Taking a maintenance dose for life?

[NotA6FigureSalary]

Hi all,

I'm now the top end of a healthy weight. Gonna lose another stone just to look/feel my best. I'm on 15mg.

But then what? I'm absolutely happy to be on MJ forever. But what dose?

I'm thinking maybe 7.5mg. Then I will only need to buy a pen every 2 months.

Any thoughts? Thanks

I'm no where near this but my first thought is the antimicrobial preservative in the multidose vial is only effective (or at least tested for) for 30 days so you're need to make a judgement about whether getting 10 doses of 7.5 mg out of a 15 mg pen is worth the risk (assuming that is what you meant when you said you would only need to buy a pen every two months).

I guess the ideal is to share with someone else - easier said that done, of course!

Have you had a look on You Tube for some advice/experiences from those in America?

Your supplier should be able to recommend a maintenance dose. I think mine does. I too plan on staying on it forever or until some other maintenance alternative comes out.

Thanks both.

My supplier is Boots. Who are a pain in the fucking tits tbh.

If they tell me to stay on a maintenance dose of 7.5mg, they will guaranteed make me buy 7.5mg pens. They won't have any truck with me buying 15mg pens and counting clicks. Cos "computer says no".

And god knows what they would say if they knew we were all extracting the extra dose with diabetic needles!

So they are the last people I'd ask for advice.

Good idea to see what folk in the states are doing cos they will be way ahead of us having had it available longer.

Yeah I hear what you say about shelf life of the pens. I think I'm willing to take the risk to save up to £100/m for the rest of my life I'm not worried about an infection. I'd only be worried if I thought the drug itself wouldn't be effective after being opened for too long. But I think both are highly, highly unlikely tbh.

If I could maintain on 5mg/week of MJ, it would only cost about £70/m. And given how much I save on takeaways/food in general, I'd still be quids in!

Presumably prices will come down at some point anyway as they always do with any new product/technology.

Wish they had invented this 20 years ago.

If I'd had MJ (and Roaccuane*!!) when I was say 16, my life would have been a lot easier!

*eventually went on it age 30, over 10 years ago.

I take the tablets Rybelsus, and will take them for life in a half dose, no problems with temperature and sell by then,

I'm planning on staying on this forever too if I can. I've thought about splitting doses but think we'd run into problems with prescribers ordering every two months. I think we could just about get away with dosing every 10 days. I'm on 7.5 but plan to go down to 5mg weekly initially and see what happens.

@NotA6FigureSalary I'm not sure how I feel about prescribers being best placed to advise on maintenance. A lot of them have been recommending us to come off at BMI 25 having built healthy habits so I'm not sure they are particularly well informed on how obesity works!

@izzy2076 agreed. Habits won't help me when the hunger comes back! I simply have a big appetite so need the drug, end of!

Boots was refusing to sell urine strips in the early 2000s in case people used them for those evil LOW CARB DIETS! Even to this day, Boots is so backward they still believe in the food pyramid ie that a low fat, high carb diet is best.

TBH most GPs are also pretty backwards in their knowledge about obesity. It's hard to find folk that are up to date with the latest science.

In the absence of any information on the safety/stability beyond 30 days I would feel uncomfortable injecting, especially so far, beyond 30 days.

Another potential option to reduce costs is "cycling", if 2.5mg gives you suppression. Do 2.5mg for 5 weeks, then nothing for 5 weeks, then 2.5mg again. Will power will be needed in the in between weeks, or perhaps any loss during the 2.5mg weeks will keep weight overall maintained so I don't spiral into obesity again. Not sure if it is healthy though messing with blood sugar levels going up and down like that.

I would be more comfortable trying that than injecting something that potentially could be compromised.

The Rybelsus tablets sound interesting, but look expensive privately if needed daily.

Hopefully they will provide a maintenance plan soon.

The insulin needles i buy to extract are sealed and sterile. Amazon. Ive always too the extra. Im on 12.5 best dose yet for me , except 2.5. Im hoping to stay on that. Although 12.5 not always easy to get .

Ohh everyone will have an opinion on the safety of your suggestion. I do the same.

No one has ever had such a strong opinion on the risks posed to me by my starting BMI of nearly 50.

Do what works for you OP. Balance the risks for yourself.

Totally agree. Some gp are saying to take 5th dose ..xx

I’m coming towards the end of the weight loss part of my journey as well.

Another 4-7 lbs to lose and then I want to stabilise and reduce my dose.

I’m currently on 7mg (from a 10mg pen) and plan to drop down to 5mg to begin with, and then down to 2.5mg, nice and slowly. And I’d like to maintain at 2.5mg.

I have been using larger dose pens for my whole journey, ever since I got past the first pen. So for my second 2 months I used a 5mg pen but stayed taking 2.5mg, plus the extra dose, so the pen lasted me 10 weeks. I’ve been on MJ for 8 months and in all that time have only ever used 1 pen up within the 30 days.

Personally I am comfortable with using my pens like this. I refrigerate all the time, and am scrupulous with hygiene, using the alcohol wipes to not only clean the pen, but the surface I am using and my skin.

I know it’s against guidance, but I also understand that there is contingency built into their calculations. Most people I know are using their pens this way to lower the costs. And I plan to keep doing so.

This is almost a year old, I don’t think OP is coming back to update what they did

I’ve been using a 15 pen for maintenance and taking 5 from it every 9 days, it’s a risk I’m willing to take for the cost saving. Have maintained my ideal weight for 4 months now. I’m going to try stretching to 12 days in between injections.

I'm on a fixed cost plan until January so will receive a pen per month automatically until then. I've been taking the 5th dose out of each pen so that by the time I get to the end of the year, I will still have a few pens in the fridge. I'm then hoping to get on to a maintenance plan with Oushk and do the same thing, order a pen per month and build up surplas in the fridge and use them in order of exipiry date. I would definitely consider counting clicks and getting up to 6 doses out of a pen, as long as I was cleaning it with the wipes and replacing the cap every time. I'm very open to being on it forever or at least long term, but can't bring myself to throw the stuff out and waste it.

Do the prescribers check why not ordering every 4 weeks?