Mounjaro sent frozen

[Sundayisworst]

I really don’t know what to think about this but I’ve had a long back and forth email with the private pharmacy I order WLI from.

I put the whole pack into my fridge when it arrived. So insulation, cold pack etc. as I normally do.

when I opened it after two weeks in fridge the ice pack was still partially frozen. The Mounjaro has been stored for two weeks minimum at below zero temperature.

Now everything I read from the manufacturer says that this is dangerous and should not be used and could be either ineffective or dangerous and should be discarded.

The Pharmacy have said they sent it with a frozen solid ice pack and not a cool pack and said this is what they always do. They are saying if I want to replace it has to be at my own cost they’re saying just go ahead and use it and if it looks okay, it will be fine.

I can’t understand why the manufacturer would be so specific about temperature if this could just be disregarded. As we all know this is so expensive and it’s vital for my health. I just don’t know what to do it’s the pharmacy who has packaged it with a frozen ice pack without giving me the information that it’s frozen and shouldn’t be kept in the packaging.

I don’t know what to do. I’m very very careful with my fridge temperature for this exact reason the medication is stored in it. I thought the insulation would be the perfect way to store it.

I am sure that like most of us this is a major investment in our health and I’m just don’t know what to do in this situation. I feel strongly that the Pharmacy should be replacing but what should I do?

They are always posted with an ice block. That acts like a fridge until you put the medication into a fridge. Why did you put the whole thing in your fridge?

The fact that you dont realise its an iceblock means it has melted by the time it reached you, which I would be far more concerned about the temperature of that medication.

Totally your fault here tbh.

You don’t put the whole pack in the fridge just the pen in the box.
I’m afraid you’re at fault for putting it in a fridge wrapped up with an ice block.

Of course pharmacies post the pens with an ice pack. This is how they aim to ensure the pen remains cold during transit. I really don't understand why you would put the whole thing in your fridge? Because either - the ice pack is still frozen and you are keeping the pen too cold. As it what has happened this time. Or - the icepack has defrosted in transit and the wool insulation stops the cold air from the fridge reaching the pen and thus you are keeping the pen too warm - which is what may have happened with your previous pens.
The advice is to check the pen for cloudiness before storing. Therefore it must be taken out of the postage parcel?

In any case, what is done is done. But I don't think you will have any comeback from the pharmacy. You'll have to chalk this one up as an expensive learning curve.

I thought they were sent with a chill pack. When I took one on holiday I didn’t use ice pack just the chill pack it came with.

im not sure now what to do.
surely being sent with a frozen pack means that they are for some time kept too cold?

No, they are not kept too cold. If you unpack your parcel you will see that the pen is in its cardboard box. This is sandwiched between two sheets of cardboard to ensure the pen is not touching the ice pack and therefore won't get too cold.
The whole thing is then wrapped in wool to maintain the cool temperature for the duration of delivery.
Upon delivery the advice is to unpack, inspect pen for damage / cloudy liquid and then use / store as required.

If the pen is properly frozen, I personally would not use it. I don't think you will necessarily come to harm, but it won't be effective as the peptides would have degraded by being frozen.
I would bin the pen and chalk it up to experience. Sadly.

The ice packs keep the pen between 2 and 8 degrees for the duration of the delivery to you, starting off at the lower end of that temp range and then getting towards the top end as the ice melts.

When you receive a package you should take the contents out, check that the box is undamaged and still cold, the prescription is correct (name label and dosage match what's in the box), and then open the cardboard box the pen is in and check the pen is the correct dosage, within it's expiry date and looks undamaged and not cloudy. Then put it in the fridge.

The "chill pack" that you took on holiday would have kept the pen below 30 degrees, but not at fridge temp.

Sorry but this is on you. They only send with the ice pack for transportation purposes. You are then supposed to just put your chilled pen in its box in the fridge.

They really are not responsible here.

What did you take it on holiday in? It’s kept cold by the ice pack. If you didn’t pack it with an ice pack then what was it you used?

