Oushk maintenance - they want me to restart at 2.5mg despite having been on 15mg for months. Very stressed.

[MJMaude]

Would appreciate any help/advice please. I started on Mounjaro in late Oct 24 with Med express. Went up through the doses and lost weight happily. Changed to Oushk towards the summer as I was getting below the BMI for a new starter and wanted to know I'd have maintenance options. Generally was ordering with a few weeks to spare so would sometimes have a pen or even two unopened ahead.

Got to the time when the price change came in an suddenly found I was having an absolute nightmare ordering. Put through requests with both oushk and med express as it was so difficult I thought I might not get any and got three pens then creating something of a stockpile. By November I still had 4 pens unopened in the fridge (was on 15mg by then as had been over a year. Approaching but not at goal). Had a maintenance consult (I was about 10lb above target) who said stick with the 15mg weekly and get back to them once at goal. I queried having problems reordering as there was likely to be a long gap. Was told to photograph my stockpile with a date and upload and this should avoid problems. I did this.

Jump to now - I have 2 doses left. The vast majority have been taken at the licenced 7 day interval. Last few I did extend to about 8-9 days as I no longer want to lose (Although the last 10 pounds were the slowest to come off!). For this reason I had a follow up consult last week. The pharmacist said don't continue to extend the interval but instead drop to 12.5mg weekly. I'm quite happy to do this and put through an order.

Pharmacist has declined it today and said I need to go back to 2.5mg due to the gap in ordering. This is despite me showing a picture with today's date, the open pen showing 2 doses in it and all prescribing details. I also uploaded the pic from November showing I had 4 pens then (with date on it). I have since sent pictures of the spreadsheet I keep with all my injection dates and doses and my account from Medexpress. I can evidence 14 pens bought since late Oct 24.

Sorry this is so long. I'm so so stressed though about potentially dropping back to 2.5mg. I have lost 9 stone and changed my life. Any advice?

Any suggestions for other maintenance providers I might try? I have evidence of every pen I've bought as well as dates I've injected. All tally up despite a time lag between buy/inject.

Swift Doctor or Pharmulous maybe? Or one of the other ones on the Monj maintenance list:

https://monj.co.uk/mounjaro-maintenance-pharmacies/

I had 2 pens bought in August with exactly a 2 month gap and I'm with oushk and bought 2 pens a few weeks ago that were approved fine. Did your pens add up completely with your gap? What date do the labels have on them? Even with 4 pens from start of November it's now approaching the end of March and each dose is 7 days, so that should be more than 4 pens.
Counting from 3rd Nov it's now 20 weeks, so I can see why they are questioning it even with the extended 8-9 days between a few doses.

My photo with 4 unopened pens is from 14 Nov. I will have started one the following week. I missed one dose in December when I was ill and have tapered the last few to 8-9 days. Now have 2 doses left. All were prescribed around September as I was struggling to get any from anyone and then got approved for a load all at once! I had a consultation on 10th November with an Oushk pharmacist when I asked if this would be a problem. She told me to (dated) photograph my stockpile and it would not.

Thank you, I'll take a look.

So the photo is from November but labels from September? Did you have evidence of the pens from Sept to Nov? clearly prescriber feels there is a problem with the dates and covering the period. Try another pharmacy like Nulife, pharmulous.
Sorry I have no idea how to delete this Gif but I didn't mean to add it 🙈

Haha, it's cheered me up a bit which was no easy task! The prescribing dates were earlier but all use by dates really long (2027 I think). I guess the only other proof I have is that I ordered 10 other pens from the end of Oct 24. I did use the extra dose in them but it's all pretty much spot on every week for the previous year. All detailed in spreadsheets with date, time and which thigh I injected!

I have a maintenance video appointment booked with Pharmulous on Friday - will lay myself at their mercy.

As well as being terrified I'm a touch annoyed that I paid for a consultation in November to discuss/prevent this issue and then another consultation last week where I was recommended to be on 12.5mg every 7 days by an Oushk pharmacist. They've also taken a payment to subscribe to maintenance. Oh well, I'll see what tomorrow brings, if not fingers crossed Pharmulous will take me.

