Talk to me about MJ …. Priming, storage and golden doses.

[scarediecat]

Do you really prime the pen every time you use it?

My pack says I can store out the fridge for 30 day. What’s the difference to wear you keep it?

I think I understand a golden dose is an extra bit left at the end?

thanks x

Yes, prime every time.

You must store the pen in the fridge until it’s opened at which time you can choose to keep it out of the fridge for up to 30 days. Most people just keep it in their fridge the whole time.

The golden dose is the medication leftover in the pen after the intended 4 doses are taken, it’s meant to be for priming but even if you prime each time there is usually quite a bit left so some people choose to extract this and take it as a 5th dose from the pen. You will need additional syringes and needles for this and to read up on how to do so safely and how to calculate dosages.

Yes you prime each time, because priming checks that the needle you’ve attached is attached correctly and isn’t a duff needle. IIf you don’t get any liquid out when priming you then change the needle and try again.

It doesn’t matter if you keep a used pen out of the fridge, as long as it’s kept below 30 degrees c. It’s personal preference. I keep mine in the fridge all the time because that’s where it is before I start using it, it’s at a constant even temperature and it’s out of the reach and sight of my youngest child.

There will always be some medication remaining after doing the normal 4 doses with the pen. It’s usually enough for one more full dose, often it’s more. I dislike all the twee names that are used for this left over medication! You either have to force the pen to turn to use the remaining medication, which sometimes doesn’t work. Or use separate syringes to extract it and then inject using those. It’s not what the manufacturer or your pharmacy would ever recommend to do, as it’s using the pen in a way that isn’t intended.

*where you keep it 😂

I agree with what others have said. I keep mine in the fridge until first use. My next pen has an expiry of Jan 2027 so it's fine in the fridge until then. When I need the pen I move it to my wfh office because my daughter's not allowed in there and I have my needles and sharps bin set up in there. It's ok in there for 30 days under 30°C.

I was told the pen is only primed once..before the first dose. Each new pen is primed once according my doctor. I see him in person.

I was also told I don't need to keep it in the fridge, but it shouldn't be in a good area.

I wasn't told anything about a golden dose.

@Sisterlovethat’s terrible advice from your GP. With the kwik pen each use is a new needle and priming is to ensure both that there is no air in the needle and that it’s not blocked. I’ve only been using Mounjaro 2 months and I’ve already had one needle that failed to prime (I presume the needle was bent/blocked inside but nothing visible) and needed replaced. If I hadn’t primed and just stuck it in myself then I might have messed up that dose. It’s one thing to want to minimise waste when priming so that you just gently push a drop or 2 out not a squirt as this will result in a larger leftover ‘5th dose’ (agree with the PP who hates the other twee names!) but you do need to prime. Those who aren’t have been lucky so far but it’s not wise at all.

Also “shouldn’t be in a food area. How many of us have the luxury of special non-food fridges? 😂 I understand he’s worried about bacteria/contamination but you can either keep it in the box, buy one of the now ubiquitous insulin cases or even wrap the pen in a sandwich bag or tinfoil. Lots of handwashing and sterilising under the cap before use. The benefits from a hygiene/risk of bacterial growth of keeping it at fridge compared to room temp far outweigh those of keeping it elsewhere unless you are laying it on top of raw meat!

however as per manufacturers guidance it is absolutely fine to remove it from the fridge after first use for 30 days before disposal. Realistically if you are making sure to order ahead so you don’t risk gaps in treatment you will need to have your next pen in the fridge for periods of time.

Priming is key. Last pen I went through three needles on one dose as it wouldn't prime. Needles were obviously dud/bent.

@Sisterloveypur Dr won’t tell you about the 5th dose, or condone it, as it is off licence use. If you are NHS it doesn’t matter to you, if your Dr is private it is likely they will be expecting you to order every 4 weeks and keeping a closer eye on you than online providers do so using the 5th dose to save money (which is why most do it) might be tricky.

Poor advice from your Dr not to prime every time to check pen/needle are ok, he is probably thinking if primed once air is out, but checking needle is working ok before using is important.

In/out of fridge after first use is a personal choice. If kept capped and in its box and alcohol swab used to clean before use each time (as per instructions) the risk of being in a food area is minimal.

Your doctor is an idiot. I would report him for this, he clearly isn’t fit to practice if he doesn’t know the basics about administration of injections.

Have many of you ended up with more than one dose left over at the end? I finished my first pen last week and we took 4mg from the leftovers with an insulin needle and used that last night. I had intended using my first 5mg pen from next week, but there is still about another dose left in my pen. People keep telling me we must have missed a dose, but the needle was primed each week and I felt like I felt it in me. My husband did the injections as he’s used to injecting himself and our horses. He thinks they were all administered properly and he counted to 5 each time. There was never any liquid on my leg.

And the next question is could I use the remaining liquid next week? Which would be at 34 days. It’s been stored in my fridge all along. Or perhaps could I do a top up at the 30 day mark then move my next jab back. So far I’ve had no SE and very little suppression, even from the higher dose last night.

Sorry, I probably should’ve started another thread.

A full dose is 0.6 ml.
With minimal priming I find that I often had around 0.8ml left in the pen after the 4th dose. I never had more than that.
Maybe you did miss a dose somehow.
I have gone over the 30 days before & used the additional 0.2ml towards my next dose but it isn't really worth the faff & means it is easier to make dosing errors when combining with another pen. So I don't do this anymore.
If I am due to move up a dose the next week I have taken the full 0.8ml as a kind of bridge. Otherwise I will measure out the 0.6ml & bin the rest.
It is all at your own risk really.
It sounds like you are quite early on in your journey so I wouldn't muck around with anything other than extracting the 0.6ml for the bonus dose. It is easy to make a mistake.