CAGRI Overdose???

skeptick

skeptick

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Let me jump in here, please. Wife's research rat took 3.75mg/ .75ml BAC water Cagri instead of her usual 7.5mg Tirz yesterday. Is now very nauseous and vomiting to point of dry heaves. What dangers should I be monitoring for and what can I do to ease her discomfort. She's the main care giver around here so not in my wheelhouse of experience. Any help much appreciated. Have made water and electrolyte fluid available for her to sip on. Up to now she has shown no sides from working up to 7.5mg Tirz. She's normally very susceptible to drug interactions. Never been exposed to Cagri before this... 65year old healthy female

My math says 5mg vial Cagri/ 1ml Hospira Bac 75unit subq= 3.75 mg dose of Cagri Injectionshop calculator agrees. Skipping 7.5mg Tirz for now.
 
She has no experience with or tolerance to Cagri already? That is a really high dosage as you know. I would expect the nausea to peak around the 3rd day, and then there to be discomfort into the 2nd week, maybe longer.

Hydration and electrolytes are good. If she can tolerate a bit of dry toast or plain rice, crackers, or soup broth, that would help. Bland foods are good, but don't force eat.

Try to keep movement up. Take walks if she can.

Maybe someone else can also add some advice. These are general types for severe nausea.
 
alphaamigo said:
She has no experience with or tolerance to Cagri already? That is a really high dosage as you know. I would expect the nausea to peak around the 3rd day, and then there to be discomfort into the 2nd week, maybe longer.

Hydration and electrolytes are good. If she can tolerate a bit of dry toast or plain rice, crackers, or soup broth, that would help. Bland foods are good, but don't force eat.

Try to keep movement up. Take walks if she can.

Maybe someone else can also add some advice. These are general types for severe nausea.
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ThanX
 
skeptick said:
Is now very nauseous and vomiting to point of dry heaves.
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Get telehealth or doc to prescribe Zofran for nausea. (If she is an American, some Medicare Advantage plans have free telehealth.)

There is over-the-counter stuff for nausea in the meantime. But generic Zofran (ondansetron) is the go-to. Cheap at the pharmacy with GoodRx.
 
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Calm Logic said:
Get telehealth or doc to prescribe Zofran for nausea. (If she is an American, some Medicare Advantage plans have free telehealth.)

There is over-the-counter stuff for nausea in the meantime. But generic Zofran (ondansetron) is the go-to. Cheap at the pharmacy with GoodRx.
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Yes, already had Zofan in medicine cabinet. Dissolve under tongue, should have absorbed some. Still sipping clear fluids. Not saying down. Vomiting clear bile fluids. ThanX
 
If she is miserable or the vomiting continues, she should go to the ER. No use being miserable when the ER can do various IV medications and give her on an IV of fluid. And better to be proactive rather than reactive.

If you are reluctant to seek medical care due to the cause of the incident, you could have a cover story that it was an overdose of compounded tirz. But honesty is usually the best policy, at least with more serious situations.
 
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The only serious issue with anything like this - gastroenteritis or really vomiting for any reason, is getting dehydrated from not keeping enough fluids down, which is difficult when you are vomiting. And if dehydration is happening , then time to see a doctor in person or emergency department. So if getting weaker or dizzy on standing , face and under eyes look hallow, high heart rate, or just feeling really bad , get help. Once significant dehydration occurs then you really need iv fluids in hospital. Not peeing much is also a guide. Letting it get to far can lead to renal failure , so it is best to err on the side of caution in seeking medical help.

Fluids should be electrolyte rehydration solution sold in all pharmacies mainly for kids with gastro. Not a sports drink. The reason is this is absorbed better and faster than water or other solutions, and you need to drink small amounts often like every 10-15 minutes. This can work to prevent kids with gastro and vomiting needing hospital and a drip so it does work. Even with ongoing vomiting it is usually possible to get some fluid in this way.

If it stays for several days it is probably safer to seek medical help , especially if the antinausea drugs do not help.

Getting doses wrong seems to be by far the most common serious problem with grey GLP drugs, so always double and triple check calculations, check again with an online peptide calculator and label everything with drug, number of mg, amount of bac, concentration in mg/ml, and usual dose if dose is stable.
 
Reglan (metoclopramide) by IV for a GLP overdose:

An accidental liraglutide overdose: case report - PMC

pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov
"treated with intravenous fluids and intravenous metoclopramide [Reglan]"

Reglan was also used for reta-induced hiccups, though it didn't help in that case:
BamaCrazy said:
They were usually pairing a muscle relaxer or nerve blocker with a gerd/heart burn medication. I tried Baclofen, Gabapentin, Chlorpromazine, Omeprazole, Pantoprazole and the one you mentioned, Metoclopramide [Reglan].

Nothing helped. I would sometimes pair Gabapentin and Baclofen at night in high doses just to fall asleep with hiccups.
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Calm Logic said:
If she is miserable or the vomiting continues, she should go to the ER. No use being miserable when the ER can do various IV medications and give her on an IV of fluid. And better to be proactive rather than reactive.
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Definitely not what any of us want, but a neccessary consideration to be sure.

OP... I don't have much for you, obviously electrolytes are your biggest consideration. Protein smoothies with blended up frozen fruit could be good for your future. Very light on the tummy.
 
birdwhacker said:
Definitely not what any of us want, but a neccessary consideration to be sure.

