Cloud Pharmacy now querying my Mounjaro maintenance and ordering schedule

[LilyRose88]

I've been ordering Mounjaro from Cloud Pharmacy for over a year, and have been maintaining for 12 months. I've been injecting 5mg every 9-10 days and using the 5th dose via an insulin syringe during my maintenance phase. Up until now Cloud has been fine about me ordering a 5mg pen every couple of months, but suddenly today when I placed an order I got a message asking me when I last injected. I explained the above and got a message back saying that this was not okay and that unless I agree to inject every 7 days and order every 4 weeks they cannot supply me.

I confirmed I would do this as I wanted to order another pen (I do have a bit of a stash in the fridge!). I then got a couple of other messages asking about my health and warning me about various potential interactions with my thyroid medication. They also asked me to confirm that my GP was aware I was taking Mounjaro. I did so and they then approved my order.

It seems that they have tightened up their prescribing. Can anyone recommend an online pharmacy that is happy to prescribe Mounjaro less frequently for someone in their maintenance phase?

They did it to me on my weight, accused me of lying basically, wanted a video call, before another pharmacist approved. I jist left them.i was quite offended, they’d all the history of my purchases , multiple pics taken over the weight loss phase as well as maintenance, which on the latter was a good year, and my images and body hadn’t changed in maintenance, then all of a sudden this woman, Amy, can’t remember started telling me there was a discrepancy, I honestly couldn’t see whay she was seeing, nor could my husband, who was quite amused by it. So I ended it with thay pen and moved. Who needs that shit.

I agree, they've suddenly become very suspicious of long-term customers. I had to send them photos last time I ordered, and they also have photos of me when I was heavier during my weight loss period. I'm looking to move to a provider that has a more reasonable approach to maintenance, and accepts that it is okay to inject every 9-10 days. I could go down to a 2.5mg pen, but that works out more expensive. Who did you change to, if you don't mind me asking.

That's odd as Cloud support maintenance so not sure why they are being tricky

It could be that they're tightening things up because of GPhC requirements or perhaps they are getting bigger and have more prescribers who may make difference decisions.

From what I've picked up on social media (and I could be mistaken), there seem to be two main ways pharmacies prescribe these meds. One is under a Patient Group Direction (PGD), where the lead pharmacist sets the criteria, so prescribing is likely to be fairly strict and close to GPhC guidance.

The other is through an employed, but independent prescriber, who can depart from the PGD if there's a genuine clinical justification (not just saving money!). The prescriber is personally accountable to the GPhC for their prescribing decisions and they need to document every decision.

It's been similar with Oushk. As they have grown I see in their group customers complaining about inconsistencies in prescribing and "arrogant" (randomly allocated to each order) prescribers. Its quite different from their early days, when Hira was everyone's best-est friend and appeared very flexible (and they ended up with an inspection enforcement notice). These days, the standard response at Oushk seems to be that prescriptions are done by independent prescribers based on clinical need.

@Puppylucky I know. They have been really supportive up to now and not questioned any gaps that I have had in ordering. My current gap was 58 days, so not even 2 months, and it isn't the longest gap I've had in ordering. I do wonder if they've either changed their policy or have recruited new, more risk averse, prescribers. I'm going to have to change provider as I don't want to order every 4 weeks. If anyone has any recommendations I would be grateful.

I moved to my London but they are very strict about rhe order period.

when I challenged cloud and said your owner says you support maintenance,at my bmi and you’ve about 18 months of my data, another prescriber came on and said oh yes we do support and yes we have your data, we will approve it. This was after the other one saying you look thinner than you say so we need a video call so we can have a look at you. But they want you to take time off work to do that, it felt so rude and I wasn’t lying. I’m also in my bloody 50s. I certainly don’t look any where close to under weight.

I read on here they did it to someone else, but then they kept doing it monthly , like they had them in their sights, and wouldn’t stop and I just thought I want a supplier who genuinely supports maintenance and isn’t going to accuse long term customers of being liars when they’ve all their images going back that long.

i expect to be treated with some respect. I’m a grown woman making a legitimate choice and spending a lot of money. There are many many suppliers, no one needs to be accused of lying like they are some wayward teen.

I’ve just ordered from med express , last week and my last order was April from a different company , I’m still bouncing around for whoever sends me a deal , I have told a couple of white lies though , I am jabbing every 12 days ish at mo & less than a full dose but have said i’m working my way through the stash I bought pre price rise ,nobody has questioned this though or asked me to prove it , I’ve only ordered 3 times since September .

Sadly there is a huge number of people abusing them which makes it a more arduous process for the rest of us using them sensibly. Just gotta jump through the hoops

Can you back that up with stats for legit pharmacies, as I don’t think it is true, but am willing to be proven wrong if you back up what ypu say.

Just personal experience with someone I know with an eating disorder who got them easily and abused them, and showed me them all sharing codes on pro anna forums. It might not be from the best of the best but I guess they all have to tighten up

It is probably the combination of 9-10 day dosing plus 5th dose that spooks the prescriber. I'm quite sure I've told them up to 10 days between doses, but that I was using the pen within 30 days, and it was approved without issue. I just ensure I order every 4 or 5 weeks, despite having a stockpile of about 12 pens.

