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.

No, there’s no study, and there won’t be as there’s no commercial incentive for the pharma company to fund research into using their drug in a more cost-effective way.

Globally people have been doing this for a long time, many many people, and the manufacturers are not stupid, they know the risks of people doing this and of taking older medication, if there was a risk to health there would be a huge warning and well publicised risks, not just a few words and el Lilly saying we can’t guarantee it after, of course they know. Public health is at risk. They will have tested this every which way before it was approved, including all risks that c come from incorrect usage, the last thing they want is thousands of people getting sick,

I've been using WLIs since early 2024. During that time, I've been very active on SM - here, Reddit and FB. During that time, lots of us have been using pens beyond 30 days and/or microdosing or dose cutting. I've seen a fair few people get the maths wrong and take too big a dose (but with minor consequences), waste a dose due to ignorance of technique, or unnecessarily increase risk slightly by using non-medical grade syringes or less than optimal hygiene practices. Some have claimed their post-30 day dose was less effective. That's it though. In all that time, I've never seen anyone, not one person, describe developing an infection.

Yes I’ve been with Oushk since January, started maintenance in March so I’m thinking in about six months I’ll stop buying and just pay the £15 a month to be able to return. Currently I don’t intend stopping as I feel it’s helping me in many other ways than weight loss, I’ve been within 3/4lb of my goal since March, I don’t want to lose anymore weight.
Of course they may change their plans, I was a bit disappointed that the price rises and changes have made it less advantageous for maintenance customers at Oushk but I may have issues moving as my BMI is 21.75 so it gets harder to find willing prescribers, I know after their inspection Oushk did say they may have to only allow new patients to join maintenace with a BMI of 23 or higher, but I don’t know if they actually made those changes or not, as an existing customer I believe you can be prescribed down to BMI 19.

I get 10 weeks of doses out of a single pen. Just be sensible:

Keep your pen in the fridge. Buy a fridge thermometer for a fiver on amazon to keep your fridge under 5 deg celcius but above freezing. You do not want the contents of the pen to freeze, as that damages the molecule that makes the magic & renders the jab ineffective.

• As well as disinfecting the red rubber dot on the pen before each use, use isopropyl alcohol (£10/litre from Amazon) in a spray bottle (£2 from Amazon) to thoroughly disinfect your freshly-washed hands, the entire pen, and the work surface/space you're working on when you're doing your weekly jab. And thoroughly disinfect the skin area you're about to jab too.
• If you use needles to draw out the golden dose, do NOT buy them from Amazon: they are not sterile. Buy sterile insulin needles from medical suppliers.

Apologies if this has already been posted but I stumbled across this calculator earlier and thought it may help those who do want to know number of clicks etc. even for micro dosing

https://www.vrgrowth.co.uk/mounjaro-clicks

Do your calcs @CatsorDogsrule on how long your stash will last given the doses you are likely to take as my last pen which I got 10 days ago has an expiry date of Jan 2027 so 17 months from when I got it. People may say that expiry date doesn’t matter either but given the new pen cost I would be trying not to invest in so much Mounjaro that I will be using it beyond that date.

I think returners with gaps in ordering is the next big growth area in Mounjaro customers. I started taking it in March 2024 just a few weeks after it was licensed and 12 months ago we were often discussing on these threads how we were going to do maintenance. Over time a few pharmacies came out with policies but all based on monthly ordering. Oushk were the first to say you could be on their books without a monthly order.

18 months after Mounjaro began being sold there are more and more customers at the end of their weight loss journey who are nervous about how far to titrate down and if they can keep the weight off themselves if they stop taking it. This part of the market is probably growing by tens of thousands every month.

Developing guidance for pharmacies on how they can serve these customers with semi regular orders or options to return if there is weight gain should be a priority for the GPhC. No one wants to see former users become obese again and end up in a yo yo cycle. Eli Lilly and pharmacies want to sell to us even if it’s not every month. I think maintenance plans are going to become much clearer over the next few months.

Good for you OP. I’ve always click counted and used the golden dose to make my pens last longer and because I started by micro dosing 1.25 and building very slowly. I take a very specific amount that works for me. I’ve lost 3 stone, 1 to go.

I am just imaging the slew of ‘we told
you so you idiot’ posts that someone reporting an infection would get, at least on MN and Reddit, and I am fairly convinced that someone who had had an infection would be quite unlikely to share the information as a result 🤷‍♀️.

I think the majority of people on forums are trying to be helpful to others so would post to warn others if they had had a problem or infection. Of course there would be a couple of I told you so’s but the majority of people would just be grateful to have been warned. I haven’t seen anyone say they have had an infection either. And I haven’t read anything in the media where a story like that would surely get picked up and (depending on the media outlet) sensationalised.

