Transferring Mounjaro / Zepbound pens into a pen cartridge?

[tcpnomad]

This might seem like a strange goal, but it serves someone who can't handle the usual dose because of adverse effects. Doing it this way lets them either divide the dose or simply use less than the entire amount.

The real issue is whether this is safe. Are the ingredients inside these pens made to remain usable across several administrations?

 

[thebonus]

tcpnomad said:

This might seem like a strange goal, but it serves someone who can't handle the usual dose because of adverse effects. Doing it this way lets them either divide the dose or simply use less than the entire amount.

The real issue is whether this is safe. Are the ingredients inside these pens made to remain usable across several administrations?

Back when I was paying Lilly, this was a regular practice for me. I'd take 15mg pens and transfer the contents into a sterile vial so I could use smaller doses. There's a video here (not made by me) that shows how simple it is:

View: https://www.youtube.com/watch?v=3RsgridKdIY

 

[BrightCandle]

Sure, that works. The simplest approach is probably to draw the liquid out using a syringe and needle, then inject it straight into the pen's 3ml capsule, because getting the vent needle in any other way is trickier. A lot of users rely on counting clicks or similar methods with their disposable pens, but when that isn't possible, this method is a workable way to take smaller doses.

 

[Granny]

Some of mine is 15mg, more than I can handle in 1 go. I push it into a syringe, then into a sterile vial, and it has been fine.

 

[indolent]

BrightCandle said:

Sure, that works. The simplest approach is probably to draw the liquid out using a syringe and needle, then inject it straight into the pen's 3ml capsule, because getting the vent needle in any other way is trickier. A lot of users rely on counting clicks or similar methods with their disposable pens, but when that isn't possible, this method is a workable way to take smaller doses.

Sadly, in the USA the injectors from Big Pharma are all made for 1-time, 1-dose use only. That differs from the KwikPens designed to last 4 weeks that you find in Canada, the UK, the EU, and likely other regions too.

 

[skeptick]

tcpnomad said:

This might seem like a strange goal, but it serves someone who can't handle the usual dose because of adverse effects. Doing it this way lets them either divide the dose or simply use less than the entire amount.

The real issue is whether this is safe. Are the ingredients inside these pens made to remain usable across several administrations?

The video shown below does the job nicely. Just be careful to verify that the Mounjaro needle has truly entered the opening of the LurLoc syringe. Each month I take 4 Mounjaro pens and empty them into a 5ml LurLoc. I choose 5ml since the springs inside Mounjaro pens are under a lot of tension, which generates a great deal of foam. Every Mounjaro pen holds 0.5ml of liquid, but once foam forms it approaches the capacity of a 3ml syringe. Once my 4 Mounjaro pens are emptied, I gently roll the 5ml syringe for a few minutes to encourage the foam to break down. Alternatively, leaving it alone also lets the foam disappear by itself. I attach a 29g LurLoc needle, put the full 2ml (4x0.5ml) into a pen cartridge, and that covers me for the whole month with fresh 31g pen needles. I can then split doses across the week in whatever amount I want.

 

[TazaTaza]

Is it your insurance or circumstances that leave you stuck with pens, since using brand-name Tirz vials would be simpler for this? IIRC vials cost less, are more convenient, and that way people manage their own dosing.

And no, it isn't built for multiple doses, it isn't "safe" since no preservatives are in it, but even so people keep drawing from single vials again and again just to have finer control over dosing. Still, to cut the risk I'd stick to one pen per vial. What dose are you aiming for compared with the pen dose? Spreading the pin days further apart might be the better option.

If you feel at all unsure, just call it off, because I've heard about people losing that liquid gold and watching it land on the table etc. spray everywhere.

 

[Vriende]

thebonus said:

tcpnomad said:

This might seem like a strange goal, but it serves someone who can't handle the usual dose because of adverse effects. Doing it this way lets them either divide the dose or simply use less than the entire amount.

The real issue is whether this is safe. Are the ingredients inside these pens made to remain usable across several administrations?

Back when I was paying Lilly, this was a regular practice for me. I'd take 15mg pens and transfer the contents into a sterile vial so I could use smaller doses. There's a video here (not made by me) that shows how simple it is:

View: https://www.youtube.com/watch?v=3RsgridKdIY

My own beginning involved drawing Zepbound pens and putting their contents into a sterile vial.

Watching additional videos would be a good idea.

The person in the clip shared earlier didn't appear to pay attention to keeping things sterile. At the very least, wash your hands and make sure the surface you work on is extremely clean.

