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Alternative injection method: getting more dosage...

For those of you who are a cheap skate like myself and want to squeeze every penny out of the expensive medication, I’ve discovered an alternative way of injection that can squeeze approximately an extra 45 ug out of the standard 180 ug syringe, bringing the total dosage up to 225 ug!!!

So here’s how you do it…
1) As you move the syringe from the fridge & throughout the preparation procedure (attaching the needle, etc.), be careful not to shake or tap the syringe so the air bubble inside remains as ONE LARGE bubble.
2) When you get to removing the air bubble from the syringe, here’s the catch: Instead of pointing the needle upwards toward the ceiling, point it downwards towards the floor so the ONE LARGE air bubble is touching the rubber plunger near the ceiling. This step is crucial because it is the volume of the air bubble that will replace the extra medicine that normally gets trapped in the plastic needle encasing between the end of the plunger and the tip of the needle.
3) Keeping the needle pointing downwards, press the plunger down slowly until the medicine fills the transparent plastic encasing between the glass syringe and the tip of the metal needle & all the air between the bottom of the syringe and the tip of the needle clears. NOTE: the big air bubble touching the rubble plunger near the ceiling is still there.
4) As you inject the medicine, two things are crucial to minimize the air bubble from entering the body: ample lighting & keeping the needle pointing down at all times! Reposition your body if you have to but the ONE LARGE air bubble needs to be hugging the rubber plunger at all times. As you inject and the plunger is almost near the bottom of the syringe, press slower so you can observe the air bubble making its way downward out of the syringe and into the transparent plastic encasing which connects to the metal needle. Continue pressing until all the medicine gets replaced by the air bubble.
5) Clean up as usual.
6) Congratulations! You have saved every drop of your super expensive medicine!

Comment 1: I am on week 30 & have done this for about 2.5 months now (9 or 10 shots). The side effects are still there but about the same as before. I am assuming the more the medicine, the faster the virus will be cleared.
Comment 2: Whether by thoughtful design on the part of the manufacturer or by coincidence, the volume of the air bubble typically in the syringe is just about the same as the volume in the plastic encasing connecting the needle and the tip of the syringe. So I can confidently push the plunger all the way to the end knowing very little air has entered my body. However, perhaps every syringe is different so please follow step 4 carefully if you are going to try this.
24 Responses
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Avatar universal
So that’s 13 to1 ratio or at the end of treatment it equals to about 4 extra shots during the course of 48 weeks and in my case add another 2 for the taper caper so in reality it’s about six extra shots during the 53 weeks, dats what I’m talking about, more bang for your buck at no extra cost to you and the doc does not have to know when being crazy and creative in getting the job done.

jasper
Helpful - 0
581854 tn?1222849871
As an experiment I just took the contents of my used sharps container and used one of the old syringes to suck out the remining drops from all the other syringes. I filled one empty syringe from the remaing drops of 13 "empty" syringes. This equals about 7.5 % left over in each syringe.
They had all been prefilled and I had always pushed the plunger to its full extent when injecting myself. I had always let the first drop out of the needle before injecting to make sure I had no air in there.
I hope your all feeling well or as well as can be and enjoying the olympics. I am going for the gold medal in couch potatoing.
Helpful - 0
372366 tn?1284403873
Ebuidy is talking about the amount of fluid left in the neck of the syringe and the needle casing.The plunger stops at the bottom of the barrel and cannot force the remaining fluid out. The plastic needle case holds more than the neck does.

In drug terms it's part of the wash.

Harry
Helpful - 0
577132 tn?1314266526
Just thought I would follow up my last comment.  I tried the way it was outlined here and while there was nothing left in the syringe after, there was a little bit of spillage during the injection as I think the air bubble causes pressure in the chamber.  Last night I was extremely careful with my shot, gently coaxing the air bubbles to the top, ensuring I didn't waste anything when I pushed out the bubbles AND I double checked that the plunger was completely depressed before I withdrew the needle.  I am delighted to say that the syringe was completely empty when I had finished!  I felt really good about this and would like to suggest that careful technique is the answer!

