How long for this to pass?!

[5mgmistake]

I took my first 5mg dose yesterday and have woken up feeling dreadful! Nauseous, upset stomach, heavy limbed. Feel sick at the thought of food, and frankly everything.

Felt okay on 2.5mg and lost 7lbs. I assumed the move up would be okay.

I have a really busy day at work today and I really can’t miss it! I’m also going on holiday on Monday!

Can anyone share their experience of feeling ill after moving up a dose and how long it lasted? I’m going to go back down to 2.5 I think. Thanks.

How long were you on 2.5 for and was it still working for you? I would go back there and if you need to move up because it's not having much impact you can do it in increments. I have never had any bad side effects but I've gone relatively slowly up the doses, and wish I had gone slower.

Yes, I am going to go back down. It was working well enough.

I was hoping for some idea as to how long feeling like this will likely last, particularly with my holiday coming up! I feel really hungover. That’s the closest way to describe it.

You only need to move up if/when suppression isn't strong enough and you don't lose weight. So your move was perhaps premature...

It took me about nine months to get from 2.5 to 5, in increments of a few clicks at a time. Even trying to go from 2.5 to 3.75 was too much and triggered the side effects for me. I had to be very careful. But on the plus side, being a strong responder helped me get to goal weight in a decent time period.

When the stomach upsets happened, I had maybe 3 really bad days and then it calmed down. So you're probably going to be ok for your holiday.. In the meantime be very careful with what you eat so the nausea doesn't turn into full on 🤮.

I was like that but it only lasted about a day. I now do my doses in an evening and I’m fine by the time I wake up. I’ve never moved higher than 5mg tho, and I’ve lost 3 stone.

5mg was too much for my OH after not getting suppression at 2.5mg. Just move up in increments. My OH is now on 3.25mg and that’s doing the job.

You will be ok by Monday I reckon . Drink a load of water and maybe take an electrolyte today too . That usually helps . I also find some exercise makes me feel strangely better when I feel sick after my jab . You could try 3.75 next time and do it for a few weeks

I just feel so cross with myself! I debated staying on 2.5 but thought I’d take the plunge as it’s all been fine so far.

I’m an absolutely terrible patient and hate being ill! And I knew I had this really hectic day today. Hopefully it will pass very soon!

thanks all

Why did you decide to jump to 5mg? Have you got a lot of weight to lose, more than 5 stones? Honestly, seriously nasty side effects are a known issue when doubling the dose and jumping straight up to 5mg.

If you’re still losing on 2.5mg, stay there until you’re no longer losing at that dose and then slowly increase would be my advice. Less chance of nasty side effects too. Why spend more money than you need to? You need to think of the long game and how long you might need to stay on MJ for up to 2 years during the maintenance phase. It’s not a cheap quick fix.

There’s really no point in going higher if you’re getting adequate suppression and it’s a mistake to try to lose weight too quickly as you risk losing muscle mass and more importantly for women, bone density.

I’ve been on MJ for over a year now and lost 5 stones by click counting to slowly increase the doses and I’m still only up to 4.5mg. I’ll stay on 4.5mg for maintenance for a while longer before slowly titrating back down. I intend on staying on a maintenance dose of MJ for at least a year, possibly longer.

Why did you decide to jump to 5mg? Have you got a lot of weight to lose, more than 5 stones? Honestly, seriously nasty side effects are a known issue when doubling the dose and jumping straight up to 5mg

But moving to 5mg from 2.5mg after 4 weeks is the standard and manufacturer recommended titration schedule, so surely most people do that? It wasn’t an odd or rash thing to do and ‘seriously nasty side effects’ is a tad dramatic.

I think it’s important to take advice from your health care provider in these situations.

I had nausea, stomach cramps and vile sulphur burps when I went up to 5mg after my first month on 2.5mg. But the discomfort lasted less than 48 hours. Then I felt completely fine. For the next month I stayed at 3.75 and had no issue and excellent level of suppression. Since that experience I've only increased in half, or less, doses. Most I've needed/can tolerate is 7.5mg

Everyone is different. I had this once and never again but my sister had it every week for a day or two.

Yes, this. The instructions were to move up a dose every 4 weeks.

I also thought you could only use the pen for 30 days. If you’re using smaller doses each time, surely that takes you over the time limit?

