MULTIPLE SCLEROSIS -
4AP RAMPING

Ramping is a way to allow the body to get used to a dose, which typically takes two weeks. The goal is to reach 30 - 40 milligrams per day in four doses, spread four to five hours apart. I have been reluctant to give direct recommendations of dosing since you should work with your doctor. However, I will suggest the following general ramp-up schedule:

5mg per day – in the morning - for 2 days

5mg twice daily (breakfast and late afternoon) for 3 days

5 mg 3 times a day (every 5-6 hours while awake) for 4 days = 15 mg/day

5 mg 4 times a day (every 4-5 hours while awake) for 5 days = 20 mg/day

10 mg (2 of the 5mg capsules) 3 times a day (every 5-6 hours while awake)
for 6 days = 30 mg/day

IF TOLERATED, 10 mg 4 times a day; every 4-5 hrs while awake) = 40 mg/day

Such an approach will get you to the 40mg dose in about two weeks. The approach assumes that you do not have any side effects such as tingling, nervousness, insomnia or dizziness at any stage along the way. If there are side effects, wait until they subside before going up to the next step. It is probably a good idea for doctors prescribing 4-AP to initially order 5-milligram capsules for the ramping-up phase.

It is a good idea to follow a plan and to make every effort to not try to speed up this process. Some have tried and found themselves with severe difficulties. Use the form on the back of this note to record your progress.

OR

Week 1 Take 5mg at 7am every day

Week 2 Take 5mg at 7am and 3pm every day

Week 3 Take 5mg at 7am, 3pm, and 7pm every day

Week 4 Take 10mg at 7am and 7pm every day

And continue at this level unless advised by physician (Complements of Dr. Steven G. Ayre).