Mounjaro pen left unrefrigerated for 4 days, is it still usable after 30 days?

[BaffledandBarmy36]

My next mounjaro pen was delivered while I was away, husband was home, and it was left outside by our bins for 4 days. It was delivered incorrectly, for example; should not have been delivered to bins and no delivery note was left so had no idea it was delivered. It was outside for 4 days at the start of June (so outside temperatures were up to 21 degrees celcius). I opened and checked it, liquid was clear and as it should be, and it was put in the fridge.

I am currently on a pen and have three weeks left on it. Meaning if I need to stick to the general advice, I'd need to use it by 30 days and on this basis I might only be able to do one dose and that's it so the whole pen is wasted.

I've queried with the supplier "Online Clinic" who are refusing to provide any help/replacement.

Has anyone used their pen past 30 days in this type of scenario where the pen has been left out of fridge and then refrigerated after a few days?

You could try putting the details into this https://tempex.lilly.com/uk/.

It has 30 days at up to 30C. You’ve spent 4 days. You have 26 days left from the point you next remove it from the fridge (provided it’s still within the printed expiry on the carton).

Was it delivered with a frozen cooler block in an insulated package or just the pen in a package/envelope?

If the latter, I'd never use that supplier again! Mine comes with a cooler block and also adequate insulation for at least a few days of transport.
There is nothing magical that is going to happen at the stroke of midnight on the 30day mark. Majority of drugs will eventually lose potency over time, rather than suddenly getting stronger, but I agree you could try to excursion link posted up thread.

@DistantEarlyWarningthats not how the usage guidelines work. Once the pen is at room temp, higher than 8 degrees, then the 30 days usage applies. It doesn’t pause if you put it back in the fridge.

@BaffledandBarmy36 I would write a clear trust pilot review of this pharmacy explaining that they don’t follow the cold chain guidance that pharmacies must follow. You should be able to store the pen up to its printed expiry date and no part of the 30 days limit should be used by the pharmacy during delivery. So they should have either refunded you or sent you a new pen.

Having said all of that, the risk is that the pen is less effective due to degrading, but many people have found that there’s no noticeable difference if they use the pens past the 30 days guideline. So as long as it remains clear and not discoloured then for me I would probably continue to use it and not worry too much about it.

If you haven’t actually used the pen, then yes, putting it back in the fridge does pause the chemical degradation. I know that isn’t what it says in the leaflet, but it’s how the science works.

Of course OP should be wary of taking advice from randoms on the internet who make claim to have spent their entire career in medicines formulation and stability, but as you’ve said yourself, it will probably be OK.

On your second point - I agree she should absolutely take the shoddy delivery further. As well as a Trustpilot review, a report to the GPhC is a good idea. www.pharmacyregulation.org/patients-and-public/reporting-concerns

Thank you everyone for your responses.

It did have one ice block and insulation but it's not been the best I've seen. I'm trying to pursue further and have also raised a complaint claim with Royal Mail for the non-compliant delivery and have sent all information to Online Clinic and waiting to hear back from them. The latter have been awful though so I wouldn't recommend.

To pay out that money and then be refused replacement/refund, it's infuriating. I wouldn't want to be doing anything risky to my health but I've not been on the pens long so wanted to see what others thought.