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.

@Anxiousmum https://ukmedi.co.uk/products/fms-micro-syringe-32g-8mm-1ml-fms-fms-32g-10ml-ukmedi-co-uk

They are insulin needles. We can buy them from any pharmacy

Can you get the screw on ones (like those supplied) if you want to click count…..would these be a more hygienic option? Obviously would need syringes for golden dose.

Also is counting clicks tricky ….. I am remembering counting scoops for baby formula and being interrupted or losing track of what number I was on.

Syringes are actually the more hygienic option and I plan to do this instead of the screw on pen needles when split dosing for longer than 30 days. The reason is the small chance of backflow of blood into the pen each injection using the pen needle leading to bacterial growth. With the syringe your body is never connected to the pen fluid.

Thank you for taking the time to reply - that’s very helpful.

Yes, you can buy a pack of 100 for about £4. They are insulin pen needles.

Thank you so much, I get it now. You extract the volume desired from the vial with the insulin syringe and then inject, rather than attaching a new needle to the calibrated vial - makes complete sense, thank you!

I'm in full agreement with you OP and I work in big pharma. It's 100% profit driven right down to the manufacturers changing the pen to remove the 5th dose.

Re the safety etc, these drugs need to make money. The faster they are out to market the better. The manufacturer will test the drug for everything in the cheapest and fastest way possible, that doesn't implicate patient health.

So as a result, we get the quoted doses going up in 2. 5s and a 30 day pen. That doesn't mean it doesn't work out side of these terms, it just means it wasn't viable to test this given the time and money the company had.
This is further confirmed by the millions of people who stretch out the 5th dose, microdose etc and are absolutely fine.
I've worked quickly up to a 15mg pen, but only am injecting 10mg every 8 days. So the pen is lasting around 8 weeks or so. And injecting every last drop of golden dose.

Counting clicks /extending pens in sure many will do now the prices gone up

I would prob be happy to use a double strength pen like 10 and use it for five

I use this chart as sometimes I have taken less

How are people doing this and getting round the pharmacy rules about gaps and maintenance? How do you keep getting new pens prescribed if you are ordering infrequently?

Yep 🙄

Personally I have pushed out on my order date by ordering every 5 weeks, my consultation questions ask have you ordered within the last 6 weeks and I can say yes, as a consequence I had 2 pens in my fridge before this price issue, so I didn’t have to rush to buy more, I just bought one early to get the old price, at some point in the next few months I will stop ordering (I am already in maintenance) but will have enough in my fridge for several more months. I will go onto a maintenance plan where I can return within a year so I have the option to continue if I need to once I’ve used my pens.
Obviously if you are still trying to loose weight you will end up with a stockpile of pens, but you can use them when coming back down once at goal, other option is to move pharmacy and tell them you have a stockpile and they may let you not order for a few months which is what will happen now as so many people bought from multiple pharmacies before the price rise, so lots of pharmacies are saying to photograph your boxes and you can then not order for several months.

Eli Lilly has indeed updated the SmPC (Summary of Product Characteristics) for Mounjaro to reflect a “reduction of the filling volume of the cartridges used in the KwikPen presentations.” This change was made on July 22, 2025, as noted by users referencing the SmPC change log. Reddit
However, this update refers to documentation only, not the actual physical fill volume of the pens. Regulatory guidance (specifically the European Commission’s SmPC format rules) prohibits manufacturers from listing overfill amounts—even though overfill is necessary for proper functioning (to account for priming and device dead space). As a result, the wording was updated to reflect the deliverable volume (2.4 ml) instead of the total filled volume (previously listed as 3.0 ml). Reddit
Community input further reinforces that no physical change has been made:
“They are updating the paperwork to comply with strict regulatory guidelines.”
“In the EU the EMA product information … has stated 2.4 ml since the day it launched, yet our KwikPens have 5 doses just the same as UK pens.” Reddit+1
So to directly answer your question:

• Yes, the SmPC has been updated to note a reduced “declared” fill volume.
• No, Eli Lilly has not physically reduced the amount of liquid in the KwikPen. The pens still contain the same overfill as always; only the documentation has changed to comply with regulatory norms.