You need to keep the pen in the fridge if using longer than 30 days.

You can't know how you will react until you try, it's all a personal learning experience so don't beat yourself up about it. The first dose of 5mg after the 4 doses of 2.5mg is the biggest step up in dose to date, so many people do experience side effects for the first time at that point. It does usually settle down.

You can do a 2.5mg dose or a part way dose like 3.75mg from your 5mg pen if the issues don't resolve soon. You can do 5 weekly injections within the 30 day usage guidance. Whether you are comfortable going beyond that timeframe is a personal decision. Keeping it in the fridge and being scrupulous with hygiene will mitigate the risks of using the pen beyond the usual timeframe.

@5mgmistake the official guidelines say 30 days, some providers will support you to have a pen in use for up to 8 weeks.

Hope you feel better soon.

Keep it in the fridge.

As long as you leave it in the fridge and don’t use it past the expiry date it should be fine. if you do take it out of the fridge for any length of time then you have to discard after 30 days. It’s to do with the possibility of contamination rather than the liquid going off.

To be clear, the manufacture instructions is to discard the pen after 30 days whether the pen is stored in the fridge or at room temperature. Also, the printed expiry date on the pen only applies to an unused pen which must be kept refrigerated.

If you decide to use the pen past the 30 days guidance, keeping it the fridge will help mitigate the risk eg contamination and bacterial growth, medication degradation etc.

This ☝️... but don't forget it also says discard the pen after it has delivered four doses.

I don’t know about you but I felt a bit rubbish at first on the 2.5mg, I had noticeable appetite suppression and if anything initially struggled to eat enough which made me feel worse with acid reflux. I found it quite confusing if I’m honest. That settled, I started using something for reflux, got organised with my food and started feeling great. I’ve just taken dose 4 two days ago and I’m definitely more hungry, so I don’t think 2.5mg is cutting it, which is normal as it’s not a therapeutic dose. I anticipate potentially feeling a difference going up to 5mg but I think I know a bit what to expect and have the resources to manage it. My prescriber is going to include an anti nausea medication just in case.

Everyone does what they’re comfortable with but you are right to flag that the pens are supposed to last 30 days and 4 doses. I could easily have got another dose out of my 2.5mg pen, but that’s not what I’m comfortable with, nor for that matter will I be counting clicks or using pens beyond their specified lifetime or number of doses because that’s what a lot of random people on the internet are suggesting. I’d also be disappointed with 5st loss in a year whilst taking WLI, as it’s only just over a lb a week and it’s difficult to see how someone with that much to lose couldn’t achieve a more significant calorie deficit than that even on the jabs, but some people’s challenges are different than mine, so whatever works I guess.

I went up more slowly: 3, 3.75, then 2 weeks (so far) at 4. After the 2nd dose of 4mg, I felt over full and bloated that night, and the following evening I started with the sulphur burps, which lasted until the middle of the following day. Also felt very full and bloated the 2nd night, fine after that.

As suggested I would go back to 2.5mg for your next shot, and stay with that until either the hunger or food noise is be owing troublesome, or until your weight loss tails off. And even then, you don’t need to go straight to 5, you can do an intermediate dose for a while and see how you get on.

Just wondering how those of you on non standard doses are doing it? Click counting or using a needle and syringe? Thanks.

OP I had some nausea and tiredness after my first 5mg dose but it got better in a couple of days and we went on holiday happily a few days later!

In your situation I’d probably stick at 2.5mg for as long as I was getting good weight loss.

@BrokenMetabolism I'd do it by click counting. There are click calculators on monj.co.uk under the Tools menu.

@BrokenMetabolism mostly by click counting. My first “extra” was a golden dose from a 2.5mg, so I got some syringes to extract that.

If I get to the point where I’m taking more than 6 doses from a pen, I will start using a syringe to extract the first couple. My logic is that there is, apparently, the theoretical possibility when you inject from the pen of some fluid from your body going back into the pen, and causing contamination. If you use a syringe, that can’t happen. So my compromise is that I will near that tiny risk for 5 doses rather than the official 3.

If you use a syringe for the first couple of doses you'll find the plunger doesn't move properly to dispense the medication. I think you can mess around with it to make the plunger catch up but I've never tried it myself.