Splitting Mounjaro Dose

[Friedslice]

Hi All,

Has anyone split a 10mg pen in to smaller doses to wean off or use as maintenance?

Im down to my last 7ib to lose and am seriously worried about just stopping MJ and piling it all back on but also cannot justify spending £230 on a 2.5mg pen when its the same price to get a 10mg one and just split it to last longer!

I know how to count the clicks and have got spare needles & alcohol wipes for the pen but just wondering if anyone else has successfully done this?

I know most advise is to only use for 30 days from opening but then some say it is fine as long as kept in the fridge and used by the ‘use by date’ 🤷🏼‍♀️

I’ve been doing this from the start to reduce the cost . It’s easy if you just think that 60 clicks equals the dose on the pen.
when I had a 5mg pen I was doing 30 clicks for 2.5mg. I now have a 7.5mg pen but do 40 clicks for 5mg . I like that I can go up by smaller increments when I want to.

Thanks @olympicsrock so how long have you used a pen for from first to last use? And no issues with effects / infection etc?

I know most advise is to only use for 30 days from opening but then some say it is fine as long as kept in the fridge and used by the ‘use by date’ 🤷🏼‍♀️

£230 for a 2.5mg pen! Is that a typo? You can get it £100 cheaper than that.

"Some say", all of the "some" I have seen state this are unqualified people who take risks. So it depends on your own risk tolerance - do not assume that because others say they would that is it safe. The risks are the medication once the seal is broken and it has been exposed to air and bacteria it could be unstable or unsafe. Or it might be fine.

Personally I am risk adverse when it comes to injecting into me. I am ok with the 5th dose (which is within 30 days) and microdosing as they make logical sense, but I would not go much beyond the 30 days (maybe I would do 31-32 on a pen that had arrived nicely chilled) without advice from a person qualified to give it. I have asked a couple of prescribers, and one said they will ask Lilly, but I haven't had a response yet.

Hey, where are you getting your pens? That's very expensive but also unusual that all doses are the same price?

I've got from Zava so far and paid £122 per pen including delivery.

Oushk look good for maintenance and say they will have a subscription plan that includes a 15% discount for every pen, bringing it down to a similar price to Zava for the lower doses.

There are definitely people out there doing what you're doing - I personally couldn't bring myself to do it. There is a post here somewhere from someone who became very ill but there may be other reasons in addition to using a pen well beyond the 30 days.

I have counted clicks to take 3.75 from a 5mg pen and am now just past 30 days with a lot left in the pen - but I'm pretty sure I won't have the nerve to use it this week 🙈😂

I’m also planning on doing this. I don’t think you will get an answer from Lily saying anything different to the license agreement that is pens are disposed of after 30 days. So the risk is one that you choose to take, same as eating food that’s after it’s sell by date.

To answer the couple asking why it’s so expensive lol, it’s because I use VOY.
To be honest I’ve always managed to get referrals so it’s been £115 a month, but prepared to pay the £230 if I don’t get a referral.
I don’t want to switch suppliers as I chose not to inform my doctor and I am also now in the healthy BMI so would also be harder to get it prescribed!

Think I’ll prob just take the risk to be honest, I’m good with maki NG sure I keep the seal clean, clean surfaces, washed hands etc so hopefully as long as I keep doing that I should be fine 🤞🏼

Also @WeAllHaveWings The advise that it can be used up until the sell by date even after opening as long as it is kept in the fridge is on Superdrug’s website, so not all unqualified people.

can you share a link/screenshot where it says it as I can only see it saying 30 days from first use discard the pen?

Not sure why they have 2 different versions….

Lasting to expiry date is for an unused pen. It is just badly worded.

While it is important to keep hands/surfaces clean there is still a risk of the medication degrading as soon as the vial is unsealed and the medication has been exposed to air, and each injection there is a risk of biological material backflowing into the vial. There are bacteria suppressing agents in the medication but we don't know how long they last.

