Continuing Mounjaro...part 14

[ObsidianTree]

Please note: Mounjaro will only be be prescribed initially if your BMI is above 30 until you get to a healthy BMI of 23 to BMI 25

Pointers for newbies:

1 - For taking your first dose you need to twist the pen a lot to get to 1! The instructions say prime each time you take a dose, but actually Eli Lilly have confirmed you only need to prime for the first ever use of a pen. (The video posted says every use, but this isn't true!)

2 - When injecting, hold down the button until the number goes back to 0. Once at 0, keep holding down the button and count to 5 with the needle still in so no medication is lost!

3 - Your first dose may not have an immediate effect. For some people the effects build slowly. It could take 3 or 4 days to notice anything, it could take a few weeks. Some people don't feel the meds working until they get to 5mg. See titration chart which shows how the medication builds up in your system. Also below you can plot the effect of your doses.
https://glp1plotter.com/

4 - 2.5mg isn't a therapeutic dose, meaning you aren’t meant to lose on 2.5mg. You need to start on 2.5mg to get your body used to the drug and gradually introduce it into your system and get used to any side effects.

5 - Not everyone loses a lot in the first few weeks. Don't feel discouraged if you don't lose a lot initially. Again, you might need a higher dose to start losing. Also, inches can be lost without anything showing on the scales. Start your journey by taking measurements and check them as you go along.

6 - If you do lose a lot in the first few weeks, please don't assume you will continue losing at this rate. The first few weeks it is usually water weight that is lost, after that a good weight loss is about 2lbs a week. Some weeks you might not lose anything, but this is ok too…again, taking measurements might show inches lost instead.

7 - Constipation, coldness, nausea, diarrhea, vomiting, headaches, aches, are side effects. There may be other side effects also. Read info here :

www.medicines.org.uk/emc/product/15481/pil#about-medicine

8 - Once you take your first dose you can choose to keep your pen in the fridge or somewhere else. It's up to you.

9 - Don't reuse any needles as this could risk infection. If you damage a needle or one isn't working, you can buy a pack of about 100 spares. https://www.chemist-4-u.com/carepoint-pen-needles-31g-4mm-pack-of-100?gclid=Cj0KCQjwiYOxBhC5ARIsAIvdH51rLZBVFQxuvS7mDJooegtK8BMiyT0PwREMRHhH_1atfQIo8TEbsmkaAkA0EALw_wcB

Also there is a 5th dose in each pen. To extract it you can either try a hard twist or use an insulin needle.
https://medbasic.co.uk/bd-micro-fine-30g-1ml-syringes-needles

10 - Protein is important as eating less protein can cause muscle wastage and hair loss. Try to have at least 100g a day.

Some natural sources of protein:
https://www.bbcgoodfood.com/howto/guide/best-sources-protein
https://www.medicalnewstoday.com/articles/321522#high-protein-foods

11 - You can use supplements, some that people use are magnesium(for sleep and constipation), protein(to reduce muscle wastage), collagen (skin elasticity), aloe vera(for constipation), psylum husks(fibre for constipation), electrolytes.

12 - Drink lots of water. Water helps with the weight loss. Drink at least 2ltrs a day. Preferably 3ltrs.

13 - Don't be afraid to feel hungry. It is entirely normal and healthy to feel hungry. Just eat something. Treat it as an opportunity to start good habits around hunger. Eat a nice balanced snack or a meal if it's a meal time. It's ok.

14 - Does it makes any difference where you inject? yes it does! Drugs get absorbed at different rates depending on injection site

In order of fastest absorption, it goes:
• Tummy
• Arms
• Thighs
furthet reading about injection sites and the effects: https://www.medicalnewstoday.com/articles/316618

15 - Abdominal side-effects are much easier to control with smaller meals. For example, having 4 small meals in the day vs 2 big meals can have an improvement in nausea and burps.

16 - You can track your calories / protein on apps such as My fitnessPal, Carb Manager or Nutracheck. Nutracheck is quite useful and easy to find foods /build recipes.

17 - Some of the places you can order from are:

Zava medical:
2.5mg £139, 5mg £139, 7.5mg £169, 10mg £189. 12.5mg £204. Zava offer refer a friend discount of 15% off. Ask for a code on here.

Simple online pharmacy:
£149 2.5mg, £149 5mg, £169 7.5mg £189 10mg

Bolt pharmacy:
2.5mg £149, 5mg £149. 7.5mg £169, 10mg £179, 12.5mg £199

MedExpress:
2.5mg and 5mg. £149.99. 7.5mg £169, 10mg £189. Coupon codes no longer working!

The Family Chemist:
2.5mg and 5mg £149. 7.5mg £169, 10mg £169, 12.5mg £194

Asda:
2.5mg and 5mg £179. 7.5mg £189, 10mg £189

There are others not listed.

18 - Worried about your supply being cut off when you get to a healthy BMI? Below is some info on some places maintenance plans.