 

[indolent]

TazaTaza said:

Is it your insurance or circumstances that leave you stuck with pens, since using brand-name Tirz vials would be simpler for this? IIRC vials cost less, are more convenient, and that way people manage their own dosing.

And no, it isn't built for multiple doses, it isn't "safe" since no preservatives are in it, but even so people keep drawing from single vials again and again just to have finer control over dosing. Still, to cut the risk I'd stick to one pen per vial. What dose are you aiming for compared with the pen dose? Spreading the pin days further apart might be the better option.

If you feel at all unsure, just call it off, because I've heard about people losing that liquid gold and watching it land on the table etc. spray everywhere.

According to what I've found online, the autoinjectors sold in the USA for single-dose use contain no preservatives, whereas Kwikpens designed for multiple doses do.

 

[Grogu]

For splitting auto-injecting pens, the approach shown in the video below is the one I would choose myself. A wrench is needed for the other option, yet to me it feels like it keeps things more sterile:

View: https://www.youtube.com/watch?v=5M7dL8F2K-0&t=196s

In the end neither method was needed on my part, since single dose vials began showing up.

A box of 7.5mg autoinjectors sat with me and I kept delaying their use, until eventually I had reached 15mg, at which point I got rid of them by using two on the same day across two weeks.

 

[skaylife]

tcpnomad said:

This might seem like a strange goal, but it serves someone who can't handle the usual dose because of adverse effects. Doing it this way lets them either divide the dose or simply use less than the entire amount.

The real issue is whether this is safe. Are the ingredients inside these pens made to remain usable across several administrations?

That's definitely true. The cartridge inside is identical to the one your pen uses. Every Mounjaro pen leaves behind 0.5ml (I verified this myself, and it amounts to exactly 1 additional dose) that otherwise goes to waste. My approach was to slice the pen down the middle using a dremel, extract the cartridge, and then load it into a pen. Others pull the leftover liquid out with a syringe and inject that way. Pulling the cartridge out carries far less risk of contamination. If you remove the cartridge from the start, your pen lets you inject any amount you choose.

 

[tcpnomad]

indolent said:

TazaTaza said:

Is it your insurance or circumstances that leave you stuck with pens, since using brand-name Tirz vials would be simpler for this? IIRC vials cost less, are more convenient, and that way people manage their own dosing.

And no, it isn't built for multiple doses, it isn't "safe" since no preservatives are in it, but even so people keep drawing from single vials again and again just to have finer control over dosing. Still, to cut the risk I'd stick to one pen per vial. What dose are you aiming for compared with the pen dose? Spreading the pin days further apart might be the better option.

If you feel at all unsure, just call it off, because I've heard about people losing that liquid gold and watching it land on the table etc. spray everywhere.

According to what I've found online, the autoinjectors sold in the USA for single-dose use contain no preservatives, whereas Kwikpens designed for multiple doses do.

What if I just mixed in a bit of bac water to act as a preservative?

 

[tcpnomad]

skaylife said:

tcpnomad said:

This might seem like a strange goal, but it serves someone who can't handle the usual dose because of adverse effects. Doing it this way lets them either divide the dose or simply use less than the entire amount.

The real issue is whether this is safe. Are the ingredients inside these pens made to remain usable across several administrations?

That's definitely true. The cartridge inside is identical to the one your pen uses. Every Mounjaro pen leaves behind 0.5ml (I verified this myself, and it amounts to exactly 1 additional dose) that otherwise goes to waste. My approach was to slice the pen down the middle using a dremel, extract the cartridge, and then load it into a pen. Others pull the leftover liquid out with a syringe and inject that way. Pulling the cartridge out carries far less risk of contamination. If you remove the cartridge from the start, your pen lets you inject any amount you choose.

That's curious. What was your method for applying the dremel to the pen?

Also, does that mean the cartridge can be loaded straight into a pen?

And how do you feel about using it more than once? From what I can tell, there's no preservative in these single use pens.

 

[eidos]

indolent said:

TazaTaza said:

Is it your insurance or circumstances that leave you stuck with pens, since using brand-name Tirz vials would be simpler for this? IIRC vials cost less, are more convenient, and that way people manage their own dosing.

And no, it isn't built for multiple doses, it isn't "safe" since no preservatives are in it, but even so people keep drawing from single vials again and again just to have finer control over dosing. Still, to cut the risk I'd stick to one pen per vial. What dose are you aiming for compared with the pen dose? Spreading the pin days further apart might be the better option.

