Continuing Mounjaro...part 17

[ObsidianTree]

Please note: Mounjaro will only be be prescribed initially if your BMI is above 30. If you have additional health conditions you can get the medication with a BMI 27. (Prediabetes, high blood pressure, high cholesterol or heart problems)

Pointers for newbies:
1 - For taking your first dose you need to twist the pen a lot to get to 1! Make sure the needle is twisted on tightly. Priming will help confirm if the needle is on securely and not faulty.
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 - Some people find that they don't need to go up a pen dose each month if the current pen dosage is working well for them. If you are unsure when to go up, speak to your prescriber.
8 - If you are having bad side effects after titrating up or you are struggling to eat your calories each day, your dose may be too high so should consider lowering your dose. Speak to your prescriber if unsure.
9 - 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
10 - Taking Mounjaro can stop birth control from being effective. If you are on birth control, consider extra protection if you aren't planning on conceiving anytime soon!
11 - Once you take your first dose you can choose to keep your pen in the fridge or somewhere else. It's up to you.
12 - 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
13 - Protein is important as eating less protein can cause muscle wastage and hair loss.
Some natural sources of protein:
https://www.bbcgoodfood.com/howto/guide/best-sources-protein
https://www.medicalnewstoday.com/articles/321522#high-protein-foods
14 - 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.
15 - Drink lots of water. Water helps with the weight loss. Try and drink at least 2ltrs a day.
16 - 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.
17 - 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
further reading about injection sites and the effects: https://www.medicalnewstoday.com/articles/316618
18 - 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.
19 - 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.
20 - Some of the places you can order from are:

MedExpress:
2.5mg and 5mg. £149.99. 7.5mg £169.99, 10mg £189.99. 12.5mg £209.99. 15mg £209.99 Coupon codes no longer working!
The Family Chemist:
2.5mg and 5mg £149. 7.5mg £169, 10mg £169, 12.5mg £194, 15mg £199
Zava medical:
2.5mg £139, 5mg £139, 7.5mg £169, 10mg £189. 12.5mg £204. 15mg £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, 15mg £199
Asda:
2.5mg and 5mg £179. 7.5mg £189, 10mg £189, 12.5mg £204 15mg £204
There are others not listed.
21- You will still be prescribed Mounjaro when your BMI falls below 30. However, it may be harder to move suppliers once you BMI is below 30 if you wanted to move.
22 - Worried about your supply being cut off when you get to a healthy BMI? Below is some info on some places maintenance plans.
The Family chemist :Would consult you as approached healthy BMI to discuss maintenance under close supervision(if you started with family chemist)
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 and does offer maintenance
Zava:Once healthy BMI will stop prescribing this treatment
Med Express: BMI 25 and cut off.
23 - 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
14th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5102149-continuing-mounjaropart-14?page=1
15th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5107426-continuing-mounjaropart-15?page=1
16th thread:
https://www.mumsnet.com/talk/weight-loss-injections/5115015-continuing-mounjaropart-16?page=1

Thread for newbies just starting out in July:
https://www.mumsnet.com/talk/weight-loss-injections/5101435-mounjaro-july-2024
Video on how to inject:

Afternoon campers! I had an email from Voy today with a 44% off code so thought great, I can use it for my next pen (10mg). I did see a bit on the email that reorders would be the lowerst (actual spelling!) dose for safety reasons but my last pen was from them so thought I’d try. Didn’t work, wanted to steer me towards a first time 40% code for 2.5mg so I emailed them.

Got a quick reply back stating 2.5mg for safety reasons so I emailed again, asking what they mean by “safety reasons” when they have supplied the 7.5mg pen a couple of weeks ago so that doesn’t make sense. Funny enough, still waiting for a response to that one. They suggested I refer it to get a discount code but I think this is less safe so told them that!

I think it’s rather disingenuous to send an email then try and steer a current customer to a lower dose then try and cite some bullshit reason why you can’t use it on a higher dose. There is no price change on their subscription site anyway but I guess it costs them more. Will keep you updated if anyone is interested?

Thanks @Melty and agree with the comments above. I was so annoyed by the article particularly as the ‘expert’ commentary came from a psychiatrist, psychotherapist and others specialising in addictions. They are clearly not experts in the physiology of metabolic health and disease. I have come to learn only recently that due to damage to our metabolic pathways that lead to weight gain there is actually little free will involved when battling to lose the extra weight. This has been a revelation to me in terms of beating myself up about my weight gain. The article suggesting that people just want ‘a quick fix’ and avoid doing the real psychological work to treat the underlying problem is pretty offensive and ignorant. More like lazy and one sided reporting by the Times, again.

2nd dose of 2.5mg today and I've had diarrhoea all morning. No pain. I've not had much bowel action in my first week now all has come at once.
I do have some diarrhoea tabs in the cupboard but I don't want to send myself back to constipated.
Any advice please?

