Golden dose scuppered due to air bubble

[JuststartedWLI]

I've just been on the verge of injecting myself with the golden dose for the first time. I extracted the liquid from the Mounjaro pen using an insulin syringe. Unfortunately, a large air bubble was present in the syringe after extraction, so I was too scared to inject it. Tapping the syringe, holding it up and squeezing it all had no effect. The air bubble would not move at all.

When this occurs, do you just have to get rid of the syringe and forget about the golden dose? If it was a tiny bubble I would have done it, but it was far too big for me to want to chance it.

I would have kept tapping and trying. How much had you extracted? Usually there is more than the 0.6ml required for the same dose, so you should have been able to expel the bubble eventually, even if losing some of the excess.

It's not as hygienic, but if done quickly, I might have considered injecting it back into the pen and drawing it up again, slowly. Possibly with a fresh syringe.

I often have a tiny air bubble, very annoying. What I tend to do is hold it so that it is at the top of the syringe (the opposite end to the needle) and inject but stop short of the bubble. No idea if that is helpful.

It is my calculated risk based on that it’s not going into a vein.

What do you mean by a large air bubble? Where?

I would very probably have injected it as air bubbles are irrelevant in subcutaneous injections but this has never happened in the 20 or so times I’ve used a syringe.

Any air bubbles should come out easily as described but don't forget this is a subcutaneous injection so it doesn't really matter.

It doesn't matter as you are not injecting into a vein.

I didn’t know this about air bubbles and subcutaneous infections! Or injections even 🥴

I do exactly the same. I figured it was worth it 😂

Sorry to jump on your Op, but I’m back down to 2.5mg now and I gave a golden dose left in a 7.5 pen.

Does anyone know how many units I need to pull into the syringe to get 2.5mg? (I’m guessing 0.3?)

2.5mg is a third of 7.5mg.

1 full dose is 60 units on an insulin syringe or 0.6ml, so 20 units or 0.2ml.

ETA @DoubleShotEspressox

Firstly, so loving the AI name MN gave me. Lost my log in details so this will do until I can be arsed to go into my email and sort it.

Air bubbles will do no harm whatsoever in a mounjaro injection.
My friend is a midwife and told me that air injected into the vein is also highly unlike to hurt you unless its a whole syringe full. Apparently its nigh on impossible to kill someone that way, no matter what horror films tell us.

I'm guessing you have like a section halfway down the syringe that's a big band of air. Happens to me because its so hard to extract all the medication in one smooth go, so I have to take it in stages. I just turn the syringe horizontal for a bit to bring it to the top. But only because otherwise injecting is a faff- not because I'm worried about the health impact.

It wouldn’t matter. In fact some pre filled syringes such as heparin purposefully have an air bubble in as it’s meant to ensure that the air pushes the last drop of the dose into the injection site. So as a HCP you’re not meant to remove the air bubble prior to injecting for those meds.

Like others have said if it’s not in a vein it’s not an issue and even then you’d need loads. If you ever have an iv in hospitals yes staff will get most of the air out but there’s always some air bubbles left.