Bit confused - golden doses, microdosing and more than 4 doses from a pen

[JuststartedWLI]

I've been on Mounjaro for 3 months. I'm on my 4th pen. I've heard about people getting an extra dose from the pen. I was under the impression that after your 4th injection, you have to get rid of the pen. Is there still enough medicine in the pen to get another dose after that? I've also heard of microdosing, for example injecting 3.75mg from a 5mg pen. Is there actually any benefit to this if you are getting rid of the pen after the 4th injection? Any advice would be gratefully received. I'd love to get an extra dose from pens to save some money.

You are supposed to discard the pen after the 4 doses because the pen locks and you cannot then use it as intended. However there is a lot of spare medication provided to use when priming each time, and it is usually enough for another full dose. You either have to break the pen locking mechanism by twisting it very hard, and then the pen can be used as you did before to do one more dose. Or, if that doesn’t work, you can use a separate 1ml syringe to manually extract the remaining medication from the pen via the red seal where you normally attach a needle. There is normally 0.6 to 0.9ml of liquid left, and a full dose is 0.6ml from any pen. So easily enough to do another dose, or to do a slightly higher dose. Some people do that as a step between one dose and the next dose level.

Doing 3.75mg from a 5mg pen isn’t “microdosing” it’s just using the pen to do a smaller dose than intended. You do that by “counting clicks”. Normally when you turn the pen to the 1 position, it clicks 60 times. To do a half dose, you’d turn it for 30 clicks. To do a three quarter dose you’d turn it for 45 clicks, and so on.

I use a syringe to extract out 0.6ml for a 5th dose, seems wasteful to throw away perfectly good medication. I do believe the manufacturer plans to reduce the extra liquid in the future. Some people hard twist but I found I couldn't do that after the first few pens and find a syringe much easier.

Microdosing is taking your dose spread over the week ie taking 2.5mg instead of once every seven days, taking 1.25mg every 3 days. I don't do this so no advice to offer.

Didn't you do any research at all in those three months? I don't know how you can not know. Anyway, I think they are getting rid of the 'golden dose'.

Forget the twee or misused adopted names stick to what it is to avoid confusion.

If you do 3.75mg (45 clicks) from a 5mg pen you will be able to do 5 doses from the pen before it locks on days 0,7,14,21,28. So within the 30 day in-use period.

After this there will still be some liquid left but the pen will lock/stop clicking when you try to access it. You can extract the same 3.75mg, 45 clicks = 0.45ml with a 1ml, 8mm, 32G (or similar) syringe bought from a medical supplier (not Amazon). This would be on day 35, 5 days outside the in-use period. Risk assessment that for yourself.

Calculating doses by clicks is simple maths. Full dose in any pen is 60 clicks or 0.6ml.

There is another dose in the pen, and it’s still within 30 days - doses taken on days 1,8,15,22 and then extra dose on day 29. Some people count clicks and use the pen beyond the 30 days.

From what I have read, if you want to use the extra liquid left in the pen after 4 doses as a "golden dose", you are better to extract and inject it with an insulin syringe because, once the pen mechanism is broken, you cannot guarantee it will measure accurately.

People use so many medical terms inaccurately. Microdosing is medically defined as taking a dose lower than the minimum recommended dose. In the US some doctors have people using very small doses (less than 2.5mg) as a way to improve general health, menopause symptoms, metabolic issues, etc but it is not normally effective for weight loss or diabetes. Using interim doses (e.g 3.75mg or 6.25mg, etc), adjusting the dosage interval or using split doses (e.g. 2.5mg twice a week instead of 5mg weekly) are not microdosing.

Hi I’ve been taking mounjaro since April and I’ve been on 2.5mg - I took a month off in September - I’ve started back and got a 5mg pen but only took 2.5mg last week 30 clicks, I plan to do the same this weekend and then will move on to 3.75mg. Do I just count 30.clicks again from zero for my next dose I’m confused as I was used to going straight to the one?

I’m still getting the results I want from 2.5mg so not going to put higher doses in my body than necessary.

as I knew the price rise was coming though I bought 5mg and 7.5mg pens and just use 30 clicks from my 5mg pen.

I’ve also used a syringe to get the extra dose at the end out.

I know it means it’ll be longer than 30 days in use, but worst case it’ll lose a little effectiveness, but it’s always in the fridge and always wiped before I use it. I’m happy to take that risk for the money saved.

I’m currently injecting 8mg out of a 10mg pen (48 clicks), so getting 5 full doses out of the pen within the 30 days. 7.5mg just didn’t agree with me for various reasons, and, whilst I felt brilliant on 10mg, I also got chronic constipation, so experimented to find a good balance, which, so far, seems to be 8mg. Also really helps with the hideous cost of the pens, as the per injection price is lower!

@BellaQ yes, you do 30 clicks again if you want 2.5mg from the 5mg pen.

@SilenceInside thank you for replying and if after another 2.5mg dose I want to go to 3.75mg I just click 45 clicks is that right - terrified of doing it wrong 🤣

@BellaQ yes, for 3.75mg from a 5mg pen it is 45 clicks. Don’t be terrified. If you are using the pen and doing less clicks than turning to the full 1 position (60 clicks), then even if you get the number of clicks wrong, the “worst” you could do is to give yourself a full dose from the pen, which is 5mg and a standard dose.

@MarketSt I also have used the pen for longer than 30 days. However, the danger is not just the pen losing effectiveness. The risk of infection will increase the longer it’s misused like this.