How to use the "bonus" dose

[WeirdyWorldy]

I'm on my 4th week of MJ and it's not really working now.

I've just injected for my last week before going to 5, and wanted to use the "bonus" dose.

But I can't get it to "click" or turn round to be able to administer it.

I think there's still a full dose in there. Any ideas how I can turn the "dose knob" to get it to work.

You've just injected 2.5mg and want to inject another 2.5mg (or potentially more) on the same day? Or have I misunderstood? So you want to do 5mg or more a week earlier than otherwise.

See here:

For the method where you use the pen again, skip to about 12mins, 30sec in...

I want to inject what's left. Not sure if it's the full 2.5.

I'm on 5ml next week. But don't want to ruin this week by gorging. 2.5 only lasting about 2 days.

Although suppose I could just start the 5ml? It's already arrived.

Save that for next week. Get 5 weeks from 1 pen.. take your time, don't rush..

Next week, just do the same with the pen, but you just twist it really hard, it will feel like your breaking the pen but it will twist, then have another 2.5 dose. Use a new needle.

Alternative is to use a syringe needle and get it all out and it will probably be a tad more so more like injecting 3.75mg instead.. 0.6ml is a dose.

Me personally I just use it as a 5th dose of the same strength.

Most people use the bonus dose to do 5 weeks out of one pen rather than 4 and spreading the cost out. You need to do a really "hard twist" of the knob to get it to go up to 1 (or as near as you can). I really thought I would break the pen, but told myself if I broke it that was fine, it was going to be chucked anyway. You'll need a new needle as well (can buy online). Alternatively you can order disposable insulin syringes, extract the bonus dose out into the syringe and inject yourself with that instead.

You can use the 5th dose next week after you have completed at least 4 full weeks on 2.5mg. Do not use earlier than the full 4 weeks completed.

If you don't want a 5th week at 2.5mg then start your 5mg pen next week.

It's potentially more than 2.5mg as the dose amount in terms of liquid is 0.6ml. If you haven't used much when priming the needles, you could have more than 0.6ml of liquid left. So rather than moving up to 5mg early, you would be moving up to nearer to 6mg or more.

Be sensible or you might do yourself harm. One week of patience is not going to ruin everything.

Remember this is a serious meditation that is prescription only for a reason.

It’s not supposed to “work” at 2.5 - that’s the starting dose for a month to get your body accustomed to MJ. Some people lose weight at this dose but it is also likely linked to changes in behaviour.

5 and above are the doses that have efficacy for weight loss. But you need the month on 2.5 so your body can handle the higher doses.

Be patient. It’s not long.

I use an injection to withdraw what's left and then use that the following week as a "stepping" dose to the next strength. So for a 2.5mg pen, if you extract the entire bonus dose, that works out at a dose of around 3.75mg, which is a good way to then get used to the bigger, 5mg dose, the following week.

Thanks folks! Some of you must be mighty strong! Took me ages to twist it!

But got there.

Speak to your prescriber OP. They may advise you to have your next jab before the full week - listen to your prescriber not people on MN.

My prescriber suggested I take my next jab after 5 days and I'm on my first pen. It's not an endurance contest taking Mounjaro but your prescriber is the best person to speak to.

So are you taking it now then?. So 5mg potentially more on week 4?

Please update us in a few days with how you feel? Be interesting to see if it has no bad affects?? .

Yes I took it.

Sadly patience isn't a virtue I was born with and thanks for PPs concern, but I wasn't going to "waste" 3 weeks of dieting and 8lb loss coz I'm a greedy guts with no self-control :)

I'd already been dosing a day earlier every week and not had one single side effect (yet). Not advised I know. But will update if I do.

Thanks again for help, support and advice. I genuinely appreciate it.

edit to say. I didn’t take an extra 5ml I took an extra 2.5 which gave me 5ml on week 4.

While I agree with you to consult your prescriber I would also do your own research too as not all prescribers are equal and do not fully discuss the advice they are giving out. The same with any advice from any HCP, do you own research and ask questions (saved my mums life once), imo this is even more relevant when dealing with remote prescribers.

Taking a dose 2 days early is fine, taking it two days early combined with increasing to 5mg on the next dose 7 days later (like the OP would have been doing) has consequences to not only that dose, but the following one and any decent prescriber would have explained that.

Taking 2.5mg 2 days early, then taking 5mg 7 days later, would have resulted in a first dose of 5mg reaching a concentration of 8mg then dropping to normal 5mg levels, instead of under 6mg and then building up in subsequent weeks (never reaching 8mg).

I would honestly move my prescriber if they gave that advice without also advising the risk/consequences of it.

You didn't take 5ml.

The medication is measured in milligrams. A dose is 0.6ml and 2.5mg. You took two doses of 2.5mg.

@hoarahloux thanks for clarifying! I got my ml and mg mixed up'!

I haven’t got the strength to twist it for the bonus dose, but my husband can do it easily.

@WeAllHaveWings I would agree that it's unlikely a prescriber would recommend doing as you set out - but what would be more likely is that they would encourage the OP to bring forward their next jab, planning to then leave 7 days before the following one (as opposed to telling the OP to just live with it because it's normal to feel hungry).

Bringing forward the next 2.5mg jab 2 days and then waiting 7 days for the next jab of 5mg is what I have set out - the result is a large, above normal 5mg levels, spike in the first 5mg dose which could be unpleasant.

Side effects could result in missing work etc and any decent prescriber should make this clear, or take into account when adjusting from the 7 day cycle when a new dose strength is going to be used the following week.

Telling the OP to be patient and ride it out for a couple of days is safer and preferable.

With respect and regardless of your lovely graphs, it's really a matter for someone to take to their prescriber? It could be that it's actually completely fine - but neither you nor I are qualified to make that call.

Since my prescriber did think it was okay, and is qualified, I'd be inclined to think that others might do too. And although that wouldn't be in line with your recommendations, it would be inappropriate for anyone to disregard a qualified piece of advice just because of your graphs.

I am not saying to anyone to disregard they prescriber. I am suggesting it is prudent to question and get clarification of any HCP's advice when it doesn't make sense or could pose risks.

Any I take offense at the suggestion my graphs are anything other than lovely 😉

@85reasons Can I also add that some prescribers are better than others. There are some who, in my opinion, too motivated by sales and sailing far too close to the winds of unprofessionalism so I agree with @WeAllHaveWings that it is sensible to question and clarify

When I was on 2.5 I took it a day early for 2 doses, but now on the 5th week of 5 and suppression lasts a lot longer. I haven't had the need to dose early.
Re the bonus dose
I would use an insulin syringe. I tried forcing the pen for the 1st time this week. It worked but when I injected, the plunger was stiff going down and it wouldn't go all the way... I must have broken something. it caused extra stress as I didn't receive the full dose and then I was trying to guess and make it up with another injection using an insulin syringe.
I think I ended up dosing a bit too much but that was yesterday morning. I haven't had bad side effects, but suppression is stronger than normal for the day after the jab!
From now on insulin syringe only for me.

I think, if you are going to use the fifth dose, a syringe is a safer option because, once you have "broken" the syringe, you cannot guarantee it is going to continue to measure correctly.
Obviously neither is recommended by the manufacturer