New pen what are you doing?

[Fatmumslim01]

With the new pens coming out and losing the golden dose I'm thinking of what to do.

I currently take 12.5 from a 15 pen, have been on MJ a year almost, lost 58 pound, another 2 stone to go.

I've heard that the leftovers medication in the new pens will be around 0.2ml (0.6 is a full dose)

Are people still going to use that as a mini dose one week? For me 0.2ml of a 15mg pen would be 5mg? Or could I potentially use 0.1ml of the 15mg to give me 2.5mg so maybe do my usual 12.5 on my usual jab day and then a little top up to take me to 15? I couldn't do this if I was already taking the full 15 as that would be over the 15mg maximum dose.

Has anyone thought about this yet?

I've had a play with
https://www.vrgrowth.co.uk/mounjaro-clicks
...and worked out the dose i need to use to maximise the number of doses at the highest possible mg, with the minimum of waste. Luckily, I'm maintaining on a 2.5mg pen but even so, I can't afford to spend more than I currently am. For me, that means 40 clicks for 6 doses of 1.65mg. Have to hope that continues to be effective. I did get as low as 1.25mg a few months back so reasonably optimistic but wish it wasn't necessary.

I need to start coming down the dose as in maintence now. I had a thought, I was gonna start trying 7.5 as reached my goal on 10mg and been on for a while..

Now I think ill stay on 10mg till I get delivered a new pen then tey 48 clicks which will be 8mg then I can get 5 weeks out of it.

Also in maintenance and have been decreasing dose towards 2.5mg from a 5mg pen which will give me 8 weeks/5mg new pen then looking to get to sub 2.5mg dose from a 2.5mg pen long term.

Biggest challenge is to stop increasing my stockpile 🙈 while leaving door open for possible reordering in future...........

I will use whatever is left towards the next dose by extracting it with a syringe and making up the difference from the next pen.

I also have a stockpile and will keep buying monthly until the smaller pens start arriving then I'll drop to every other month until my stockpile is gone. I believe Oushk will allow that with evidence of the stockpile.

@AmandaBrotzman Oushk seem to be tightening up and have mentioned this a few times recently, they mentioned something about tightening of GPhC guidelines op in January.

they allow 6 weeks max between pens, any longer they will want to see the pens and the labels with dates prescribed to ensure no gaps in treatment as prescribed. Any gaps longer than 6 weeks and they will ask questions/potentially drop dose prescribed. It also is a bit of a lottery as it falls to the decision of whatever independent prescriber your order is randomly allocated to.

The only way I can see to use up my stockpile with them is to go on their flexi plan and pay £15/month and not order, so I am looking at other providers that allow breaks in maintenance without charging.

@WeAllHaveWings I think pharmolous allow a gap of 12 months although I haven't used them myself. Might be worth emailing them?

thanks @Fatmumslim01 Heard that about Pharmulous and also swift, I was looking at the Pharmulous site earlier today and it looks ok, I need to get my next pen delivered then I can have a think about what to do next. I will probably need to order a pen or two off Pharmulous to become a customer before having a break when I use up my stock. They say normally bmi 24 or higher accepted for transfer patients, others will be considered on case by case basis.

Yes definitely have a look at Pharmulous or Swift, there's no reason to pay for the ability to come back when there are cheaper pharmacies willing to consider it.

You will need to provide proof of your stockpile, take photos of the stickers on the boxes showing the prescription dates etc. Also, get in contact with them sooner rather than later, so you aren't just someone trying to prove it a year from now (or whatever) when you want to order again.

i don’t understand the golden dose, the amount left in the pen each month stays there as i have no clue how to get it out, it won’t click any further or dull they syringe any other way

@lollypop42 people either force the pen to twist when it won’t click any more, it’s hard to do but can be done. If that doesn’t work, people buy separate 1ml syringes with fixed 8mm needles. You can extract the remaining medication via the red seal using a syringe, and then inject it.

Wegovy has a 0.25ml left over fluid, which is a third of a pen exactly, so I would extract it with a syringe and jab it then add so many clicks from next pen to make the dose I required. Its either that or use the left over fluid from 3 pens which I wasn't keen on doing due to the delay. I will be doing the same with mj.

Some/all of the 0.2 left will be used for priming. Pens currently hold an extra 0.8 which allows for the golden dose 0.6 and still leaves 0.2 for priming.

i will just carry on (getting 4 doses instead of 5) as I only have just over a stone to go. Hoping to be at goal in a few months then start tapering and come off it by the end of the year. I am on 15mg.

My husband and I are both on a 5mg dose to maintain, we had already decided we would buy a 10mg pen and then use it as a vial and inject via insulin syringe, so this means we will get 4 weeks out of each pen. Maybe a 5th for one of us, this brings the price down and we will move to only one of us ordering, not ideal and we will notify our GPs of the accurate dose we are both on, but saves us a 100gbp a month,

I don't prime at all. You can see a tiny dot of fluid as soon as you've attached the needle so you know it's working.

I did not know there was any extra in Wegovy. 😮

I'm close to my goal and have considered using Wegovy for maintenance. The extra with Wegovy will certainly be a factor if staying on Mounjaro proves too expensive.

Not always you can’t. This week took 2 goes at priming before any dot was visible. Some weeks when I do it I get a dot, others a stream shoots out!

If I don't get the dot immediately I twist the pen all the way to 1 but before I inject I press the plunger ever so slightly until I see the dot, then inject, rather than priming properly and losing medication. That way I get the full 0.8 as my bonus dose and have a slightly higher dose that week for a bit of a boost.

Well clearly you can't see a dot if it's not working! I've only had one needle not work and I simply changed it.

Agree in 17 months I've never had to prime other than the first few weeks because a bubble always appears at end of needle. If it doesn't immediately I give it a few seconds and if the doesn't work I tilt it 180° and the bubble comes. Rather keep the extra for extra dose.

Yes it's not enough for a full dose and I think most don't notice it and bin it but I could clearly see a gap with fluid so extracted it to check and used it.