Move to swift doctor?

Swift Dr

@MeridaBrave @MrsMiagi Does Swift Doctor support maintenance plans which include injecting less frequently? I am a bit nervous about trying to order elsewhere and having the same problems that I am having with Cloud. I've looked at their website and its not clear how their maintenance support works in practice.

Yes they seem to be very flexible. I told them about my stash and they were fine

Hi LilyRose88,

We’re sorry to hear that our approach to maintenance has caused frustration.
We recognise that maintenance is an important part of long-term weight management, and we fully support patients who have reached this stage. As a clinically led service, however, we must ensure that every prescription remains safe and appropriate. This means we may occasionally ask for updated information, such as your current weight and BMI, or invite you to a video consultation.

These are routine clinical checks and are not a sign that we distrust our patients or are looking for reasons to stop treatment. They help us meet our professional responsibilities and provide safe, personalised care. Our clinical approach allows us to support patients get to a healthy BMI and we can also consider restarting treatment for patients whose BMI is below 30 following an individual clinical assessment. To safely offer this level of flexibility, these checks are an essential part of our prescribing process.

We also understand that everyone’s circumstances are different. Where clinically appropriate, our team can offer flexibility and individual support with missed doses, treatment breaks, restarting treatment or changing doses.

We recently launched our Maintenance Portal as a dedicated hub for ongoing support. There is no maintenance subscription, and taking a break does not mean you are simply “switched off.” You remain our patient and can return to us for support when needed, with any prescribing decisions based on an individual clinical review.
We would really like the opportunity to clear up any misunderstanding and discuss your concerns, as feedback is important for our growth.Please contact our team directly so we can look into this properly while protecting your privacy.

Kindest regards,
Cloud Pharmacy

You can book a consultation with Swift Doctor and agree how you will proceed. It costs £30 for 20 minutes with a doctor, but gives you a £10 code off all future orders.

I think the main thing you want with any pharmacy is you can be open with them about past use and where you are now and they support you though that without the judgement (or perceived threats of stopping supply!)

My maintenance consultation with Swift Doctor was helpful (I ordered a couple of pens from them before I had it). They noted in my file I had a stash and we agreed a 5 month order break. They also allow longer pen in-use periods if appropriate. When I spoke to them they advised longer periods between injections but were not keen on click counting.

So I am able to reduce some of my stash from previous partial dosing and agreed a potential way forward. I just need to keep them up to date with what I want to do when I am restarting ordering so they can keep it on file.

I also think the combined doctor and pharmacist model works really well especially if there are potential interactions with other medications the doctor can talk with you about and help you understand any issues. Dr Bano is really approachable, professional and supportive.

I was with cloud for maintenance for over a year without issue and they suddenly got a bit funny and said there was a discrepancy with my details. I tried to resolve it but they are so slow with getting back to me. I changed to Pharmulous, did the video selfie with me stepping on an off the scales and they were so easy to deal with (as Cloud used to be)

I had to start at 2.5mg but that’s ok as I never went higher than 3.75mg.

@cloudpharmacy Could you let me know who I should contact at Cloud to discuss supporting me during maintenance? The pharmacists who messaged me offered zero flexibility with missed doses or different ways of dosing during the maintenance phase. I was very honest about injecting every 9-10 days and they made it clear that this was not acceptable and that they would only authorise my order if I agreed to inject every 7 days. Maintenance is an important factor and many people find it works best for them to inject less frequently than when they were trying to lose weight.

Nonsense, your pharamcist accused me of lying, she told me after several messages where I urged her to look at previous photos, and my history, thay there was a discrepancy between my images and my weight. Very odd that no one thought that the 12 months before hand as you took my money , and no other pharmacy thinks it. She then told me I had to do a video call so they could look at me. She wanted to prescribe, just a lower dose than I wished, it felt like you were trying to get rid of old stock. She even started telling me hunger was normal and to get used to it. Like I was some wayward teen, you were also fully aware this was on my gp records and my gp was supportive due to previous health issues ie high blood pressure.

thats not supporting maintenance. Thats treating customers poorly. I won’t pay to receive messages like that.

Hi LilyRose88,

Thank you for coming back to us with more detail. We're sorry to hear that this was your experience, as we never want patients to feel unsupported.

We'd really like the opportunity to review the advice you were given and discuss your experience with you directly. If you could email our Patient Care team with your details, we'll arrange for the appropriate member of our clinical team to give you a call and answer any questions you have about your maintenance plan.

[email protected]

Kindest regards,
Cloud Pharmacy

Hi,

We're really sorry to hear that this was your experience. We never want any patient to feel dismissed or unsupported, and we're sorry that your interactions left you feeling this way.

We take feedback like this seriously and would welcome the opportunity to look into this further. Please email our Patient Care team with your details, and we'll arrange for the appropriate member of our clinical team to contact you directly.

[email protected]

Kindest regards,
Cloud Pharmacy