Pen expiry

[Parrish]

If I wanted to use a 15mg pen to administer 2.5mg I would twist it 10 clicks. But this would mean I would run out of time to use the whole pen within its 30 day expiry..,

has anyone got any experience of using a pen past its 30 days? Is it still effective?

I have but not for as long as you would need to use it for a 15mg pen in 2.5 doses. But I’ve used pens for 6-8 weeks and not noticed anything. Just my experience, not a recommendation etc etc etc

I use mine for 6 weeks - days 0,7,14,21,28,35. So just 5 days over and I am ok with that low risk. I personally wouldn't push it any further.

The 30 days are there for a reason. Every pen has been stored and used in different conditions domestically, each person's response to the medication in that particular pen beyond 30 days may be different. Anecdotal "evidence" is worthless. I have seen a couple of posts in the past where people were ill after using a pen longer, but no know knows if it was the extended use of the pen or they would have reacted that way anyway.

I would also not be confident in the accuracy of dosing just 10 clicks or 0.1ml of medication or if scaling of the concentration vs the volume of medication between 15mg and 2.5mg will impact the effectiveness.

Why are you dropping from 15mg back down to 2.5mg? Would it make more sense to taper back down slowly?

I've done 35 days too but not beyond. I would also agree with point above with tapering down. So don't jump immediatelt from 15 to 2.5mg, go down slowly eg 12.5mg or 10mg next few jabs before you drop again.

It’s not about effectiveness - it’s the risk of bacteria getting into the pen and breeding. Every time you use it you risk sucking back fluid from your body into the vial, and you pierce it with a needle that may introduce bacteria.

many people do use a pen over and over again - it’s up to you to decide what you’re comfortable with. But the 30 day guidance comes from the manufacturer.

I have been buying 15mg and using less for ages. The advice is just because the companies don't want you to realise it's much cheaper that way. I use an insulin syrinfe rather than counting clicks. Just be careful to use a wipe each time on the end.

Just to reassure, fluid from your body does not get sucked back into the vial. It really doesn’t.

@Finallydoingit24 Do you have any evidence to provide this reassurance? I'm hoping you do, as it would be helpful to many of us.

As well as the manufacturers literature stating it as being a danger to share pens due to this possibility, there are photos on Reddit allegedly showing blood that has backflowed into a pen via a needle tip. I'm not convinced by these photos but would like to see evidence on why this isn't possible.

The Centre for Disease Control says otherwise (and they don’t sell Mounjaro)

https://www.cdc.gov/injection-safety/media/pdfs/Insulin-Pen-Safety-Handout-P.pdf

I’ve done 42 days, it was fine

I saw on social media someone showing the instruction leaflet for a tirzepatite pen (ie same medication as Mounjaro) purchased in Germany. It says you can use it up to 12 weeks after opening. Diabetics inject daily and seem to be able to use the same pen for many many more injections than MJ users do. It’s up to the individual obviously but I do think the manufacturers are loving the fact that people are blindly accepting the 30 day rule (as well as the move up to the higher dose every month advice).

@Finallydoingit24 the German Kwikpen patient leaflets are available on the Eli Lilly website. They also say 30 days (picture).

While we know the US pen and preservatives are very different, it doesn't make sense there would be different instructions for Germany which is more likely to use the same pen and preservatives that the UK use and therefore have the same, or very similar, instructions across the UK and EU.

It’s not the Mounjaro brand, it’s generic tirzepatide. What is the additional ingredient that Eli Lilly add that means it expires after 30 days when the same drug by another manufacturer does not?
It’s Team RH (who by the way I dislike) if you want to check it for yourself.
Anyway I have no skin in the game but I’d much rather get 6-8 weeks out of a pen than 4 🤷‍♀️. Both my waistline and wallet are happy.

@Finallydoingit24 There is no such thing as "generic tirzepatide". It is only produced by Eli Lilly.

The source of the information sounds unreliable. Of course it is up to you what risks you take, but you should make sure the decisions you make and the "information" you share are based on credible information for your own and others safety.

Well I suppose technically there are pharmacies mixing compound tirzepatide, like those produced in the US. Eli Lilly are trying to enforce their patent, but production is widespread. The stuff the previous poster mentioned from Germany is likely gray market stuff and probably sold "not for human use" but yeah it definitely shouldn't be held up as an example of medical information.
investor.lilly.com/news-releases/news-release-details/lilly-update-mounjaror-and-zepboundr-tirzepatide-compounding

I looked into this more as I'm interested.

The referenced experiment shows there was a 4.1% (6/146) chance of backflow. The same needle was used in all of the injections and the injectors used a rubber tube for the experiment.

Eli Lilly doesn’t distribute compounded tirzepatide, so vials could contain anything - mixed by anyone, stored in any conditions, and with zero regard for expiry dates.

But I guess, if anyone is comfortable injecting mystery juice into their body, then "discard after" dates aren’t going to register in their brains!

There is no comparisons that can be made between those vials of who know what and legal tirzepatide.