So it comes down to whether you choose to take the risk for yourself from unqualified risk takers saying "I'm sure" or "I think" it "should" be ok.

@WeAllHaveWings I don’t see it as badly worded, I read it as it can be used until the expiry date when kept in the fridge, or for 30 days after opening when kept out of the fridge, as that’s what it says lol.

As PP have said, it’s only really Eli Lilly who can confirm but as far as I can see their stance is 30 days after opening whether kept in the fridge or not, but there’s not a huge push on it so I don’t think the risks are really that high if you’re careful.

I’m on my second month of 5mg. Instead of 4 doses of 5mg I’m doing 5 doses of 4 mg counting clicks. Working well for me.

The difference is the question "How long does a MJ pen last in storage?" meaning before it is in use. Which is why it is badly worded.

If you ask Superdrug for clarity I guarantee they would confirm 30 days from first use as that is the Lilly instructions. The same bad wording is in the two leaflets that come with the pen, one talking about storage of the pen before use and the other after.

it’s only really Eli Lilly who can confirm but as far as I can see their stance is 30 days after opening whether kept in the fridge or not, but there’s not a huge push on it so I don’t think the risks are really that high if you’re careful

What do you mean by "there's not a huge push on it"? They have clearly given the discard after 30 days information in the patient leaflets, what more "push" would you expect?

As I said, if anyone wishes to ignore the instructions it is their risk to take and I hope they have no issues with it, but they will be taking that risk based on unqualified internet posts.

@Bitezbabe a hint when using the 5th dose in this way. Next time you do your 48 (I think?) clicks mark where you are turning to in the dose dial with a marker.

This means if the pen jams/stops on your fifth dose before you get to 48 clicks you know where to hard twist too if you still want to stick with 4mg (doesn't matter if you want to go to 5mg). Mine did that last time and it was a pain trying to work out where to turn the dial to.

How did you work out there are 60 clicks total in a pen? Thank you!

Hi
When extracting does from the pen to a syringe, what is 2.5mg in ml ??

@Granma2008 it depends on the pen strength. A full dose from any pen strength is always 0.6ml in volume. How much medication is in that 0.6ml depends on the strength of the pen. If you have a 2.5mg pen, then a 0.6ml dose would give you 2.5mg. If you have a 5mg pen, then a 0.6ml dose would give you 5mg, so you'd need 0.3ml from a 5mg pen to give you a 2.5mg dose.

What strength pen do you have?

So I've would my 5mg pen fully and forgot to count the 30 clicks to give half dose as the 5mgs made me sick...any suggestions how I give myself 2.5mgs?

0.6 ml if it is a 2.5mg pen

60 clicks for each prescribed dose in a pen. 60 clicks also equals 0.6 ml which is a standard dose

Heya, any any ideas??? Please tia xxx

@Froggy79 are you saying that you've wound the pen out to the 1 position, and left it like that since yesterday? Or have you wound it back in already? Not pressed the end, but just wound it back down to 0.

So you’ve wound it out to 60 clicks but don’t want to inject that as you only meant to do 30 yes?

only way I can think of would be to ignore the mechanism and separately extract 0.3ml with an insulin syringe to inject. As I don’t think you can reverse the clicks without pushing out the dose. You would then need to do the same next time too - to be honest it doesn’t sound ideal as not sure if storing the pen with the end wound out could cause any issues in terms of storage/sterility. You might need to just write off the second half of that dose and push it all the way back down to zero (which would squirt out the air and rest of that dose) rather than waste the rest of the pen.

There is a website called GLP1plotter that helps you work out how many clicks to do the dose you want, or tell you how much is in your systems if you inject on different days or anything else.

And I use these

https://www.chemist-4-u.com/carepoint-pen-needles-31g-4mm-pack-of-100?utm_source=braze&utm_medium=email&utm_campaign=C4U_Canv_RepurchaseEmail2

Can’t you just wind it back to 0 and start again (but count it this time)? The pens I use let me wind up and back as many times as I like…