I'd just let nature do it's thing for 24hrs. You're getting a good clear out after a week of inactive gut so would be reluctant to take any additional meds today and reassess tomorrow. Just drink plenty of fluids and eat bland food little and often. Eggs are a good source of nutrients and can firm things up a bit too.

Hey all. Help?!
Took bonus dose out. I had used less one week but how much this look like? 5mg. Think it's about 7?? I only want 5 tho as sick enough on it so what should I take?
Thank u xx

@Dagnabit I got that email with the 40% offer too, I will try to ask them to see if I can order my next one, I got a 10mg from them last month so we shall see...

Thanks @KrankyKumquat that's great advice, much appreciated

Just over 4 weeks, officially a stone down, sub 80kg (79.5) for the first time in 10 years, maybe more. I am super happy. Have just started my 5mg doses (although took a little less than that for fear of too much supression/nausea) but expecting a slow down these next four weeks which I'm fine with.

My daughter has had confirmation of her Zava order so she starts as soon as that arrives, I'll let you know if it arrives cold.

That looks like 0.6mls in your pic, so if it's a 5mp pen, you've got 5mg. It's not a good syringe size to measure such a small amount accurately!

Thank u! Yep now u say it I was looking under the green bit.
I had other ones but can't find them 😕
I ll go it and hope for best 💞 🙏
Thanks again x

Good luck xx

Looks like there is an air bubble to tap to the top and then push out of the syringe too. That will reduce how much is in the dose too as the plunger will be a bit closer to zero.

There is another article in the Times today about a poor lady being taken to hospital due to side effects from a Wegovy dose increase from the initial 0.25mg to 0.5mg. She met the criteria for the initial prescription (BMI over 30) and also the subsequent dose increase after 4 weeks as per the manufacturer’s guidelines. Quite scary and I think the manufacturer’s instructions should build in more caution to cover those who have a strong response to the lower doses of these drugs (I am in that group). Sadly, there was much vitriol in the comments blaming the poor lady for being stupid for buying drugs online and a general theme around people with obesity being lazy and needing to exercise self restraint. Depressing. I added my two pence worth but my comment was very much going against the tide.

That article is pretty terrifying but of course we don't know if there's more to it. Did she follow the dosing guidelines? How many calories was she eating? Where there any warning signs? Some people push through dreadful side effects, increasing their dose regardless, which clearly is risky.

Thankfully for me, I couldn't see any comments, presumably because I sneaked behind the paywall to read the article 👀

does anyone have a MyProtein code?

Saw this on the MJ Facebook group and thought it was interesting for anyone who had had pens arrive with the ice melted

edit - sorry photo didn’t attach but it’s in the next post!

Sorry photo didn’t attach!

It's disappointing that so many arrive warm. I had drama getting my delivery from Zava but when it finally arrived, it was definitely cold.

I'm midway through week 5 and I've dipped under 16st for the first time can remember!

SW 16st 13lb
CW 15st 13.5lb
GW 11st

And I've lost 1.5inch off my waist.

I'm starting on 5ml this Thursday and then have 10 days until my hols. Hopefully that's enough time to get my body used the higher dose.

I'm quite constipated but confess I don't drink much water. I'm going to make an extra effort in the hope it will help.

Had a response from zava about my pen with a completely melted and not remotely cold icepack. They say that all is fine and that the icepacks are supposed to melt in transit and that the pen will still be between 2 and 8 degrees. There is no way that the pen was fridge cold but they are clearly not interested. My last order with them, despite discount codes.

I will use the pen and hope for the best but distinctly unimpressed.

Is there an official source for this? I agree with the statement but unless there's a page by the manufacturer or the MHRA saying it I suspect we'll get suppliers saying that it's not their problem.

I would notify MHRA to be honest. If its arriving warm then it's outside manufacturer guidelines. Any issues, Eli Lily will say it wasn't stored /transported appropriately. It's clearly falling outside the cold chain.

Have actually answered my own question. The Eli Lilly webpage for pharmacists has this info:

https://medical.lilly.com/uk/products/answers/how-should-the-mounjaro-tirzepatide-kwikpen-be-stored-217607

It is very clear that they aren't permitted to use the 30 day allowance.

Given Zava are claiming it wasn't cold that's an issue that would still need to be resolved but it does mean @Fromthesidelines you have a clear basis to place your complaint on if you want to make one.

@Ineffable23 if you click on the photo to see the whole thing, you can see it's from the Lilly website

Thanks @Ineffable23 and @Melty. I think the problem is that, although I could feel that the pen was not cold, I have no way of proving it and zava are saying that their shipping is good for 48 hours and delivery was within that time scale. My worry is that they may have used an icepack that wasn't completely frozen in their haste to keep on top of a volume of orders they weren't staffed to deal with.
I don't think there is much I can do other than try and find an alternative supplier. But I suspect that there are many out there who are seeing the opportunity offered but do not necessarily have the infrastructure to cope with demand.