Tapering Plans

The attached spreadsheet is based on Altchuler, S.I. (1995), Process for determining drug taper schedules, US Patent # 5468222 A, assigned to the Mayo Foundation For Medical Education & Research. It serves as a discussion point between you and your physician for determining an appropriately paced medication taper. The spreadsheet contained herein is for informational purposes only, and does not constitute a recommendation for making medication changes. By using this spreadsheet, you agree that you are working with a physician and/or pharmacist to safely and appropriately taper.


Spreadsheets

For iPad Users
  1. Download the Numbers Spreadsheet for MacsTested on iOS 8.
  2. Select "Open with Numbers."
  3. Double tap the values you wish to change.
For Mac Users with Numbers (Updated 1/2/15)
  1. Download the Numbers Spreadsheet for Macs. This has only been tested on Yosemite running Numbers v. 3.5.
  2. If you experience errors, please see the directions for Users without a spreadsheet program below.
  3. For Numbers '09 users, try this version: Numbers '09 for Macs.
For Excel Users (Updated 1/2/15)
  1. Download the Excel Spreadsheet for PC or Excel Spreadsheet for Mac
  2. If you receive a warning about "Protected View," click Enable Editing. This will allow you to make changes to the document.
    • Note for Mac Users: If the document doesn't allow you to make changes:

      This problem is caused by a temporary file that was not deleted after a previous edit session was completed. The file is hidden and not normally visible through the Finder. The easiest way to view hidden files is to install the hidden files dashboard widget which is available here.
      Use the widget to show hidden files then use Finder to open the folder that contains the spreadsheet you wish to edit. If your spreadsheet is named abc.xlsx, you will also see a file named ~$abc.xlsx. Delete the file that begins with ~$ and you will be good to go.
Users without a spreadsheet program
  1. You can use Excel online to edit documents.
  2. You will need to register an account with Microsoft.
  3. Download the Excel Spreadsheet to your computer and then upload it into Microsoft OneDrive.
  4. Open the file from OneDrive by selecting it. It will open in an Excel interface.

Instructions

  1. My Doses - Enter the dose you will begin tapering from (in mg), the size of your pills (in mg), and how many times a day you dose (maximum is 8 doses)
  2. Dose Amounts - Enter each of your doses (in mg), up to 8 doses. Leave blank if the dose dose not apply.
  3. Rates and Dates - Adjust these values, as appropriate, and as determined by your physician. The following table gives some general % guidelines:

     % Reduce (ml)
     Per days

     Start with (ml)
     20
    1
    0.5
    1
    1
    1
    2
    150
    75
    75
     10 1
    0.5
    1
    1
    1
    2
     300
    150
    150
     5 1
    0.5
    1
    2
    2
    4
    300
    150
    150

  4. Advanced Preferences - Dissolve half pills - By selecting "2" for yes, you will dissolve less medication as you reduce. Example, if your pills are 0.5 mg and you are reducing from 1 mg, when you reach 0.75 mg dose in the taper, you will begin dissolving 0.75 mg into liquid, rather than 1 mg. Hide Dates - By selecting "2" for yes, dates will be hidden.

The Taper Plan


  1. Date - Shows the dates you will make your next reduction. If you opted to Hide Dates, there will be no information displayed here.
  2. Dissolve (mg) - The amount of medication you will dissolve in liquid, in mg.
  3. in ml liquid - The amount of liquid you will be using. Please discuss the appropriate liquid to use with your pharmacist (e.g., water, milk, etc.).
  4. Remove ml - The amount of liquid you will be removing.
    • NOTE: Rather than removing the liquid, you can simply drink the amounts for each dose shown in the Drink (ml) - Dose 1, 2, 3, ... columns. Any liquid that remains you can either toss or save to use for a later dose.
  5. Dose (mg) - Your new dose in mg at each step in the reduction.
    • NOTE: The spreadsheet only displays two (2) decimal places. A dose of 1.490, 1.491, 1.492, 1.493, and 1.494 will be displayed as 1.49.
  6. Progress - The total percentage you have reduced.
  7. Drink (ml) Dose 1, Dose 2, Dose 3, ... - The amount of liquid (in ml) that you will drink for each dose.
    • NOTE: The amounts here are rounded to make determining the amount that you pull in your syringe easier, since most syringes are marked in increments of two (2). If you have removed water before pulling your doses, you may find that you do not have the amount of water required for the last dose (e.g., if Dose 4 says 74.76, you may only have 74.72 ml). This is OK! You are still getting the right amounts for your total daily dose. If this concerns you, however, you can set Reduce ml and Per Days values to match your dosing: Dosing 2, 4, 8 times per day = Reduce 2 ml, Per 2 days; Dosing 3, 6 times per day = Reduce 3 ml, Per 3 days.