Split dosing

[ohdoriswheresthesalad]

I’ve been taking 7.5mg for 2 weeks now and the first 3 days are rough! I’ve been vomiting, anything I eat during the day comes back up at night as it’s clearly sitting in my stomach for ages! I’m losing weight but don’t feel that it’s a “safe” way, keep being sick for 3 days of the week!
I’ve read about maybe doing 1/2 dose Monday and 1/2 dose Thursday does anyone have any ideas on this? Wondered if this could lessen my side effects but still give me enough suppression/satiety.

I’ve emailed my pharmacy but no response as yet.

What was your suppression and weight loss like on 5mg? I personally wouldn’t split doses but would move back down a dose and then gradually move up if needed

It was fairy good to start with but did lose it the last week and a half I’d say and weight loss was minimal the last 2 weeks. I’ve lost 2.5lb so far on 7.5 but am only 8 lb away from my goal.

How much have you lost so far? 1-2lb a week is a healthy loss. I’d definitely move back down to 5mg especially as you are having bad side effects and only have 8lb left to lose.

I’ve lost 2st 0.5lb.

OP how much did you lose on 5mg? What was your reason to move up to 7.5mg?

I lost 7.5lb on 5, the majority was on 2.5. I moved up each dose as I felt like suppression was wearing off after a while and I was getting food noises back. Med express said when I asked, to move up if I felt it wasn’t working as well as before.

I do this so I don’t get such a rollercoaster of highs and lows. I realize it’s not in line with the instructions, of course.

@shrinkingthiswinterhow do you find it? I know it’s not in line with instructions, but I’d be interested in your thoughts and how you’ve managed on it if you don’t mind sharing.

Looks like you were losing just over 2lbs a week on 5mg, which is good.

The 'chasing suppression' comes at a cost if that's what you're doing and making you unwell. Everyone reacts differently to this.

My recommendation is to go back to 5mg - I would rather some food noise instead of puking everyday.

Maybe try the 7.5mg in a few weeks when your body has been on the med a bit longer.

I do the same as @shrinkingthiswinter but only because I was worried about side effects. I’m usually very sensitive to medication so I was very cautious, even micro dosing at the beginning i.e. only taking 1.25 mg of MJ per week.

But seeing as you are so near goal OP, I don’t know why you just don’t go back to 5 mg, as you will have to consider maintenance and lowering dose or stopping, anyway.

If 5mg felt like not enough but 7.5mg was making me vomit I would probably go back to 5mg and either accept I would lose the last 8lbs more slowly or, after a week on 5mg try 6mg and then 6.5mg etc until I found the correct dose. I would rather stick to a weekly injection of a non standard dose than take a dose that had made me vomit over two microdoses in the hope that that would make it easier to stomach. It might not.

I'm considering doing the same next week but kind of opposite to your reason. I'm 5th week in on 12.5mg, have my jab Sunday evening and come Thursday my suppression is gone for the last 2 weeks. I'm going to try maybe going for 7.5 on Sunday and then 5 on the Thursday see how that pans out🤔

It works very well for me. I’ve done it most of the way through. When I wanted to go up from 2.5 I injected an extra 1.25 halfway through the week. Then after some weeks I started doing 3.75+1.25. But this isn’t at all in line with the instructions and I’m confident about my maths and also happy to experiment on myself. I lose about a kilo a week and probably would have lost exactly the same if I’d followed the instructions like a sensible patient.

Thank you all for your advice, it’s really helpful.
when I do my next dose next week I shall try 5 again from my 7.5 pen and see if that helps. My target of 10 and a half stone just puts me in the healthy BMI so once I get there I may want to lose a touch more just to give me leeway.
i may then do what @Chouxrecommended and go up to 6 etc to see if that helps.
one friend told me to go up to 10mg but I don’t really want to do that if this is making me vomit for 3 days!

I do this and it works like a dream! I’ve finally found something that doesn’t make me take 50% off my week in bed I’ll. I started because I had no supression on 2.5 for about 4 weeks so I went up to 5 for 4 weeks but that made me rather ill. Started 4 weeks of 2.5 twice a week and now I’m on 3.75 twice a week

I wouldn't be comfortable injecting twice weekly regularly without my prescriber saying it was ok for me.

The medication has a 5 days half life, and no-one knows the potential impact on your body processing the medication to clear it out your system twice a week - does it put extra stress on your liver, pancreas etc? Obviously some do this, and may have no (apparent) side effects (yet), but they are not you and I would see this change in the dose schedule not as a low risk.

This is one to speak to your provider about.

I have reached out to my provider but no response as yet @WeAllHaveWings. I was just wondering about “real peoples” reactions while I was waiting for med express to get back to me.

@Laurabelle9so you’re on 7.5 in total? How’s your suppression/satiety/ side effects?

Real life reactions are interesting to hear about @ohdoriswheresthesalad , I would be also tempted to ask those that have tried it what did they based that decision on. Was it their own provider who said it was ok to do and do it regularly, was it from solid research they can link to, or just anecdotal posts online they decided to blindly follow? Glad you have contacted your provider and hope you listen to their advice (whether they approve or not), it’s risky to make changes like this one without medical advice - what appears to works with no apparent negative effects for one might not be safe for another.

It’s clearly common sense and logic, independent thinking, and knowledge (as to why pharma companies decided on once a week for the majority ie. compliance issues for those who don’t like injecting or aren’t able to do the maths). Obviously for those who are uncomfortable with any of that, they can just follow the basic guidelines.

If my provider doesn’t advise it then I won’t do it, I’ve followed the “rules” so far. I will go down to 5 next week and see how that goes then maybe go up each week.

It is well known the medication was designed with a 5 day half life as once weekly injection compliance was easier for patients to comply with.

Just because one part of how the medication was designed with a specific half life to aid compliance, you cannot then automatically invoke "common sense and logic, independent thinking, and knowledge" without evidence that injecting twice a week is safe for all patients to do. Can you back up with credible evidence?

It is not simply about rigidly following the basic guidelines. It is about assessing which changes are low risk - 5th dose, adjusting dose up or down is minimal risk.

Injecting twice a week, unless advised by someone qualified, is "clearly" a higher risk as there is no evidence of using the 5 day half life formulation of the medication that has been designed for a weekly schedule.

Just an update - med express did not advise split dosing but to take a lower dose for my next jab this evening and next week. I’m going to take 6.25 from a 7.5 pen which I believe is 50 clicks?