This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
Where I part company with post #57, and it is a narrow parting.
A missed dose in a weekly schedule is not a trough to chase. With a week-long half-life you are perturbing a slowly moving average, and the labelling for licensed products in this class says take it if the next dose is far enough away and skip it otherwise.
Post #61 is the version of this I will quote in future. One addition.
Practical answer on micro-titration, since the theoretical one is upthread: do the simplest check first, write down the result, and only then decide whether the complicated explanation is needed. It usually is not.
Thank you for the correction. I would rather find out here than later.
I had written a reply contradicting post #61 and deleted it. Here is what survived.
Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
Adding the caveat now so it does not have to be extracted later.
Micro-titration: the concept of increments smaller than the labelled steps. It has no evidence base from trials but is described by some people. The downside is that very small increments are hard to measure accurately with a syringe.
Happy to be the one who is wrong here if it settles the question.
I would call the community position on micro-titration likely rather than established, and I would be comfortable defending that hedge.
The question underneath micro-titration is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.
Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.
Building on post #68 rather than restating it.
A titration plan written down in advance is easier to stick to and easier to abandon deliberately. An improvised one becomes a series of decisions made on the worst day of each week.
A note on scope: what I am saying about micro-titration applies to the case in the first post and I would not extend it further without checking.
Everything in post #70 holds. The case it does not cover is the one I have.
Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
I would be glad to be shown a cleaner way of putting this.
Building on post #72 rather than restating it.
I would rather this thread reach "we do not know" about micro-titration than reach a confident answer that nobody can support when asked.
On micro-titration, the part that usually goes wrong is that the question is asked as though it has one answer. It has a range, and the width of the range is the interesting bit.
If you can post the two or three numbers you are working from, several people here will check the arithmetic rather than argue about the conclusion.
The most useful thing anyone has posted about micro-titration in this category was a table of what had been measured and by whom. That is what I would want again.
Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
That is the honest state of it as of this week.
Post #79 is right about the mechanism and I think understates the practical bit.
Reframing micro-titration slightly, because I think the disagreement is about the question rather than the answer. If the question is "does it happen", yes. If it is "how often", nobody here knows.
Worth separating two things that post #79 runs together.
A missed dose in a weekly schedule is not a trough to chase. With a week-long half-life you are perturbing a slowly moving average, and the labelling for licensed products in this class says take it if the next dose is far enough away and skip it otherwise.
Stating my assumptions rather than smuggling them in.
Micro-titration: the concept of increments smaller than the labelled steps. It has no evidence base from trials but is described by some people. The downside is that very small increments are hard to measure accurately with a syringe.
Right, and stated more narrowly than I would have dared to state it.
Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
That is what the documentation says. What happens in practice is usually close.
Two sentences on micro-titration and then I will stop, because the rest is speculation and the thread is better without mine.
What is documented is narrow. What is inferred from it is broad. The gap between them is where every argument here lives.
Writing down the date, the dose and the site each week takes fifteen seconds and is the single most useful record anyone here keeps. Memory reconstructs a titration history that never happened.
Happy to be corrected if someone holds better data than mine.