MedExpress: Once at healthy BMI continue on maintenance dose for 6 months and then step down medication and monitor loss
The Family chemist :Would consult you as approached healthy BMI to discuss maintenance under close supervision
Curate: up to 2 years
Cloud: up to 2 years
Boots: Cut off at BMI 23
Asda: Cut off at a healthy BMI
Pharmacy2u: Will supply for maintenance
Bolt:Individual assessment once BMI 22
Zava:Once healthy BMI will stop prescribing this treatment

19 - If you want to switch suppliers, make sure you have pics of your Mounjaro box with your name and dose. This will come in useful when other suppliers ask for evidence.

1st thread:

https://www.mumsnet.com/talk/weight_loss_chat/5007744-mourjano-starting-soon?page=1

2nd thread:

https://www.mumsnet.com/talk/weight_loss_chat/5028495-continuing-murnjaropart-2?page=1

3rd thread:

https://www.mumsnet.com/talk/weight_loss_chat/5037623-continuing-mounjaropart-3?page=1

4th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5044316-continuing-mounjaropart-4?page=1

5th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5048290-continuing-mounjaropart-5?page=1

6th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5057916-continuing-mounjaropart-6?page=1

7th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5062935-continuing-mounjaropart-7?page=1

8th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5068850-continuing-mounjaropart-8?page=1

9th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5074054-continuing-mounjaropart-9?page=1

10th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5080755-continuing-mounjaro-thread-10?page=1

11th thread:
https://www.mumsnet.com/talk/weight_loss_chat/5085436-continuing-mounjaro-thread-11?page=1

12th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5090788-continuing-mounjaro-thread-12?page=1

13th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5096704-continuing-mounjaropart-13?page=1

Thread for newbies just starting out in June:

https://www.mumsnet.co
m/talk/weightlosschat/5082791-mounjaro-june-24-starters

Video on how to inject:

I saw that. 😂

Thanks @Slimstar13 I'm ordering tomorrow so will try your code then.

I posted earlier about being hit by horrendous cramps/the runs today for the first time. I'm not convinced it's the MJ, maybe a bug. Husband is at home so he very kindly heated some soup with a slice of whole meal toast for me to try as not eaten yet. He had something else. I managed to eat most of it and joked kill or cure.

The best before date on the tin is December 2022. Oh goody. Google tells me I should probably be okay...

To be fair, sugar free sweets give me diarrhoea if I eat too many 😂 That’s why I always avoided the Slimming World treats. I don’t think it’s specifically the Lidl gummies though!

@MelissaLouRocks I mean don't get me wrong if the general consensus is that they will give you constipation relief then fair enough I stand corrected but in that case I think Lidl may need to rethink their choice of sweeties 😂

I'm thinking of updating the op post with information on when to titrate up to the next pen.

I think for those of us (myself included) that have had bad effects like diarrhea and vomiting had these effects as we moved up pen dosages too fast. Would others agree that this was probably the reason?

I have noticed on here a lot of us do tend to move up the pen dosages quickly, whereas in the US people generally don't do that. They wait for the pen effects to stop working / or they stop losing weight. I wonder why a lot of us don't wait until we feel our pens aren't strong enough? Is it the excitement of the new pen doses becoming available so we end up rushing? Maybe also others seeing people go up dosage so go up too without really considering if they need to?

I feel the advice I should add should be:

7 - You don't need to go up pen doses every month if the current dosage is working well for you. If you are losing and have good suppression, don't go up to the next dose. Wait until you stop losing weight and start feeling hungry for most of the week after taking a dose.

8 - If you are having bad side effects like vomiting, diarrhea, don't go up a dose for your next pen. You might need to reduce your pen dose.

Any edit ideas on this? Or should I say something else completely?

What happened to your post @WannabeHealthier ? I didn't see it

@ObsidianTree I think it may also be worth mentioning half doses. Lots of people seemed to be getting symptoms moving from 2.5 to 5, so I used 3.75 for 2 weeks before moving up, as I think did quite a few others.

Thanks to whoever used my ZAVA code 😊

@ObsidianTree good idea yeah. I feel like perhaps it's the prescriber that contributes to that feeling of 'gotta get through these doses quickly' mentality. I've noticed that each email at each dose (at least the ones I've received) opens with 'ready to order your 5mg? Ready to move up to 7.5?' and at first I fell for it because I was considering a second month at 2.5 but they actively talked me out of it and then it dawned on me. Of course they want you on higher doses because they're worth more.
Check out cynical sally here 😂

@ObsidianTree I think it's really interesting about titrating up - I'm no expert obvs! 😅 But this is what I've been doing, relatively side-effect free:

Basically I've been doing smaller jumps than per the schedule, trying to go easy.

Week 1-3 - took 2.5mg as advised. Felt the effect starting to lessen in week 3.
Week 4 - took final dose plus part of the bonus dose - 3mg or thereabouts.
Week 5 (now on 5mg pen) - took 3.75 - half the dose from 5mg plus remaining "bonus dose" from the 2.5mg pen.
Week 6-7 - took 4mg, counting clicks
Week 8-9 - took 5mg.