Also I took in one of the syringes that had some left over to show my NP and she seemed unconcerned as she said that a little extra would always be put in the syringe to compensate for the squirt etc.  By law the drug company must ensure there is enough medicine in the syringe as per the FDA regulations.

Also, I received my 8 week results and I am still UND!
Helpful - 0
577132 tn?1314266526
Hi, I'm new here, and this is my 2nd go round on the treatment.  4 years ago I was a non-responder after 6 months of INF & Riba. Earlier this year I was enrolled on the Roche/Pharmasset RO Study for Geno 2 & 3 Non Responders and bless that study drug I was UND at 4 weeks, I've not recieved my 8 week results as yet.  Now I'm back on the INF & Riba and it will be my 11th shot tonight.  Anyway, I just carried out an experiment with a couple of my used prefilled syringes, and yes, I discovered there was some left over which would lead me to think that I am NOT getting my full dose, unless they add in some extra to cover this, which doesn't seem likely if other people are saying there is only 180ug in the syringes.  I must admit that last time on tx I felt the same thing as there was always medicine left over in the prefilled syringe and I always wondered if I was getting the full amount.  So, I am going to mention this to my supervising nurse and get her feedback.  I would say it was pretty imperative to get your full dose wouldn't you, given how lengthy and expensive this treatment is. I'm also going to ask for the vial that you draw up yourself for the rest of my tx. Thanks for the tips and I'm going to try this technique tonight.
Helpful - 0
Avatar universal
All this pounding and sucking work on the  tube may be gettn otta hand here....LOL...sorry...i had too.
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Avatar universal
maybe a rolling pin?
Helpful - 0
476246 tn?1418870914
How about trying to suck it out with a straw???
Helpful - 0
Avatar universal
Again, you can't get more than 180 ug out of the pre-filled syringes because they only hold 180 ug, regardless of what it looks like with the bubble in the way.
Helpful - 0
Avatar universal
I dont like having a sliced open messy tube of paste lying around...there is a bout 5 uses left over in the tube...i like the hammer pounding idea better.
Helpful - 0
338734 tn?1377160168
I think he is using the pre-filled syringe, but I must still be missing something. Aren't you still paying for 24, 48,  or 72 doses no matter whether you are injecting 90% or 100% of each syringe? It is not like you can save up those extra few micrograms to spare the cost of the last injection, so isn't the cost the same?

As for the extra amount of medicine in the dose making a difference as to how fast you clear: well maybe.

One thing I noticed that pertains to the pre-filled syringes, is that the plunger seems to stop for me (because of the small size of the flange on the cylinder and the large size of my hands) before all of the medicine is injected. If going by feel alone, I would not get the full dose if I didn't check visually as I always do now. I think in the first few weeks of TX, I may not have injected the full dose. I have been thinking about going through my sharps container to see but I figure that there is nothing to be done about it now and also it is a hassle to break the seal on the container.

Maybe this is a valid caution for those starting treatment to check visually to make sure that the plunger is pressed all the way to the bottom. Even if you do not go to the extreme measures ebuidy suggests, you can at least make sure you get the full intended dosage.

Brent
Helpful - 0
476246 tn?1418870914
How about cutting it open and scraping the rests out with your tooth brush.... ROFL


Helpful - 0
Avatar universal
Trish,
   I believe that he is talking about the prefilled syringes (like i have) .  It sounds like you have syringes that you fill yourself.

  
Helpful - 0
Avatar universal
Okay, am I missing something?  There is always left over meds in my vial.  I inject 1.0 of air in the vial and then insert the needle into the vial and flip the whole thing upside down, so the vial is upside down and needle pointing up, then pull back on the plunger keeping the tip in the meds and pull back on the plunger til I get my 1.0  I NEVER get a huge air bubble up there, always get some air but a huge one?  Sometimes it's been a bit of a pain getting that last little bit of stubborn air out...but never even close to 45mcg worth of air??  As it is, I'm able to put more meds into my syringe than the 1.0 I'm supposed to fill it up to and I usually go a little past that for good measure...and always meds left in the vial.  