But is the Mounjaro itself frozen or cloudy, OP?

Also agree this is unfortunately your fault as user error and not the pharmacies mistake to replace. No judgement but I really don’t understand why you’ve been putting the whole thing in, as all the pharmacies I’ve ordered from have stated in instructions to discard transit cooling products so that information is given. I’m a HCP and we store kwik pens in their boxes in a fridge. I’d chalk it up to an expensive mistake but definitely wouldn’t use it if it’s become frozen

Firstly. Why on earth did you not open. Secondly if the ice pack was still frozen two weeks later it mean your fridge was too cold. Thirdly just because the ice pack was frozen it doesnt mean the pen froze. Test it yourself. Take 30ml of water and put it in the fridge in a cool pack with an ice pack as see if the water is frozen 24 hours later.

I took it in the package unopened. Prior to that it was in my fridge. I thought that the pack was a cold pack. I didn’t realise they send a frozen block. It was definitely just a cold pack at the airport.

then on holiday it went in the fridge as normal.

No it looks ok

I definitely haven’t heard anything about taking it out of the packaging. But I do accept I may have just missed this instruction.

I do make mistakes- and fairly frequently!

i am grateful to all of you taking the time to answer me here and I now realise this is my own mistake for not opening the package.

the reason I left in the package was that since going on holiday when I thought better not to open before travel, I had ordered 2. So one came with me and wasn’t frozen because the airport staff looked at it. Then the one I left at home remained too cold.

now you’ve all said that it’s my mistake and questioned why I didn’t know to unpack it I’m left baffled by my own decisions.

I can’t afford to replace it so I’ll use it and see what happens. I’ll try a week anyway. I’m a fool. But not for the first time. And sadly not for the last time either.

Things do happen sometimes and we all make stupid mistakes and think why did I do that! I don’t know if you know about them but you can actually get insulin pen cases with cool packs that you put in the freezer. I use them when travelling to my partners before putting my pen in the fridge cos I just prefer it to be kept cold. Will see if I can attatch a photo. I don’t put the pen directly against the freezer pack but it has kept it cold

Your mistake unfortunately. I’d probably still use it (against guidelines) but there’s a chance it might not work now it’s been frozen.

This is a very good idea. I’m going to do this just for some peace of mind

I hadn’t considered that they would be posted with a frozen ice pack. I thought that the pharmacy must have accidentally used a frozen pack. I feel bad for arguing with them now.

I thought If the product was in with an ice pack at any time then it would not be safe. But as you have all explained- it is in a cardboard box with two extra pieces of cardboard so the ice is not actually against the pen itself. I have honestly never seen any instructions about the packaging but like I say- I’m no stranger to making errors.

Thank you. I’m going to do this. I’ll use on Sunday and see how the week is.

there’s no air bubble in the pen and the pharmacy say there should be one
this is just something else for me to worry about

If it was just the ice pack that was still frozen and not the liquid in the pen it will be absolutely fine. There isn’t always an air bubble in the pen, in 15 month think I’ve only had a couple of pens that had a tiny air bubble so I wouldn’t worry yourself about that.

Agree with @Time4changeagain there might be an air bubble in the pen but there doesn’t HAVE to be an air bubble. I’m on my 14th pen and have rarely had air bubbles and if they were there they were very tiny.

If the pen itself isn't frozen then I would think it's ok.

I agree. If the pen itself is not frozen then it is absolutely fine.

I've rarely seen an air bubble either and am on my 15th pen. Hopefully the medication is unaffected by your mishap.

Don’t feel too bad OP. MN is such a harsh place sometimes! You bad girlie! Sometimes I have thrown the whole package in the fridge till later as I’ve been too busy to unpack it at the very moment the postman gives it to me. In a way, your post is very instructive and so I’ll think twice next time ty 🙂. PS. I’ve never seen any instructions on unpacking but perhaps my pharmacy doesn’t send them 🤷‍♀️.