Dose-splitting - don't care anymore

[Glowingup]

Just venting about the ridiculous situation with pharmacies putting their prices up by insane amounts. All along they have told us that buying higher doses and splitting them to get more use of the pen isn't allowed and is dangerous. I have friends in other countries (Sweden and Germany) who are on them who have been explicitly advised by medical professionals that the 30 day rule is pure bullshit when the medication is kept refrigerated and are prescribed 15mg to be split into doses of 5mg (or 7.5 mg). I have also been following a former olympic athlete called Jo Fargus who is on tiktok. She is Australian and her doctor tells her to split the doses and click-count and she gets 15mg pens prescribed by that doctor and takes a 5mg dose. They've been taking the piss out of us all this time and the price-hike thing is an example of even more piss-taking.

Anyway, through my entire journey, I have click-counted and I have lost two and a half stone and am a couple of kilos from healthy BMI. I have used pens for at least double the 30 days. I now have half a 7.5mg pen, a full 7.5 mg pen and have just been approved for a 10mg pen. I will inject 3.75mg every 8 days rather than every 7 to make it last a bit more. By my counting, I have 30 doses left and at every 8 days, that is 240 days so well into 2026. That should be enough to get the last few kilos off and some maintenance. I will take pleasure in taking every single last golden dose too. Greedy fuckers.

But it is the actual manufacturer EL that has increased the UK prices across the board. Hence the pharmacies having to increase the prices they sell it at.

Your beef should be with the makers of the drug. It is them as well who state the 30 day pen usage.

Yes my beef is mainly with them and they’re the ones who came up with the 30 rule too. It seems in other countries prescribers are a bit more realistic and flexible though. Hopefully the ones who have been creaming off huge profits for ages (like Oushk with their merch and Facebook groups) will now go under as I don’t think many people will want to or can afford £300 a month.

I agree and am planning on doing the same. Still feel a bit nervous about going well over 30 days but as you say it seems to happen elsewhere and no issues. What will your longest period be for using the same pen? By my reckoning I will end up using 1 pen for 10 weeks I think, could even be longer

The increase in costs may make using the pen excessively outside of its in-use period more tempting for many of us. It has crossed my mind in the last few days, but the risk profile, mostly from unknown risks, hasn't changed in any way.

I get that the whole situation is just horrible, but health and safety must always come first. Encouraging its use in what sounds like an act of defiance based on unreliable or anecdotal advice, simply because we feel a loss of control, is each person’s choice. In my view, it’s foolish, but ultimately, only the patient will bear any consequences.

FYI - you won't be taking the "golden dose" for long as they have logged a SmPC to notify they are reducing fill in the pens.

Also this is not pharmacies that have caused the price increases it is Trump and Eli Lilly. Pharmacies profits are unlikely to have changed significantly with this price increase, they have also been hit hard on cash flow with the rebate in arrears scheme. I do not wish any pharmacy or their staff lose their livelihoods, smaller pharmacies have always needed to charge more as they have higher overheads per pen than the large volume pharmacies do.

My supplier got arsey when I was stretching out the doses and had a small gap between orders. Threatened not to supply at all.

I can’t afford the medication now so I am using up what I have so far. So it doesn’t matter really what they think about my use of the golden dose. I can’t afford to order any more than I have now but with split dosing and increased intervals I can stretch it quite a long time.

apologies for double post

So far I have used pens for up to 8 weeks but will stretch this to 10-15 weeks now.

I use my pens for longer too. I have done it for ages. My friend who is a pharmacist said it's fine.. just keep it clean/cool etc. Common sense! Anyone who throws pens out after 30 days is daft imo.

FYI - you won't be taking the "golden dose" for long as they have logged a SmPC to notify they are reducing fill in the pens.

What does this mean?

I don’t know the abbreviation but it’s on Reddit - they’ve filed a document to change the specification of the liquid volume in each pen so there is enough to prime but not a full extra dose on top. It was always going to happen.

I agree @Glowingupand have worked out my own dosage schedule with the pens I have remaining to reach goal and then titrate back down. Careful hygiene and refrigeration make the risks within my own personal assessment acceptable. I plan to register for maintenance with a provider I’ve used already at the point in time where the pens I have evidence for should run out (much sooner than they actually will run out). If I need to buy one 2.5mg pen at that point I will.

Nice that they want to put a stop to anyone wanting to make the medication more cost effective. Well, seeing as I am not going to order any more after my 10 mg arrives later this week, I won't be affected by that.
I think that sounds like a good idea with registering for maintenance and potentially buying a 2.5mg pen in the future.

I’ve always made mine last two. Makes no difference

I've been titrating my own doses since Jan and definitely had no problems.
I take anything between 2.5 and 4 mg...am on maintenance.
There is no risk in going over 30 days except the active ingredients might degrade so worse case scenario is it's not as effective.

I found on Google that 30 clicks gets 2.5 out of a 7.5 pen. I still have 2x 7.5 doses left but will be taking 2.5 only for the next two weeks and then bin the pen and start W as a last attempt on this type of medication. I was fine on 2.5 but anything higher hasn’t really gone as well as I hoped. After 6 weeks of non stop nausea it now makes me sick as a parrot for about 3 days and when the sickness subsides the food noise comes back. In hindsight I think I did best on 2.5 but moved up on advice of the prescriber. So hopefully lowest dose of W may be enough to take the edge of.

2.5 isn't half of 7.5 though?. 20 clicks is 2.5mg 30 clicks is 3.75mg

Ah thanks. I’ll have another look. I found it on Google

I have to say it has been an eye-opener to see over the last few weeks how many people have never previously realised how utterly unethical and ruthless big pharma truly is. We are heavily protected by the NICE and NHS in the UK.

here, use this link https://www.vrgrowth.co.uk/mounjaro-clicks

No. 60 clicks is a full dose so 20 clicks would be 2.5mg.

Do you need to google how to divide something by 3 though?

60 clicks = full dose, in this case 7.5mg
7.5 / 3 = 2.5
60 clicks / 3 = 20clicks.

I have no idea how dosing works or how many clicks there are in a pen tbh so yes thought Google was a good place to start.

Agreed currently using a 10 pen to split t into 5 and 2.5 doses, the only thing is the gap which the pharmacies are arsey about cos they're not getting their dollar, so I've ordered from different pharmacies and stockpile to get to goal I'm , 8 13 lost 3 12 stone so far 1 2 to go then we'll see about doing same for maintenance, the pharmacies and eli lilly are greedy bastards through and through, they know this drug is beneficial on a number of levels and they don't care how they squeeze the money out of folk, so make up arbitrary rules to justify it naah, I've been OK,doing this, wouldn't have to if they made it affordable and or accessible for all.

Right now I have no choice but to break some rule. I either do one more 10mg and go cold Turkey or I split dose and use up the entire pen until the stock issue resolves. Neither is a risk I had factored in when I risk assessed starting this journey. Right now I have zero way to use it as recommended unless that involves taking a 10mg shot and waiting weeks for the next one. I don't want to titrate back up either. If I had to do that I'd stop and choose obesity.

The price increase and subsequent stock shortage has been handled badly and I'm not above making a stupid desision either.

Agree it has been handled really badly. It seems some pharmacies have been giving out several pens at once without planning ahead for the ongoing needs of their regular patients until new stock arrives resulting in people being left without their medication.