OP... I don't have much for you, obviously electrolytes are your biggest consideration. Protein smoothies with blended up frozen fruit could be good for your future. Very light on the tummy.
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Much better today. Vomiting stopped. Drinking fluids, soup. ThanX all
 
skeptick said:
Let me jump in here, please. Wife's research rat took 3.75mg/ .75ml BAC water Cagri instead of her usual 7.5mg Tirz yesterday. Is now very nauseous and vomiting to point of dry heaves. What dangers should I be monitoring for and what can I do to ease her discomfort. She's the main care giver around here so not in my wheelhouse of experience. Any help much appreciated. Have made water and electrolyte fluid available for her to sip on. Up to now she has shown no sides from working up to 7.5mg Tirz. She's normally very susceptible to drug interactions. Never been exposed to Cagri before this... 65year old healthy female

My math says 5mg vial Cagri/ 1ml Hospira Bac 75unit subq= 3.75 mg dose of Cagri Injectionshop calculator agrees. Skipping 7.5mg Tirz for now.
Click to expand...
I accidentally injected the wrong vial once too, but luckily it was just BPC.

Like most of all my previous mistakes in life, my brain was on autopilot. So now that you posted this, I am rethinking my process, besides going slower. Like not putting everything in the same case, not having all the labels look the same, etc. I am going back to smaller, different-colored cases for vials in the fridge, mostly single-vial cases.
 
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oh man, sounds rough. I'm glad she's able to keep fluid down today at least. Hope she feels better soon, rough lesson.
 
Calm Logic said:
I accidentally injected the wrong vial once too, but luckily it was just BPC.

Like most of all my previous mistakes in life, my brain was on autopilot. So now that you posted this, I am rethinking my process, besides going slower. Like not putting everything in the same case, not having all the labels look the same, etc. I am going back to smaller, different-colored cases for vials in the fridge, mostly single-vial cases.
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Ditto. I had mixed up a vial of Cagri 5mg/1ml and only used it once .5mg and didn't immediately label it and put it in fridge intending on loading the balance to my new Savio pen. Went to grab our Saturday morning Tirz, mine in a V1 pen, hers in a vial, guess which vial I grabbed... Now in clearly labeled vial... Hope I didn't scare her off from Glp's, she was kinda slow to come around to be willing to give Tiez a try.. I didn't push it and she came around on her own... Now if I can get her to use a pen and be able to stick her own lab rat. Got two new 'pretty' pens on the way.
 
CJsMom said:
If you filter, try putting them in different sized bottles - Tirz in a 5ml and Cagri in a 3ml.
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Using a 5 mL vial of cagri would allow for diluting cagri more, so more units would be required for an overdose.

Elora will require higher doses than cagri, so another reason to switch eventually.
 
If you keep them in vials, get a multicolored pack of vial caps (in a addition to vial labels). I use certain color caps for certain peptides. For me, the cap color helps to keep things straight. But always check the label anyway.
 
alphaamigo said:
If you keep them in vials, get a multicolored pack of vial caps (in a addition to vial labels). I use certain color caps for certain peptides. For me, the cap color helps to keep things straight. But always check the label anyway.
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Already have and use colored caps and "now" all vials are accurately labeled. Was one of my 'stupid human tricks'... ThanX
 
dogmom said:
How is she doing?
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Thanks for asking. She's making progress towards her normal self which includes working to hard. This am she was up before me and had moved her "sick" supplies to the living room sofa and had gotten her ice water and has been sipping that and nibbling on her homemade sourdough toast that she asked me to fix. She's sleeping alot, has had a BM, and has urinated a few times. Wanted me to heat up some canned chicken noodle soup but thinks it tastes 'off'. Her nausea has stopped and is keeping water and toast down. Situation was entirely my fault. Cagri was mine and I reconned a 5mg/1ml vial and in my haste to try it on my rat I didn't label the vial and put it in the fridge with out her knowledge. While doing our regular Saturday morning pins she ended up using 75 unit of the cagri instead of her 75 units of Tirz. She 1st vomited about 12 hours later and went downhill from there. Scared me and I don't scare very easy. My risk tolerance is off the charts compared to hers... I was giving serious thoughts to trip to local ER Thanks for asking after her. And a special big THANX to all for giving me things to watch out for....
 
alphaamigo said:
If you keep them in vials, get a multicolored pack of vial caps (in a addition to vial labels). I use certain color caps for certain peptides. For me, the cap color helps to keep things straight. But always check the label anyway.
Click to expand...
Good advise... I'm using 3 different colored pens, tan for insulin(which my PCP has been tapering me off of, on my last pen now), gold pen for my Tirz, and silver for my Cagri which I just started). And I have coming tomorrow a 5x5 Wolverine stack, and have coming a Convi pen and a Bird pen. Turning into a peptide junky. Paying for it all with the money I saved by not buying a quart and half of ice-cream every night(not exaggerating)... ThanX.
 
domin8brix said:
Oh yikes. Cagri is REEEEEEEALLLLLY strong, like start .25mg max dose strong. I started at .5mg and regretted it soooo much, went down to .33 and it's still gotten me a little. Highly recommend some Bonine or Zofran and lots of fluids.
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It is KILLER strong! After weeks, I'm fine at .5 - which is great, cause it kinda makes it a bargain. I can't imagine dosing at what his poor wife took! Oooooofffff!🥹
 
SoCalGirl said:
It is KILLER strong! After weeks, I'm fine at .5 - which is great, cause it kinda makes it a bargain. I can't imagine dosing at what his poor wife took! Oooooofffff!🥹
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Day three, she's doing much better this AM. She got up before me and fed the dog who can be very persistent. She requested a slice of her homemade sourdough bread, toasted , cut in half with peanut butter on half, which she nibbled on till gone, requested cherry popsicle and got that down fine, said it was exhausting to eat all that and has now gone back for a nap, with dog who there's no way I could keep from going to bed with her All's well...ThanX
 
I’m glad she’s okay!! 5mg Cagri is no joke. I went up to .8 today and I’m feeling rough…
 
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