If I can't get the stubborn air out, I guess I could flip it upside down but isn't it alot harder to know when to stop, to know when you've hit solid air?  The other way, I just plunge away.  I think I'd actually risk losing more meds doing it upside down.  At least straight up I know how much is in my syringe and haven't really had any problems getting my full dose.  
Helpful - 0
Avatar universal
LOL first ya blow air back into the tube, then get the ballpeen hammer, turn yer head to the left, pound 3 times...

I'm with the majority on this one, cheap as I am.

c
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Avatar universal
Any ideas on how to get that last glob of toothpaste outta the tube?
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Avatar universal
Your technique advocates leaving the air bubble in and relying on your eyesight , judgment, good luck to not inject the bubble into your body.  If the bubble happens to inject into a small vein....goggle up , "air bubble", embolism and stroke to see if this "money saving" tip is worth the potential costs.  And if the air bubble gets injected into your fatty sub-Q along with the rest of the medicine then you significantly raise the likelihood of an infected abscess developing.  We're already low WBC count to begin with.

I like to save on gas, meat and orange costs - not my health.



Helpful - 0
Avatar universal
LMAO, I thought I was the cheapest guy in town and didn’t have to be because insurance was paying for it. When I started this treatment back then after the second shot I thought the same thing, what a waste, so I then started holding the syringe up and pulling the plunger back a little more to allow more air into the barrel before attaching the needle casing. Then after the attachment I pointed the needle down and tapped the syringe a couple of times to get the tiny bubbles to condensed at the plunger side and then push just enough to let the a few drops to come out. I also watched closely not to put air under the skin when injecting close to the end. I don’t know what I saved but what I do know is that I got the full 180. You are right in that you might as well get every last drop and who knows it may have gotten me to where I’m at today, UND. Good point to bring up cuz there was no way I was going to mention this during treatment, lol. I looked at it this way every little bit helps and forget the 80/80 rule cuz, 100/100 is better but that’s just me.

jasper
Helpful - 0
487070 tn?1313665952
I had my shot class instructed through a pegasys representative who said too there really is 180 in the vial.The plunger may be be postioned to look like more, but once you squirt the bubble out, that's all that's left.
Helpful - 0
Avatar universal
Maybe I'm missing something, but I never lost any measurable Peg injecting it the normal way. But even if some is lost, I highly question losing 45 ug, which translates to 20% of the dose. Maybe closer to half of one per cent if I get careless with the "squirt". I think what is deceiving is that it *appears* there is more Peg in the barrel than there really is because of the air bubble. My understanding is that you will only get 180 mg/ug no matter what technique you use because that's all they give you.

-- Jim
Helpful - 0
487070 tn?1313665952
ebuidy, I am sorry the high price of the meds has you doing this, but my main concern is your health & safety.Are you putting the small amount in the vial back in the refrige.I am concern that you can infected yourself with bactria.Are you using a new neddle tip every time? Also "the more me meds the better at clearing the virus". Using more than the reccommened dosage can be dangerous. Interferon effects the White blood cells and often causes a drop in platelets and neutrophils.Please talk to your doctor about this.I want to see you clear this virus as safely as can be.Better safe than sorry. Please be careful
Helpful - 0
Avatar universal
This procedue sounds different i must say,ive also heard that a air bubble would have to really big to cause any damage,like a syringe full,but still...this is interesting ,you say you save 45ug out of 180ug....thats almost half...are you sure?
Helpful - 0
Avatar universal
Might be why I didn't go UND at 12 wks???  NOT!!  :)  
Helpful - 0
179856 tn?1333547362
Nobody should be that much of a cheapskate when it comes to SVR and taking meds properly.

I understand wanting to save some copay money but.......is it REALLY worth it? I wouldn't advise trying this to anyone. But I'm glad it works for you.
Helpful - 0
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