CONTROVERSIAL- Golden dose and using after discard date

[HelloWorld2577]

Hello!

It seems this is a topic people feel really strongly on so just wondered if anyone had the same thoughts as me and wondered what you would do.

So, recently I took 5mg, had a horrific reaction so decided as 2.5 didn’t work for me any longer I would dose down slightly to 3.75 (also controversial…). This means I will get 5 jabs of 3.75 out of my 5mg pen WITHOUT using the golden dose. Or 6 using the golden dose. This will take me over the ‘discard date’ but expiry date is not for an entire year and I keep the pen in the fridge.

It seems a lot of people seem to think it’s like poison as soon as it goes over that discard date. I understand they recommend this for a reason, MJ is a diabetic medication and therefore it needs to be working at its full efficiently for that reason… but if taking to support weight loss (as I am) if it loses a bit of its efficiency I can’t see why it would be a problem!?!

Does anyone else agree with me? what would you do? Just seems wasteful to bin a pen with a lot of medication in!

I agree. I've had great weight loss just through very small dosages tbh. I haven't even done 2.5. Probably about 1 or even less. I listened to a podcast about micro dosing, and it made a lot of sense. Not for everyone obvs but has worked well for me, without any side effects whatsoever.

That’s interesting! I have had judgemental comments from others opting to take 3.75mg as its ’not a dose’ but if 2.5 is safe and 5 is safe why would 3.75 cause issues 🤯

I sometimes take 6 doses or 3.75mg from a pen. Never seen a judgmental post about it or it being "controversial", it is a minor low risk tweak. I must be hanging about the wrong threads!

Of course some people are sticklers for rules, but that is their approach and who am I to judge them.

Others opinions don't bother me as I am confident with my own research and risk assessment so I don't generally ask for/need validation or feel the need to justify myself, I also don't recommend to others to do the same as me as I am very aware it is a POM and it is not my place to make recommendations.

Yes, this absolutely 💯

People are sheep, you could see that in covid, they are sticklers for following rules even though they might not make any sense.

I plough my own furrow. But again keep it to myself. It works for me.

I personally don't use it after the 30 days are up but I do take 4 x 3.75 doses out of a 5mg pen. It means that a lot of medication is wasted but I'd rather bin it than risk it.

For me it's like taking 1 paracetamol when the recommended dosage is 2. This doesn't feel risky whereas using the medication after it's been open 30 days would.

Isn't the issue contamination risk rather than it being less effective?

Whenever you open a sealed vial the contents are no longer sterile and bacteria could grow and then you are going to inject that into yourself.

Keeping it in the fridge reduces the risk but does not eliminate it and the risk calculation is that after 30 days of being open even if refrigerated bacteria could multiply to a harmful level.

The expiry date is obviously much longer as whilst the vial remains sealed it is sterile. The expiry date is more to do with effectiveness the discard date is infection risk.

If you are planning to do this then at least be very sure that you are doing everything you can to prevent the vial becoming contaminated by using and keeping it in the most sterile environment possible.

I've taken out of date paracetamol before 🙋‍♀️ But taking an injectable liquid medication a LONG time past it discard date doesn't sit comfortably with me.

6 doses I am ok with. The 5th dose on day 28 (within 30 days and you don't even need to break the pen to get it with 3.75mg from a 5mg pen) and 6th on day 35. 5 days is still within my risk adverse nature.

I'm planning on doing 3.75 x5 out of a 5mg pen when I move up next month. Undecided on a sixth dose yet but I'm not against it. I wouldn't use a pen that had been started any longer than that but I'm happy to be flexible and make my choices. People will always judge with this medication, I'm learning to tune out that noise!

I would but I would be very careful and not take the piss with it. I would only take it a week or two beyond the 30 days and be very careful about keeping it as sterile as possible.

I’m prepared to keep for 36 days. Which is 6 doses - the final day being the 6th dose. I don’t have any logic behind it, other than I am very religious in keeping my jabbing hygenic with alcohol wipes and always keep the pen refrigerated. I also believe there would be some leeway in expiration - otherwise Elli Lilly /prescribers would be far more strident in highlighting the expiry time.

