Switching from compound to name brand

[john_askins]

Hi all - I have been on the compound since June. Had pretty good results. After Eli Lilly lowered their prices, it ended up being cheaper having my doctor prescribe 15mg and making my smaller doses from them. Today was the first day that I took the name brand. I was nauseous, dizzy, lightheaded, and overall sick within one hour of taking it. Crazy side effects I’ve never had before. Is this normal? I’m currently laying in bed out of commission on Christmas because I am so sick.

 

[Grogu]

Hi all - I have been on the compound since June. Had pretty good results. After Eli Lilly lowered their prices, it ended up being cheaper having my doctor prescribe 15mg and making my smaller doses from them. Today was the first day that I took the name brand. I was nauseous, dizzy, lightheaded, and overall sick within one hour of taking it. Crazy side effects I’ve never had before. Is this normal? I’m currently laying in bed out of commission on Christmas because I am so sick.

Are you sure you took the correct dosage? The 15mg Lilly direct vials are 30mg/mL and compounded vials concentrations are usually not that high. So, if you took the same # of units that you were used to taking with compound, you probably overdosed. That would be the easiest explanation.

If you adjusted for the higher concentration, when did you take your shot today? If you took it before food and then ate a bunch of stuff that may be causing the nausea. What did you eat today? Did you drink?

I've used Lilly vials and compound interchangably over the last year and really didn't notice any difference between the two.

Hope you feel better soon! Hang in there!

 

[BellyD]

Yuppers, one of my worst mistakes is eating a lot the day of injection or heavy the night before! I'm always hungry day 7 of Triz. I'll ruin myself 😭

 

[john_askins]

Are you sure you took the correct dosage? The 15mg Lilly direct vials are 30mg/mL and compounded vials concentrations are usually not that high. So, if you took the same # of units that you were used to taking with compound, you probably overdosed. That would be the easiest explanation.

If you adjusted for the higher concentration, when did you take your shot today? If you took it before food and then ate a bunch of stuff that may be causing the nausea. What did you eat today? Did you drink?

I've used Lilly vials and compound interchangably over the last year and really didn't notice any difference between the two.

Hope you feel better soon! Hang in there!

That was my initial thought. I’m on 5mg and I took .166mL of the name brand so I don’t think it was an overdose. I actually took it after eating and it wasn’t much food. Had 1/2 a beer and decided I wasn’t in the mood. I didn’t do anything out of the ordinary other than switching away from the compound. The only thing I can think of is the compound has b6 in it and maybe I actually need the vitamins.

 

[druell235]

Hi all - I have been on the compound since June. Had pretty good results. After Eli Lilly lowered their prices, it ended up being cheaper having my doctor prescribe 15mg and making my smaller doses from them. Today was the first day that I took the name brand. I was nauseous, dizzy, lightheaded, and overall sick within one hour of taking it. Crazy side effects I’ve never had before. Is this normal? I’m currently laying in bed out of commission on Christmas because I am so sick.

Just out of curiosity how did you make smaller doses? The Zepbound vials are single use once punctured? Did you add bac water to stretch it out and give it a preservative? The Zepbound vials just use sterile water, meaning they don't have the benz alc that the compound vials do?

ETA. Should add that I am not trying to call you out, just curious as I have heard of people doing this and just curious about your process.

 

[Grogu]

That was my initial thought. I’m on 5mg and I took .166mL of the name brand so I don’t think it was an overdose. I actually took it after eating and it wasn’t much food. Had 1/2 a beer and decided I wasn’t in the mood. I didn’t do anything out of the ordinary other than switching away from the compound. The only thing I can think of is the compound has b6 in it and maybe I actually need the vitamins.

The 17 units sounds right. Yes, the B6 is supposed to help with nausea, maybe that’s it. If you have any zofran, that would probably help right away. Hope you feel better!

 

[Grogu]

Just out of curiosity how did you make smaller doses? The Zepbound vials are single use once punctured? Did you add bac water to stretch it out and give it a preservative? The Zepbound vials just use sterile water, meaning they don't have the benz alc that the compound vials do?

I'm not the OP, but I've read a number of posts on reddit from people that have used their Zepbound vials for multiple doses. I remember one person even saying that her pcp, who had advanced training in pharmacology, said it was okay for a "couple" of punctures.

I personally don't trust a word that comes out of their mouth as far as shelf stability, freezing, preservatives, etc. of Zepbound. Lilly has a vested interest in saying that these vials are single use. I'm sure if they had it their way, there wouldn't even be vials. I think that Lilly hoped vials would end the shortage and put an end to compounding.

My plan originally was that I would split Zepbound doses, but even that really isn't economically feasible. But if I had, I would have added some bac water. Right now, I'm using up the remaining vials that I have (maybe 25 of them) by splitting with a family member. I inject her dose and then draw the rest for my dose and supplement with compound (and then eventually grey).

 

[john_askins]

Just out of curiosity how did you make smaller doses? The Zepbound vials are single use once punctured? Did you add bac water to stretch it out and give it a preservative? The Zepbound vials just use sterile water, meaning they don't have the benz alc that the compound vials do?

ETA. Should add that I am not trying to call you out, just curious as I have heard of people doing this and just curious about your process.

I just thoroughly wiped down the puncture section of the vial, put in a syringe and pull out the dose I need. I then wipe everything down again and store it in a clean container in the refrigerator. There are a little over three doses in each vial. That’s how they tell you to do it with the compound so I see no reason you can’t do it with the name brand. According to EL their product will stay good in the refrigerator for over a year. So while they suggest not using each vial for more than one puncture, it’s a small risk I’m willing to take.

 

[YoYoFat]

I just thoroughly wiped down the puncture section of the vial, put in a syringe and pull out the dose I need. I then wipe everything down again and store it in a clean container in the refrigerator. There are a little over three doses in each vial. That’s how they tell you to do it with the compound so I see no reason you can’t do it with the name brand. According to EL their product will stay good in the refrigerator for over a year. So while they suggest not using each vial for more than one puncture, it’s a small risk I’m willing to take.

I thought this would be obvious, but I guess not.

The reason you can’t do this is because compound is made with a preservative so that a single vial can be used multiple times up to the BUD, similar to using BAC for reconning grey. It keeps bacteria away.

Single use brand name vials have no such preservative. You’re risking bacterial growth after the first puncture.

It’s not a small risk.

Multiple use vials and single use vials carry very different safety profiles for multiple uses.