@Itscoldouthere is Ousch you are with ? Think they are the only one that allows stop start maintenance

tho their conti flixi etc plans may change

I have always used the 'golden dose' and stretch my injections out up to 10 days after reading about the shelf life of the product according to other countries.
I am 10lbs from a comfortable target weight now, have ordered a 12.5 from Medexpress (hopefully it comes) and I will use that to titrate down from 10mg and come off all together. Assuming I get enough for 5 x 12.5 doses, I should be able to do, 7.5×4 5x4 and then 2.5 for whatever is left.
This gives me until about the end of November and I'm on my own!

I'm with Pharmulous who have also confirmed that I can return within 12 months of my previous order - presumably at 2.5mg or 5mg after such a long gap.

I am now in maintenance and have been ordering with them consistently for over a year. I did this to ensure a maintenance friendly pharmacy has full records of my ordering and weightloss journey.

I also have a stockpile to use up due to ordering every 3-4 weeks in larger doses than I take, plus using every drop of the medication in the pens. I also ordered a few pens from other pharmacies along the way.

Depending on how maintenance goes, I should have enough to last at least 12-18 months so haven't had to order during this difficult price hike period.

The 30 day rule is to do with the multidose vial with microbiobial agent, and nothing to do with the drug itself. The general guideline for multi-dose vials is to discard after 28 days unless the manufacturer says otherwise, which they do in this case - slightly longer. This is the same for all drugs that are administered from a multi-dose vial.

Yes, only a very small percentage of MD vials will be contaminated if you go beyond 30 days, especially if you follow all the basic sterility rules (washing hands well, wipe septa with antibacterial wipe and leaving to dry before using, new needle etc). Risk is yours (very small but very serious), but there is no way EL would suggest that you use much beyond the 28 days though. I always take 5 doses from my pens and then discard.

That's useful to know thanks. I'm considering switching to Pharmulous

I have heard good things about pharmulous

tho some companies won’t take on healthy bmi /23 even with proof

I just wanted to say I was pleased to see this discussion come up. The price rise has made people have to think. Frankly, if the advice from the manufacturer on what to do is set out, then following it by the word as one's choice cannot be criticised. However as MJ / WLI as a means to weight loss draws you in for months, at least. Thinking time. You can call on things. Come here, chat. Look on social media. This forum helped me with the link to the monj web site to see competitive prices. It helped me after first pen not waste the golden dose. When the forced twist feature on pens stopped working,, which was discussed here, I got syringes from Amazon.

I rather thought going up one mg step each pen if you were still reducing was the default position so followed. I've been lucky in that I've not had debilitating side effects. Constipation was my minor point but I got that that links the slowed digestion. Psyllium husks capsules helped. I only held back with going up a dose in part because it'd nearly reached all I ever thought i could and had to think further, and in part because higher doses cost more.

My own point from social media YouTube was that if food noise gets worse at the end of your 7 day week - my supplier has that as a Q for patients on the reorder form - go to a 5 or 6 day cycle. 5 days for me.

I had not got the idea of stocking up on pens I must say. So the price issue has hit me.

I did not see that going a short time over 30 days on an open pen was high risk and to dump on day 31, but I'm interested to contrary views here. Also comparing advice and practice in other countries is helpful. Linked to that is buying a high dose pen and rationing, core point here.

So thanks for this line of chat.

I've previously ordered from Numan but because I changed suppliers, I cancelled the subscription. What's interesting is I logged on to the Numan website yesterday and my prescription is there and has a valid-to date of 12 months. I assume that to mean I can go back to them within 12 months? Maybe?

I have dosed off lable from the outset. BMI was over 40 so I have a long way to go. 2.5mg just wasn't having any effect so I started jabbing every 4-5 days to get though the pen and move up. For 5mg I have stuck to every 5 day. That 5mg every 5 days works out at just less than 7.5mg per week, but this way is working for me brilliantly at this dosage so I'm going to stick with it.

