AmoPure arrival

Posted this in the public square amo thread, but thought I'd add it here as well.

Received my order last week, 9/25. 30mg with blue tops. Most pucks broken. Straight to freezer.

Reconstituted with hospira bac, 2ml (2025 exp date bac water). Vacuum sealed, confirmed during reconstitution. Noticed no gel-ing like others have mentioned. Perfectly clear, stored in fridge overnight.

Injected rs today with 25 units after leaving out for ~30min.

Zero reported stinging or burning. Reportedly felt exactly the same as previous compounding injections.
 
Posted this in the public square amo thread, but thought I'd add it here as well.

Received my order last week, 9/25. 30mg with blue tops. Most pucks broken. Straight to freezer.

Reconstituted with hospira bac, 2ml (2025 exp date bac water). Vacuum sealed, confirmed during reconstitution. Noticed no gel-ing like others have mentioned. Perfectly clear, stored in fridge overnight.

Injected rs today with 25 units after leaving out for ~30min.

Zero reported stinging or burning. Reportedly felt exactly the same as previous compounding injections.
Thanks
 
Posted this in the public square amo thread, but thought I'd add it here as well.

Received my order last week, 9/25. 30mg with blue tops. Most pucks broken. Straight to freezer.

Reconstituted with hospira bac, 2ml (2025 exp date bac water). Vacuum sealed, confirmed during reconstitution. Noticed no gel-ing like others have mentioned. Perfectly clear, stored in fridge overnight.

Injected rs today with 25 units after leaving out for ~30min.

Zero reported stinging or burning. Reportedly felt exactly the same as previous compounding injections.
Thanks for the details. I have the same blue tops with mostly broken pucks. I won’t get to them for about a month but nice to know.
Appreciate your post 👍🏼
 
I've received Amo C5,S5, "L" 15 and "L" 30... All have the same blue tops... (Best to have your label maker handy while unpacking)

Here's a pic from Amo on what to expect after shipping. I think they explained the lack of mannitol might explain the fragile cakes. (Hasn't impacted efficacy of my product)
 

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I've received Amo C5,S5, "L" 15 and "L" 30... All have the same blue tops... (Best to have your label maker handy while unpacking)
Wow. They don’t make it easy I guess. I thought it was helpful for them to use different colors on their end as well.
Interesting regarding the mannitol content having an effect of the fragility of the cakes.
 
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Posted this in the public square amo thread, but thought I'd add it here as well.

Received my order last week, 9/25. 30mg with blue tops. Most pucks broken. Straight to freezer.

Reconstituted with hospira bac, 2ml (2025 exp date bac water). Vacuum sealed, confirmed during reconstitution. Noticed no gel-ing like others have mentioned. Perfectly clear, stored in fridge overnight.

Injected rs today with 25 units after leaving out for ~30min.

Zero reported stinging or burning. Reportedly felt exactly the same as previous compounding injections.
My experience is the same with 30 also blue top.
 
Just an update, I've been on compounded for 15 weeks. This was my first week of research. Got an injection site reaction for the first time ever. Not bad, red circle around it and sore. No swelling.

I understand injection site reactions are normal for subq injections and especially tirz, just wanted to note this for research purposes.

Anyone else had a similar experience?

I still have some compounded left. Going to switch back and use it Thursday (I do split doses) and see if there's a reaction.
 
This is AI generated and probably not very accurate. But I found it interesting to have a ballpark estimate in order to consider what the reasons for what I perceive as more recurring reports of reactions from some vendors.

As a disclaimer, I would be careful making any assumptions based in this, since I have no way to verify the data. Personally I would give any reputable lab the benefit of the doubt and assume it has to do with availability of materials since it is on the grey market.
_________
Here’s the revised text, incorporating a production size of 10,000 vials and breaking down the total cost savings and savings per vial, separated into material and standards categories.

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Potential Causes of Injection Site Reactions in Compounded Semaglutide

If many users of semaglutide from a particular compounding pharmacy experience injection site reactions, it could be due to fillers (excipients), impurities, or suboptimal manufacturing practices. Below, we’ll explore potential causes, why cheaper excipients are used, and the potential cost savings for a production size of 10,000 vials of compounded semaglutide. We’ll also provide a detailed breakdown of savings by materials and standards.

1. Fillers More Likely to Cause Reactions

Certain excipients used in lyophilized semaglutide may cause localized reactions. However, they are often chosen due to cost or availability. Here’s a breakdown of the most common fillers and their associated savings:

Mannitol or Sorbitol (Bulking Agents)
- Purpose: Stabilizes the drug and bulks up the volume for accurate dosing.
- Reactions: Can cause osmotic imbalances or mild allergic reactions, leading to swelling or inflammation.
- Cost Difference:
- Mannitol: Around $100-$150/kg.
- Alternative (Trehalose): Around **$500-$700/kg.
- Usage: Assuming 50 mg per vial, for 10,000 vials:
- Using mannitol: Costs about $50-$75 total.
- Using trehalose: Costs about $250-$350 total.
- Total Savings: Around $200-$275.
- Savings per vial: $0.02-$0.03 per vial.