I’ve been taking sub doses from a 5 mg pen for 17 weeks (after the standard 4x 2.5 mg and then the bonus dose for that pen) - currently up to 4.5 mg.

I do discard after 5 doses as the antimicrobial agent in the multi-dose vial is only effective for 30 days. No amount of money would make me risk a serious infection - the risk maybe fairly low but still a no from me. I’m happy to get 5 doses out of a pen rather than 4, and discard the rest.

Speaking as someone in the industry. The antimicrobial agent has only been tested and registered for 30 days but all the anecdotes and evidence suggests it's good for at least a year. If you are very clean in your handling, and keep in the fridge there is no biological reason your MJ won't still be working great at 80-100% a year after official expiry. But this is totally at your own risk, and on you, if you end up with infections, septicaemia or other things you don't want.

I’m planning to take 5 doses of 3.75 from a 5mg pen. The 5th dose will be taken on day 28 and I’ll discard the rest. As pp said, no hard twist will be required and it’s within the recommended 30 days. I’m simply not ready for 5mg or potential side effects , I know I might be lucky to have none but can’t risk it as I have so much going on this month. 2.5 isn’t fully working anymore so can’t stay on that either

It’s totally a personal decision but to me it just isn’t logical that 2.5 and 5 are fine but in between isn’t. I couldn’t tolerate gastro effects at 5 so have had 3.75, 4 and now 4.16mg. As such I have had 5-6 doses from my 5mg pen and I get the 6th dose out with an insulin needle. It seems to have been fine for a good few months now but totally respect if others prefer not to stray at all from the guidelines. and it’s definitely a bonus that it’s working out cheaper because of an £122 pen lasting 6 weeks.

I took 3.75 on Saturday and I am feeling great. No side effects. I think doing 3.75 before 5 should be recommended as last week I was so so miserable. I want to lose weight with MJ but I don’t want to be miserable doing it!

3.75 is working how 2.5 was for me before it wore off. Feeling suppression and portion sizes seem to be getting even smaller! I had ONE chipolata last night with some roasted carrots and 1/4 a microwave root veg mash and I was stuffed.

MJ really is amazing.

I think I’ll possibly just do the 5 doses of 3.75. I didn’t even think about the contamination aspect of the vial. I am very cautious as have health anxiety! Always clean properly & put the sterile needle on. Pen gets put into a zip lock bag, inside another bag inside the fridge and I clean the surfaces and scrub hands every week I do it😂But I might just leave it at 5 doses! X

I actually hadn’t thought about slowly moving up from 3.75 up to 4 and then so on. That may be an idea for me actually! I done 45 clicks this week and so far so good, so may do 50 next week, 55 the next and then 60 then I’ll be able to just do a bonus dose of 5mg for week 5 and not need to stress about the dates etc!

I think that makes sense too.
But personally I’m adopting the approach of only moving up if I’m not losing weight anymore/noticeably don’t have hunger suppression.

as long as it’s working I’m sticking at the dose so was at 3.75 and 4 for about 4-5 weeks each I think. Remember that it is cumulative too I think so builds up in your system every week even without you increasing dose.

How many clicks is 3.75 on a 5mg pen? I can’t remember how many clicks a full dose is meant to be…

@MJnotMJ full dose is 60 clicks. 3.75mg is 45 clicks.

Math's is -

desired dose / pen dose * 60 clicks = number of clicks

e.g. 3.75 / 5 * 60 = 45 clicks

or if using a syringe

desired dose / pen dose * 0.6ml = ml

e.g. 3.75 / 5 * 0.6ml = 0.45ml

Yeah as the above says too I’ve worked out the following

Clicks from 5mg pen

60 clicks for 5mg
55 clicks for 4.57mg
50 clicks for 4.16mg
45 clicks for 3.75mg
30 clicks for 2.5mg

Thank you both!

Adding a version of the click chart. Column C shows how many doses you might get from a pen without breaking it. Column D number of doses you might get using the extra liquid.

I am currently on the dose highlighted in red.

That’s a very good chart to have @Herewegoagainandagainandagain