown above; each row defines the next dose and how many days to remain at that level.

#
Dose (mg)
Duration (days)
0
60 mg
days
Starting dose
1
2
3
4
5
6
7

Enter the commercially available strengths for this medication, comma-separated.

The algorithm will use commercial strengths where possible and find the minimum additional compounded strengths needed (max 4 capsules per dose).

How to Use This Tool

  1. Enter the starting dose and select the unit of measurement
  2. Define each reduction phase — one line per dose level with the target dose and duration in days. Use “Quick Fill” for evenly spaced reductions or add phases manually
  3. Choose the supply mode: “Commercial + Compounding” if the patient can use off-the-shelf capsules for some doses, or “Compounding Only” if all capsules will be custom-made
  4. For commercial + compounding mode, enter or select the available commercial strengths, then choose whether the optimiser should determine the compounded strengths automatically or if you want to specify them manually
  5. Click “Generate Schedule” to see the full taper plan
  6. Review the capsule combination column — items marked [C] require compounding, unmarked items are commercial
  7. Check the preparation summary for total capsule counts, separated by commercial and compounded

Formula & Methodology

Multi-Phase Taper Approach

This tool uses a multi-phase taper model where the clinician defines each dose level and its duration separately. Unlike a simple linear step-down, this allows for slower reductions at lower doses — a pattern commonly recommended for antidepressant and benzodiazepine tapering.

Commercial + Compounding Optimisation

In practice, many taper protocols combine commercially available capsule strengths with custom compounded capsules. For example, a duloxetine taper might use the standard 30mg and 60mg capsules for higher doses, but require compounded 5mg or 10mg capsules for fine-grained reductions at the lower end.

The optimiser treats commercial strengths as fixed inputs and then finds the minimum number of additional compounded strengths required to cover every dose in the schedule. This minimises compounding cost while leveraging readily available products.

Capsule Optimisation Algorithm

The algorithm finds the minimum set of capsule strengths that can achieve every dose using no more than 4 capsules per administration:

  1. Collects all unique doses from the taper phases
  2. Tests whether commercial strengths alone can cover all doses
  3. Computes the GCD of all doses and generates candidate compounded strengths
  4. Iteratively tests combinations of 0, 1, 2… additional compounded candidates (combined with the commercial set) until full coverage is achieved
  5. Verifies each dose can be assembled within the 4-capsule limit using a recursive combination search

Clinical Applications

  • SNRI tapering (e.g., duloxetine, venlafaxine) — often requires compounded low-dose capsules
  • SSRI dose reduction (e.g., sertraline, fluoxetine)
  • Benzodiazepine tapering (e.g., diazepam, oxazepam)
  • Corticosteroid tapering in long-term therapy
  • Opioid dose reduction in pain management

Frequently Asked Questions

Why is gradual dose reduction important?
Abrupt discontinuation of many medications (especially CNS-active drugs) can cause rebound symptoms, withdrawal reactions, or clinical deterioration. A gradual reduction schedule allows the body to adjust physiologically and minimises adverse effects.
How does the "Optimise for me" feature work?
The algorithm analyses all the doses in your taper schedule and finds the smallest number of capsule strengths needed. In mixed mode, it keeps your commercial strengths fixed and only optimises the additional compounded strengths. This minimises compounding cost while using commercially available products where possible.
What does the [C] tag mean in the capsule combination column?
Capsules marked with [C] are compounded — they need to be custom-made by a compounding pharmacy. Unmarked capsules are commercially available and can be dispensed from standard stock.
Can I mix commercial and compounded capsules in a single dose?
Yes. The algorithm will use commercial capsules wherever possible and only add compounded capsules when needed. For example, a 50mg dose of duloxetine might be dispensed as 1 × 30mg (commercial) + 1 × 20mg (compounded).
Can I have different durations for each phase?
Yes. Each phase has its own duration in days. A common approach is to use longer durations at lower doses to allow more time for physiological adjustment.
What if the exact dose cannot be matched with available strengths?
If a dose cannot be assembled within the 4-capsule limit, it is flagged in the schedule. You can add more manual strengths, adjust dose steps, or use the "Optimise for me" mode which guarantees coverage.

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