I have 7.5mg, 10mg and 12.5mg pens in the fridge, but going to use them for 5mg every 5 days.

My thoughts on the long gap are:

● Wait and see how the market changes. Because I think the pharmacies want our business and lots will face this gap issue due to stock piling. I think the pharmacies may develop a solution.
● wait to see if prices come back down, when demand is lower (due to stock piling) and so big voucher codes start. If i see a good value discount code ill buy on credit card even if i dont need it at that time.
● Contentious, but another idea of mine is, 6 months down the line when my stockpile is low, is to find the most lax, less scrupulous pharmacy to get a pen. Because I'll only need one pharmacy to not look at the date of my 12.5mg box and give me a new 15mg, to then have a genuine prescription which I can use to buy elsewhere.
● Or, stretch as long as possible and buy another (15mg) pen even though I don't need it yet, in 2 months time. Common sense says to me that an 8 weeks gap will be tolerated, as a minimum. Repeat every other month, but use the pen for 5mg, or maybe 7.5mg by then, doses.
● My final idea is to move to Wygovy in 6 months time. I'm not averse to it. I'd just be put off by having to start at a lower dose. So like above, I'd try multiple pharmacies until I find one that will start me at the equivalent to 7.5mg Mounjaro.

"Risk is yours (very small but very serious)..."

Is anyone here able to explain what the infection risks actually are? In real terms, as in, what would happen in average cases.

I've been thinking about this. I use good hygiene and will be using the pens for longer than 30 days and more than 5 doses. I know that infection risk is low, but possible. But I've then been considering, what is actually going to happen if there was bacteria transferred?

I realise that all infections can be serious. But the vast majority of times someone gets infected it is not serious. It just needs antibiotics. Say a Mounjaro pen did transfer a bacteria. I would guess that I'd see maybe a lump, pussy maybe, or rash at the injection site? GP prescribes antibiotics, it clears up.

To my thinking, that's not a massive big deal. There is a tiny risk that an infection is passed from pen to body. Then within that risk, the likelihood of that infection itself bring serious is even more miniscule and its more likely to just be a mild inconvenience.

There's a risk I could get a flesh-eating bacteria in anything I do in life, but that risk is tiny so I don't live life in a sterile bubble. I think of this in a similar way. But then maybe that's just my laissez-faire attitude and the risk is much greater.

Is anyone here able to explain what the infection risks actually are? In real terms, as in, what would happen in average cases.

No, no-one can explain this because there is no published safety information beyond thirty days.

I realise that all infections can be serious. But the vast majority of times someone gets infected it is not serious. It just needs antibiotics. Say a Mounjaro pen did transfer a bacteria. I would guess that I'd see maybe a lump, pussy maybe, or rash at the injection site? GP prescribes antibiotics, it clears up.

I don't mean to pick on you @AmberLime but I have to address this. Antimicrobial resistance, including antibiotic resistance, is an existing global crisis, although it's not much discussed outside of healthcare communities at the moment. Antibiotics were one of the greatest medical discoveries of the 20th century and we all take them for granted but we are all, doctors and patients alike, going to have to start treating them with a lot more respect and caution over the next couple of decades. Please, when you are making your own personal risk assessment, consider re-evaluating the attitude that infection is an acceptable risk because antibiotics are a guaranteed treatment.

@AmberLime if you have poor aseptic technique then the 30 day limit won’t help you. If you don’t wash your hands, don’t use the antiseptic wipes on the septum, touch the needle inside the carrier, you can introduce bacteria into your pen on day 1.
If you then store the pen at room temperature in a warm room, you’ve got a bacteria breeding ground. The manufacturer has to assume users are stupid. And that’s one reason they tell us to check the contents haven’t gone cloudy.
So minimise the risks above and keep your pen in a fridge which inhibits bacterial growth (just like it does with food), however you personally decide to use it. You really don’t want an infection, so please take the risks seriously and do everything to avoid it.

As in the % risk of it happening? There's no study is there? Or is there?

Google about insulin pen repeted use and risk. That has studies