Overfilled syringes?

[lab-rat]

I have a question for anyone that might be using 180mcg prefilled syringes (Pegasys).  Have any of you ever noticed your syringes being full past the 180 mcg mark?  This caught my attention for my last couple of shots - they seemed to be around 40-50 mcg past the 180 dosage mark. (This is after I squeezed the air out).  I never really noticed this before nor paid much attention.  I just assumed that the dosage in the pre-filled syringe is the dosage listed on the prescription label and I just injected it all.  Here's a really idiotic question (since I only have 1 shot left)...should I be squirting out the excess fluid?

[pcds]

If your dose is 180 that is the mark you syringe needs to be at.  They always give extra to help get out the bubbles doesn't mean you should inject the extra.  I would not take more then prescribed with asking your MD.  I'm kinda anal when it comes to medications being taken as prescribed.

[spectda]

Hi-
I spoke a little too quickly. There is no danger in taking a little too much, but I wasn't aware that they make a pre-filled syringe that is not a ready pen. I had wondered what they were talking about since it's difficult to see the level in a redipen
dave
http://www.pegasys.com/injecting/pegasys-syringes.aspx

[spectda]

Hi-
You are responding to a three year old post. They were talking about the redipen, not the syringes that you fill yourself. studies have been done and that small amount of interferon would not possibly cause any kind of overdose. You are not supposed to squeeze out some extra from the redipen.
-Take Care- Dave

[ibamech]

when I was on interferons I noticed the same thing so I called the pharmecitical company that sendt me the drug and they said they do overfill and you are to  squirt out the overfill.

[mremeet]

"My problem is that push as hard as I will, there is always a squirt left after I take the needle out!"

Man, I'm not even touching that one... ;-)

[lab-rat]

Yay!...good riddance to Vincent Price.  I'm glad he's gone and glad to hear that you're getting back in shape and enjoying yourself...especially after that skin nightmare.  I also have "ghast" - a tan...but I hesitate to mention it since I shouldn't be in the sun.  I've found that treatment hasn't really stopped me from doing most of the things that I would normally do, so I have nothing to complain about.  (I'm still ready to quit though!)

You're right, I've been on full dosage of meds..but it's still a mystery to me exactly when I went UND since I've had 3 of those dreaded "29's" between week 8 & 16.  But I'm just going to see what comes of it...the doc gave me 80% odds the last time I talked to him so whatever happens, happens.

BTW - Thanks for everything...your advice and input is really appreciated.   Cheers to your SVR!!!

[ladywhy]

A reality show...now that would be interesting...

[glucklich]

my problem is that push as hard as I will, there is always a squirt left after I take the needle out!

[mremeet]

I wouldn't say back to normal, but definitely feeling better. Hair is still thin, still dealing with some emotional demons (effexor withdraw was a drama in itself), but the my skin is clearing up (I even have *ghast* a tan???), itchies and prickly needle sensations have subsided, hgb has completely rebounded and as far as I know my 490 ANC's have gone back up (they haven't checked them since week 2 post). Hearing and eyesight are improved, muscle mass and tone seem to have returned somewhat, but there's still a lot of work to do there. Been drinking too much beer, but I love microbrews so much I can't help myself, and after this nightmare lets just say I'm in the mood for chillin' ;-)   Overall it looks like Vincent Price has left the building - good riddens to him, although he'll probably return at the end of my life (providing I don't buy it on a motorcycle or something), so maybe I shouldn't be so cocky.

Anyway, it IS hard to believe you're almost done. Hard to believe we're already at this point isn't it? I'm sure you'll be back on your feet in no time, not that you were off your feet anyway - being the hearty side free uberfrau you are ;-)  The hard part is the waiting, but from what I recall you've taken your full measure of drugs (including riba), you went UND within a reasonable timeframe, and have completed your full course of treatment (unlike myself). You've got a lot going for you, I'd guess the odds of SVR-ing are definitely well over 50% for you. So hang in there, the fun part starts in a few weeks. On the one hand you'll start feeling a lot better, on the other hand the dread of waiting for your VL results lurks in the air. They oughtta make a reality show out of this situation, it would certainly beat Survivor (and actually really live up to its name).

Ok enjoy your last shot, in the meantime we're all pullin' for ya!

[lab-rat]

Thanks - and good luck to you as well!  I can't believe I'm almost done.  

I'm glad I'm not the only one that experienced this.  I thought I was losing my mind...it seems I would have noticed this issue before week 46 - lol.

I agree with you and Jim about the air in the syringe...I don't think it matters at all when injecting subq...but I'm sure I would have jumped ten feet off the ground if someone injected my vein directly with a huge air bubble!  I'm glad they didn't have to do that to me!!  They did have to switch to a different arm during one of those vampire visits...it just seemed to dry up.  I imagine (and hope) those extreme blood draws will be a thing of the past for post-tx.  

I guess you're pretty much back to normal by now?  

[mremeet]

I experienced the same thing. Most of my shots were pretty much dead on the money after the air was expelled. I usually would also push a drop or so out to make sure no air was present. But later in my treatment I got another batch of IFN that contained some clearly overfilled syringes just like you describe. It wasn't a big deal, I just pressed out the extra, although I would have been very comfortable injecting the extra as well, I definitely don't think it would have harmed me (in fact it probably would slightly boost antiviral effectiveness). I know a guy that double dosed IFN for his first several weeks and went UND at week 4 (previous relapser), so I'm pretty sure more is better speaking from an antiviral perspective (with no regards to additional side effects of course). If it's your last shot I'd do every last drop just for the added psychological benefit of knowing you gave it your all in every sense of the word.  Also, I think the concerns many people have about a small amount of air getting into their system might be unwarranted. When I was getting my second PK at week 12 (where they make multiple blood draws at various time intervals throughout the day) the nurse screwed up installing the heplock and couldn't seem to get it to flow blood properly. So she was injecting saline solution along with a quite sizeable air bubble in an attempt to get the obstruction (clotted blood?) cleared. And when I saw that syringe plunger go all the way down which also drove the air bubble into my vein I winced and pulled back (frankly it scared the hell out of me). The nurse and her assistant smiled and kinda laughed at me and said the air bubble wouldn't hurt me, it wasn't "like in the movies". I had to admit, the only reason I thought it was bad was because of what I'd seen in films and TV. I dunno, I'm sure a big air bubble directly injected into your veins would not be good (embolism anyone?), but apparently a smaller bubble is not as deadly fatal as I had imagined. Considering the tiny amount of air in the peg syringe and the fact that it's not injected intravenously, probably means it's all but harmless.

Anyway, best of luck on your last shot. Wishing you an SVR in another 3 months!    

[lab-rat]

Thanks Jim - it seemed to be way past the 180 mark to me (by about 40-50), even after the bit of air was gone.  But I couldn't imagine wasting any medication, that would make no sense.

[jmjm530]

I always squirted a tiny bit out just to make sure there were no air bubbles. After the squirt, it's pretty much on the 180mg line. Later in tx, I didn't do the squirt (just pushed in as close as possible before it would squirt) not wanting to waste anything :) Whatever little air may have remained isn't going to do any damage with a sub-q injection.

-- Jim

[jmjm530]

Short answer is "no".

I thought the same, but by the time you get all the air out it's pretty much on the money. It's possible that a very little air bubble is making the difference. My suggestion is not to squirt out any "excess" fluid, but to inject the entire 180, as labled.

-- Jim