Now my 7.5mg pen has arrived and I will get up there, but I've got a bit left in the 5mg pen and I'll keep staggering up I think.

At the moment my appetite suppression is really good but my weight loss isn't the fastest - I'm keen to find out if the higher doses of 7.5mg and above will improve my losses or not.

But I work FT and have 2 little kids so really need to not lose days tied to the bathroom! Touch wood so far the gently-gently approach has been great in that regard, I can eat but I'm not craving anything and there's been little in the way of gastric woes. Can't complain!!

This may be a silly question and I am in no way advocating this but I am curious if it can be done as this drug is so costly!

.... What is people purchased 5ml/10ml/15ml (obviously when they have done their 4 weeks of ordering a previously lower pen) but staying at the lower dose?

So I'm on 5ml and planning on staying here for a few months hopefully. Could I not just get a 10ml next and get 8 doses instead of 4 (+extra dose!) for a similar price?

I understand the shelf life is 6 weeks after opening but if it was kept in the fridge, maybe it would be fine as it would only be open 7 weeks?

If it was one provider, I think it would be difficult as they would wonder why you didn't order monthly, but as we shop around for best price that seem irrelevant.

Anyone done/doing this?

Edit:

7 - You don't need to go up to the next pen doses every month if your current pen dosage is working well for you. If you are losing and have good suppression, you don't need to go up to the next dose. Wait until you stop losing weight and start feeling hungry all the time.

8 - The move up from 2.5mg to 5mg can be quite a shock to the system. Some people chose to take 3.75mg dosage for a few weeks to ease the transition. If you experienced bad side effects on 2.5mg, perhaps titrate up slowly taking 3.75mg dosage first when you decide to move up pens. See click chart for pen click dosage.

9 - If you are having bad side effects after titrating up, like vomiting, diarrhea, you might need to reduce your dose.

Could I ask you lovely bunch for your help working out how much I administered today?

I did the hard twist method for the 'bonus' dose from my 5mg pen. The dial didn't return back to 0 afterwards as I effectively broke the pen, but I assume I got the standard dose as the plunger went down by the familiar amount.

This is what was left in the pen after I injected, so I withdrew it into a seperate syringe and jabbed again with a new needle. I'm a bit confused as the line isn't at the top, probably because of bubbles, so I can't work it out.

My brain turns to mush when numbers come into things 🤯 (ADHD and dyscalcular)

Pic 2 shows the pen now completely empty.

Thanks in advance!

Another pic if it helps, this was before I tried to push some of the bubbles out.

Yes this is true. In UK the providers seem to promote going up pens without checking if you're even coping on the dose your on. Also their emails tend to be generate auto generated!

I don’t know it got hidden! All I said was that sugar free sweets give me diarrhoea!

I think it's down to each person if they decide to do this. Obviously manufacturers say 6 weeks, but there has been no research to confirm if the pen will last longer or not.

I will be testing this myself if I decide to use less from a pen and it happens to still have meds in it after the 6 week cut off.

The problem like you've said, with getting a 15mg and using for 5mg doses, is that eventually your supplier will notice. Might take them a while but eventually they might decide not to sell you anymore pens as you haven't take any for a while etc. Med Express will make you start again at 2.5mg if you go over 6 weeks.

I got an email from Asda after 6 weeks asking me to order a new pen. I have moved away from them now, but they have finally noticed!

That's weird!

@GoingforitJune24 if you can't show suppliers you have ordered from someone in the last 4-6 weeks you will be sent back to Go and have to order a 2.5mg pen again. So you can use the pens slower but you have to keep ordering to not get cut off. Some of us are already doing this by using the 5th dose and are forming mini stockpiles in our fridges.

I would say about 0.60ml in that dose.

If I get air in the syringe, I push it out until it's just liquid, so it's easier to count.

Good idea and the wording is fine

Do we need to add a bit on eligibility to say you can get access at BMI 27 if you have certain health conditions?

Posters also get worried about maintaining access when they go under BMI 30 - so reassuring providers will continue to provide to healthy BMI (but switching providers under 30 can be tricky).

Thanks again for doing such a fab job! X

@ObsidianTree I think you should be a little careful about wording some of that in a way that sounds like medical advice almost. I'd maybe just say "you don't have to go up every month" but not add the bit about sticking on the same dose. Just letting people know they don't have to increase would be helpful I think. We could always suggest people speak to their prescriber if they don't think they need to increase.

I'm just thinking about the attention this medication is getting in the press currently and how journalists could put a spin on our friendly advice if they wanted to!

Thanks Obsidian!

When I tried to let the bubbles out I was losing liquid so I wasn't as thorough as I should have been.

So if its approx 0.60ml does that mean I've had about 10mg in total when combined with the 0.6ml i got from the hard twist? Oo eck 😵

Zava accepted me btw, happy days. I got a 10mg for around £160ish.

If anybody needs a code for 15% off then mine is. REFHWJ3C