Yes that’s the one. £15 a month just in case

@Choux this is me. Scared to come off and gain lots and the meds really do help hip and ankle pain but def can’t afford to stay on it at these prices

will they drop or make a pill that does the same ?

@VelociraptorsVelociRapping
And yet happy to admit they can't do maths, don't understand the difference between mls and mgs, or got flustered/distracted and double-dosed by accident? I've seen several 'am I going to die?' posts. I don't see the difference to be honest. I also find the more specific, date/prescriber/amount to lose communities on here (not aibu for example) very supportive when people cock up, as I think they would be if someone said their injection site had gone green and was oozing puss!

This isn't true. The insert was adapted in July, and it applies to current stock. So no need to add to the panic. This is literally said on that Reddit thread.

Thanks @Choux .

My 3 longest dated pens (bought from Pharmulous in Jun- early Aug) are all Feb 27, so they take me to 18 months, although some other pens are Apr and Nov 26.

I keep a detailed spreadsheet of all pens, doses of jabs taken, etc, which includes all expiry dates. I might consider a month or two over, if I still have lots left, but that's something to think about if it happens.

It was more difficult last year when we were getting very short dated pens of only 1 to 3 months, but the expiry dates have been much better this year.

Pills are already in trial by both EL and NN and the application to license a US Wegovy pill is already in. This says they aren’t as effective as injections which makes a low dose pill perfect for maintenance. Nausea is a more common side effect but perhaps that would be remedied by a lower dose being used for maintenance rather than weight loss.
https://www.bbc.com/news/articles/czerly4wwwyo

I have an idea of where a lot of those people would sit on a Dunning-Kruger curve tbh and I think very frequently posters don't realise the level of ignorance that their posts betray (and to be clear, I'm not calling anybody stupid - but very very few people on these threads, myself included, is equipped with the combination of scientific knowledge and specific expertise in this drug and delivery mechanism to make a meaningful judgement).

I think you're probably right that the incidence of infection is vanishingly small. I also think that cutting through the layers of self-selection to use social media posts as a primary form of data for this assertion is very poor methodology and not to be encouraged. Both of these things can be true.

I know I sound like a bossy prig. I don't really care. This thread is turning into posters egging each other on to take greater and greater risks to get one over on evil money-grabbing Eli Lilly. There need to be voices of caution.

Have there been any reported cases of anyone getting an infection from a pen used longer than 30 days? Because I haven’t seen one single report of that. I have seen so many about pancreatitis, severe nausea, dehydration, fainting etc. But never anything about someone suffering ill effects from exceeding the time limit or using the golden dose (other than those who have overdosed doing that but I am very confident that I won’t).

It’s a bit like babies bottles. Lots of us made up 24hours worth back in the day without incident, but because there is a risk of breeding bacteria, the advice is now to make up one bottle at a time.

The risks of going beyond 30 days aren’t particularly high on day 32, but they do increase with time and no one can give a definitive answer as to what is safe beyond the 30 days recommended.

I’m also mindful that some people using WLI are also diabetic and that the risks from infected injection sites are potentially higher for them.

I’m not aware of any deaths from using pens beyond 30 days, but there was a Coronors prevention of future deaths notice about a year ago after someone sadly died following administration of an injection without adequate skin cleaning.

I’m not a purist here - I’ve made a personal decision to use my pen on day 35 if I can. But I’m very much aware of the need for scrupulous measures to reduce the chances of allowing bacteria to colonise.

This one? If so this is an intramuscular injection administered by a nurse on a 77 year old lady. There are no details here of her general health and immune system. But the injection was administered by a nurse following her training protocols. Reading this doesn’t stop me doing my regular MJ injections although does make me wonder if I should use the wipe on my skin as well which the instructions don’t specify.
https://www.judiciary.uk/prevention-of-future-death-reports/patricia-lines-prevention-of-future-deaths-report/

https://www.vrgrowth.co.uk/mounjaro-clicks

hu guys Fat old climber on u tube created this dose calculator! It is excellent. Works out ur clicks, golden dose and frequency for what u need.
www.vrgrowth.co.uk/mounjaro-clicks

It appears intramuscular injections use needles which are 1-1.5 inches long so much longer then MJ needles which are subcutaneous injections. Am not sure if that longer length pushing bacteria further into the body makes any injection acquired infections harder to treat.
https://www.mycomedical.com/post/right-needle-and-syringe-for-b12-injections

@Chouxwhen I first trained to do injections back in the time of the dinosaurs, we were taught to always use an alcohol swab to clean the skin first. That guidance was then updated and considered to be unnecessary unless skin was visibly dirty. The argument was that if the alcohol didn’t have time to dry, it could make the injection more painful, and that the risk of introducing infection was very small.

ISTR that the point the Coronor made in that situation was that a swab that cost a few pence just might have prevented the sepsis and the subsequent death. I do think the risk is small, but I take care to clean my own skin each time as it is an avoidable risk.