Bonus Dose?

[jp35]

I’ve read some comments about people getting 5 doses from one pen. How does this work please?

Each pen, regardless of strength, officially dispenses 4 doses of 0.6ml = 2.4ml. The pen holds 3ml of medication.

The extra liquid is there for any extra priming and also as a buffer for accurate dosing. It is usually enough for a 5th dose. The pen locks after around 258 clicks so the 5th dose is not able to be dispensed normally.

You need to extract the liquid from the end of the pen, through the red seal using a syringe (buy from a medical supplier, not Amazon). A full dose of any pen strength is 0.6ml.

(there used to be a method called hard twist to get the medication out using a pen needle but that is unreliable now as appears the pen design has changed)

There are two ways you can access and use the remaining medication after you’ve done 4 normal doses, and the pen locks. Either you try to “hard twist” the pen mechanism once it’s locked and hope it doesn’t totally break the plunger mechanism. You can then use the pen as normal for one more dose. Or, you can extract the medication using a 1ml syringe, bought from a UK online pharmacy like UK Medi. Syringes bought from Amazon aren’t medical grade.

I have done the first method twice, but subsequent attempts have resulted in the plunger mechanism totally breaking and no longer working to inject. Now I use separate syringes to do it.

Thank you for the replies. Where do you buy syringes from? I guess it’s not something you can just pop into a chemist and buy?

Would anybody be able to link a syringe for this where the needle is the same size as on the pen please ?

Ukmedi do 1ml 8mm syringes or SHD medical do 12mm 1ml syringes which I use and insert only half way, I got them as they were a lot cheaper and wasn't expecting to stay on mounjaro for so long but I'm a slow loser at 1lb a week with prediabetes so I needed higher doses for effectiveness. In 6 pens I hard twisted effectively twice and used 4 syringes. With the syringe method you can extract all of the remaining fluid, for me it's 0.7ml which is usually a bit more than a standard dose but good as a transition to a higher dose.

@ymemanresu that depends on what size needles your supplier has sent!! They could be anywhere from from 4mm to 12mm which all work for subcutaneous injections.

You are very unlikely to find syringes with fixed needles shorter than 8mm which are the ones I have used very happily for the last 10 pens. If you are desperate for 4mm you can use Luer Lock where you can change the needle which has to be bought separately.

Can you use the standard 4mm needles we get in our mounjaro packages with Luer Lock syringes?

@Mysticmaiden no. My understanding is that they don't fit and you need to buy the Luer Lock ones specifically. Never used them myself though as never felt the need!

I have these from UK Medi. I ordered 10 of the luer lock syringes and they sent 5 of each luer lock and luer slip (perhaps they ran out of luer lock). Both work with the needles linked further below, and I have used both at least once each.

1ml Unifix Luer Lock Syringe
1ml Reduced Dead Space Syringes (luer slip)

The luer lock is an easy twist on/off action, especially if you choose to change the needle between extraction and injection, but it looks like there is a bit of dead space (internet implies it will be around 0.1ml, no way to tell how much). It works ok for me as I don't use every last drop of medication just now and I still get what I need.

The luer slip syringe has a reduced dead space which means less medication lost, you simply push the needle onto the syringe, but it is a little bit harder to pull the needle off if you want to change needles/only put the needle in your sharps bin, so make sure you don't press it on too hard in the first place like I did as it didn't feel very secure.

The needles from UKMedi (example below of the one I use) come in different lengths and gauges so you can choose one that matches your pen needle from 4mm to 8mm. I would just be careful if choosing a very fine 32G as (only from posts on here) it seems more prone to bending, especially if using the same needle to extract and inject.

31g Light Blue 6mm Meso-relle Mesotherapy Needle

@Mysticmaiden the luer lock/slip is much narrower/different way of connecting compared to the pen needles