If you feel at all unsure, just call it off, because I've heard about people losing that liquid gold and watching it land on the table etc. spray everywhere.

According to what I've found online, the autoinjectors sold in the USA for single-dose use contain no preservatives, whereas Kwikpens designed for multiple doses do.

Per the FDA (https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/217806s042lbl.pdf):

ZEPBOUND is a clear, colorless to slightly yellow, sterile solution for subcutaneous use. Each single-dose pen or singledose vial contains a 0.5 mL solution of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg of tirzepatide and the followingexcipients: sodium chloride (4.1 mg), sodium phosphate dibasic heptahydrate (0.7 mg), and water for injection. Eachmulti-dose vial or single-patient-use KwikPen contains 2.4 mL of solution, which provides 4 doses of 2.5 mg, 5 mg,7.5 mg, 10 mg, 12.5 mg, or 15 mg of tirzepatide per 0.6 mL. Each dose contains the following excipients: benzyl alcohol(5.4 mg), glycerin (4.8 mg), phenol (1.08 mg), sodium chloride (1.05 mg), sodium phosphate dibasic heptahydrate(0.8 mg), and water for injection. Hydrochloric acid solution and/or sodium hydroxide solution may have been added to adjust the pH. ZEPBOUND has a pH of 6.5 to 7.5.

Click to expand...

How the contents of the cartridge hold up is mostly a question of how aseptic the preparation was, even if all you use is a buffer plus NaCl.

For my own part, with a pen and a pace of one pin weekly, I would stop at 3-4 weeks.

Were a longer stretch needed, my approach would be to make up multiple single-use cartridges and keep them refrigerated. Alternatively, multiple single-use syringes kept in the fridge. Hospitals keep insulin in polypropylene syringes with sterile 0.9% NaCl for as long as 2 months under refrigeration. At the 3-month mark, 90% of the activity is still there, and no contamination appears.

 

[skaylife]

tcpnomad said:

indolent said:

TazaTaza said:

Is it your insurance or circumstances that leave you stuck with pens, since using brand-name Tirz vials would be simpler for this? IIRC vials cost less, are more convenient, and that way people manage their own dosing.

And no, it isn't built for multiple doses, it isn't "safe" since no preservatives are in it, but even so people keep drawing from single vials again and again just to have finer control over dosing. Still, to cut the risk I'd stick to one pen per vial. What dose are you aiming for compared with the pen dose? Spreading the pin days further apart might be the better option.

If you feel at all unsure, just call it off, because I've heard about people losing that liquid gold and watching it land on the table etc. spray everywhere.

According to what I've found online, the autoinjectors sold in the USA for single-dose use contain no preservatives, whereas Kwikpens designed for multiple doses do.

What if I just mixed in a bit of bac water to act as a preservative?

When it comes to single-use pens, I've got no knowledge at all, mate. Here in Belgium, Mounjaro is only ever supplied as a multiuse kwikpen.

 

[TazaTaza]

indolent said:

TazaTaza said:

Is it your insurance or circumstances that leave you stuck with pens, since using brand-name Tirz vials would be simpler for this? IIRC vials cost less, are more convenient, and that way people manage their own dosing.

And no, it isn't built for multiple doses, it isn't "safe" since no preservatives are in it, but even so people keep drawing from single vials again and again just to have finer control over dosing. Still, to cut the risk I'd stick to one pen per vial. What dose are you aiming for compared with the pen dose? Spreading the pin days further apart might be the better option.

If you feel at all unsure, just call it off, because I've heard about people losing that liquid gold and watching it land on the table etc. spray everywhere.

According to what I've found online, the autoinjectors sold in the USA for single-dose use contain no preservatives, whereas Kwikpens designed for multiple doses do.

In the US, I'm not aware of Kwikpens being available for mounjaro — supposedly Zepbound has them (largely cash-pay, while single-use pens get pushed through insurance), and that's handy since Kwikpens contain preservatives and let someone dial in a custom dose. With a Kwikpen, extraction wouldn't be necessary at all. A person could go with 2 units, 3 units, and so on, rather than being locked into one dose per push of the pen.

Judging by what OP wrote, the pens in question sound like the single-use autoinjectors — one dose each time you push, and no preservatives inside them (L*ly states this plainly on the box and in the info pamphlets), which makes things trickier. That's why my inclination would be to stretch out the pin days instead.