There have been a few posts like this on the Oushk site, they are being inflexible with any gaps, want pharmacy labels dates to line up with treatment and dropping patients down the doses.

Do let us know how you get on with Pharmulous. I am thinking of moving from Oushk to them too (or Swift) as I have a growing stockpile from partial dosing.

Try Swift.

Thanks all. I have video appointments booked with Pharmulous on Friday and swift on Sunday to see if i can fix this with with either one. I'm absolutely bricking it. I have changed my life with mounjaro and thought I was being proactive wrt maintenance. Live and learn.

They better not do this to me, mine is due next week. I had maintenance call in d3cember with all th3 height and weigh stuff and made my order about six weeks ago for Wegovy 2.4. I had four or five pens in August too so this is my first order from then. They've had my money some time now but obvs not despatched I tried several other suppliers and noone would prescribe 2.4 they all wanted me to hav3 the lowest dose.n

I wouldn't mind if Oushk had been clear with me from the start but they were so reassuring that my stockpile wouldn't be an issue.

Same here

Good luck. I really thought having had a couple of video consultations where I laid everything out and they gave their recommendations that 12.5mg dose would be authorised no trouble. It's not even as though I'm asking to stay on 15mg - I'm asking to taper down to see how it goes.

I’ve had exactly the same issue with Oushk and have just changed to WePrescribe. Got a video consultation within a week and the pen arrived the following day.

Oushk sent me a very apologetic email after one fiasco and then promptly did the same thing the following month despite me paying for a maintenance assessment. The pharmacist flat out refused to prescribe based on the dose spacing I’d agreed in writing with a previous one. To be honest with many now prescribing off-label I can’t see Oushk’s approach being a winner for them

They are getting caught out with Hira, everyone’s bestest friend, appearing to say one thing in the lives - photo your pens with the date and that will be absolutely fine - when what is meant is photo your pens with the pharmacy label dates so we can make sure you have enough with the correct dates to cover the gap when using no pen for longer than 30 days.

Add to that their independent prescribers are individually accountable to evidence their prescribing decisions it sounds like pot luck if you get one who feels more comfortable prescribing higher doses after a pen apparent gap than another.

That's interesting. I'll take a look at weprescribe. Are you still losing or at maintenance? I had assumed the pharmacist who did my consultation last week would prescribe the agreed dose.

I’m maintaining @MJMaude but don’t mind if I lose a bit more. I went with WePrescribe as their TrustPilot reviews were good and the prices better than Oushk’s. There’s £40 off for new patients and 10% off for returning customers which helps. The only thing I haven’t liked so far was that there’s no way to choose a delivery date.

Do you know if they have bmi limits for new maintenance patients? I'm hovering around 22 at the moment I think. Thanks

I had similar problems with Oushk. I won’t bore you with the details, but it was a right mess. I just wonder with their heavy social media approach, they are getting a lot of fraudulent customers. I personally hated being treated like a criminal, the endless verifications, taking your money & not sending the product. I was stressed too, like you, as I was over a week late injecting when they finally deigned to send me my script.
I am now with Swift Doctor - well named, they are quick. I received my pen just under 24 hours from ordering - impressive! Price wise, they are middling, but I can live with that.
I had an initial phone consult, then had to send through ID verification, copy of my last script and a video of me on scale & showing my bod. Unlike Oushk, I will never have to do that again.

Yes! I have uploaded the same proofs to Oushk time and again and everytime I log back in it's reset to not completed. I'm not that bothered about price - at the end of the day it's an arm and a leg anyway! So scared to lose my progress though.

Anyone know if the "golden dose" is likely to be a problem/not for the new providers? The only discrepancy in my dosing is that I have withdrawn the extra dose to get a fifth. All bar one still used within 30 days of opening. All extra doses withdrawal in a sterile/aseptic fashion.

10 pens from end Oct 24 takes you to August and that's a month each, you still are missing sept to mid nov so can you see how they are questioning. Mind you, I've always been told Oushk allow 6 weeks per pen. I order monthly but sometimes leave it 5 weeks and its fine. Good luck with the other pharmacies

That's because I take the "golden dose". Works out at 5 weeks per pen and within their 6 week reorder guidelines.