Sucrose or Other Sugars
- Purpose: Acts as a stabilizer and bulking agent in lyophilized formulations.
- Reactions: May cause hypersensitivity in some individuals.
- Cost Difference:
- Sucrose: Around $50-$100/kg.
- **Alternative (Pharmaceutical-grade lactose): $300-$400/kg.
- Usage: Assuming 20 mg per vial, for 10,000 vials:
- Using sucrose: Costs about $10-$20 total.
- Using higher-grade lactose: Costs around $60-$80 total.
- Total Savings: Around $40-$60.
- Savings per vial: $0.004-$0.006 per vial.

pH Buffers (e.g., Sodium Citrate or Acetate)
- Purpose: To maintain the pH level and stabilize the drug.
- Reactions: Improper pH can lead to irritation at the injection site.
- Cost Difference:
- Cheaper Buffers (Sodium Citrate): Around $50-$100/kg.
- Higher-Quality Buffers (Phosphate):
Around $200-$300/kg.
- Usage: Assuming 10 mg per vial, for 10,000 vials:
- Using cheaper buffers: Costs about $5-$10 total.
- Using higher-quality buffers: Costs around $20-$30 total.
- Total Savings: Around $10-$20.
- Savings per vial: $0.001-$0.002 per vial.

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2. Standards & Processes More Likely to Cause Reactions

In addition to the excipients, cost savings could come from **cutting corners in manufacturing processes**, particularly around sterility and quality control. These choices can lead to contamination, residual solvents, or other impurities that cause reactions.

Sterility Standards
- Purpose: Ensures that the product is sterile and safe for injection, especially for multi-dose products.
- Reactions: Lower sterility standards can lead to bacterial contamination or foreign particle introduction, causing infections or irritation.
- Cost Difference:
- High-standard sterility: Around $3-$5 per vial.
- Lower sterility practices: Around $1-$2 per vial.
- Total Savings: For 10,000 vials, using lower sterility standards saves about $20,000-$30,000.
- Savings per vial: $2-$3 per vial.

Freeze-Drying & Purity Standards
- Purpose: Properly removing solvents and impurities from the powder.
- Reactions: Incomplete lyophilization may leave behind residual solvents, which can cause irritation at the injection site.
- Cost Difference:
- High-end freeze-drying process: Around $2 per vial.
- Lower-grade process: Around $0.50 per vial.
- Total Savings: For 10,000 vials, using cheaper equipment saves about $15,000.
- Savings per vial: $1.50 per vial.

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Summary of Potential Savings

| Category | Total Savings (for 10,000 vials)| | Savings per Vial |
Materials
| Mannitol vs. Trehalose | $200 - $275 | $0.02 - $0.03 |

| Sucrose vs. Higher-grade Lactose | $40 - $60 | $0.004 - $0.006 |

| Cheaper pH Buffers vs. Higher-quality Buffers | $10 - $20 | $0.001 - $0.002 |

| Standards & Processes |
| Lower Sterility Standards | $20,000 - $30,000 | $2 - $3 |

| Lower Freeze-drying Standards | $15,000 | $1.50 |

| Total Savings | $35,250 - $45,355 | $3.525 - $4.536 per vial |

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Conclusion: Total Potential Cost Reduction

For a batch of 10,000 vials, a compounding pharmacy can save approximately $35,250 - $45,355 in total by opting for cheaper excipients and cutting corners in sterility and processing standards.

This results in a savings of $3.525 - $4.536 per vial.

Decision-Making for Pharmacies
A pharmacy may opt for these cost-saving measures for a few key reasons:

- Profit Margins: Cheaper materials and standards can significantly increase margins, especially for bulk production.

- Competitive Pricing: Lower production costs allow pharmacies to offer products at lower prices, making them more attractive to consumers.

- Availability of Materials: Cheaper excipients like mannitol or sucrose are more readily available and easier to work with.

- Regulatory Flexibility: Compounding pharmacies often have more flexibility with their processes compared to commercial manufacturers, which may lead to more cost-cutting opportunities.

However, these savings come at the potential cost of product quality and patient safety, leading to a higher risk of injection site reactions, inconsistent efficacy, or even contamination. It is essential for patients and healthcare providers to be aware of the trade-offs in quality that come with cost-saving decisions in compounded medications.
 
Just an update, I've been on compounded for 15 weeks. This was my first week of research. Got an injection site reaction for the first time ever. Not bad, red circle around it and sore. No swelling.

I understand injection site reactions are normal for subq injections and especially tirz, just wanted to note this for research purposes.

Anyone else had a similar experience?

I still have some compounded left. Going to switch back and use it Thursday (I do split doses) and see if there's a reaction.
For whatever reason if I inject in my thigh this happens but not my stomachs. But yes this is normal. You can always test your bac water since a lot of people seem to be sensitive to that
 
Just an update, I've been on compounded for 15 weeks. This was my first week of research. Got an injection site reaction for the first time ever. Not bad, red circle around it and sore. No swelling.

I understand injection site reactions are normal for subq injections and especially tirz, just wanted to note this for research purposes.

Anyone else had a similar experience?

I still have some compounded left. Going to switch back and use it Thursday (I do split doses) and see if there's a reaction.
I’ve been 100% on red rock Tirz and sometimes I get injection site reaction, sometimes I don’t. Sometimes it’s red, sometimes bruising.

I personally am not concerned with it
 
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