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08-01-2013, 12:13 PM #1~ HRT Specialist ~
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Important Refill Note
There have been many clients the past few weeks requesting refills for their testosterone who are not due for a refill based on the dose the doctor prescribed them. Numerous are clients who post here at steroid .com and we appreciate everyone one of you, but in an effort to keep everyone happy and calm let's try to keep a few things in mind.
*No pharmacy can fill a prescription for a controlled substance early.
*If you are not sure how much you're supposed to be taking, please give us a call. Guessing and guessing wrong won't get you a refill.
*If you measure your testosterone out incorrectly, for example, you are prescribed 100mg/wk but draw out 1cc thinking this is 100mg, you will run out in half the time you are supposed to. Do not let this happen to you. Call and discuss where you're supposed to draw out your medications to on the syringe if you're unsure. DO NOT GUESS!
*Ignorance is not an excuse when it comes to a Controlled Substance.
The following should help:
RX 200mg/wk 10ml Bottle - Will last 10wks
RX 150mg/wk 10ml Bottle - Will last 15wks
RX 100mg/wk 10ml Bottle - Will last 20wks
RX 75mg/wk 10ml Bottle - Will last 26wks
RX 50mg/wk 10ml Bottle - Will last 40wks
If you are prescribed to split your dose into 2 injections per week, this does not mean you inject your total dose both times.
Example: RX 100mg/wk split into two doses - Inject 50mg per injection. 50mg 2x/wk
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08-01-2013, 01:17 PM #2
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08-01-2013, 01:40 PM #3
Mike, now that I see your list a question popped up in my head! how log will a 10ml vial of testosterone once the seal is punctured become contaminated and unusable? not asking about potency just contamination.
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08-01-2013, 01:43 PM #4Banned
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this isnt mike it's low testosterone ..mikes name is low t mike.
unless he has 2?
so are you saying your docs only prescribe the 200mg/ml bottles? what if some docs prescribe 100mg/ml?
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08-01-2013, 02:08 PM #5Member
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08-01-2013, 02:30 PM #6~ HRT Specialist ~
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All testosterone has an expiration date, depending on the brand/manufacture, this will determine how long the expiration date is from the time of compounding. Testosterone will still be good for several years after it's made before it loses potency. However, most compounding pharmacies and even many big name pharmacies won't put an expiration date on their bottle great than 1-2yrs.
Contamination: Keep your testosterone in a safe clean place and you shouldn't have any issues. Wipe the rubber top with an alcohol swab before you inject if you're concerned and you'll be fine.
You are correct, this is not LowT Mike.
The doctors prescribe a set dose of testosterone to take. The testosterone then comes dosed at 200mg/ml. If the doctor prescribes the patient to take 100mg/wk, this means the patient will inject 0.5cc per week.
There is no reason to throw it away. The only reason that would be said is if a pharmacy just wants you to purchase from them more often or a doctor is very misinformed.
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08-01-2013, 02:46 PM #7Originally Posted by Keep_It_Moving
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08-01-2013, 03:04 PM #8~ HRT Specialist ~
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Not all HCG has an expiration of 30 days. The expiration again depends on the manufacturer.
How it works:
A batch of HCG is made, the pharmacy will test its potency for up to a certain point and however far they test it this is the expiration date. The pharmacy finds HCG is good for up to 30 days and they'll put a 30exp on it. It may very well be good up to 60 or even 100 days but if they don't test it up to that point they will not put those dates on it.
What we know:
Reconstituted HCG will not lose potency for 120 days if kept refrigerated. After 120 days it will lose approximately 10% of its potency per month. Unfortunately, testing for extended exp dates is extremely expensive and many pharmacies simply won't spend the money.
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08-01-2013, 03:28 PM #9
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08-01-2013, 04:28 PM #10
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08-01-2013, 04:35 PM #11
LOL Kel, we should call everyone Mike!
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08-01-2013, 04:45 PM #12Banned
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08-01-2013, 04:58 PM #13~ HRT Specialist ~
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Testosterone Cypionate most commonly comes dosed at 200mg/ml. However, you can find it in other strengths, but 200mg/ml is by far the most common. A compounding pharmacy can also make it in any way they want mg/ml wise. One of our pharmacies actually makes theirs at 210mg/ml.
Most common of the Big 3:
Testosterone Cypionate : 200mg/ml and 100mg/ml (most commonly prescribed testosterone in the U.S.)
Testosterone Enanthate : 250mg/ml and 200mg/ml, less common at 100mg/ml (commonly prescribed in the U.S. most common world wide)
Testosterone Propionate : 50mg/ml and 100mg/ml, less common at 25mg/ml (rarely prescribed but there are exceptions)
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08-02-2013, 07:05 AM #14New Member
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I'm a little confused on the dosing. I was prescribed a total of 100mg/week of testosterone cypionate in a 10ml vile. My dosing is split into 50mg Mondays and Thursdays with my Rx reading 0.5ml 2 x/week.
So according to my calculations doesn't 1ml (or cc) = 100mg for a 10 week supply?
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08-02-2013, 07:18 AM #15
You will always run a week short or longer with a vial. Figure .15ml syringe loss and .1-.2ml loss just by getting bubbles out and lubing the needle. So your talking .3ml lost a week x 9 weeks=about 2ml lost. So I would say your chart is a little off.
A doctor will probably lose a little less but let's be honest. Most of us are rookies meaning not professional.
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08-02-2013, 07:19 AM #16Banned
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08-02-2013, 07:41 AM #17New Member
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OK, that clears it up - my bottle is 100mg/ml.
Thanks!
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08-02-2013, 08:52 AM #18~ HRT Specialist ~
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If you're losing a full 1ml then something wrong is happening with the way you're drawing out the gear. Losing more than that means something is horribly wrong. However, even if you are somehow legitimately losing that much, no pharmacy can legally refill your bottle.
*The needle is lubed just by the mere fact that you stuck it in the vile. You do not need a lot of oil shooting out of the top and running down the needle.
*Pushing out air bubbles. You do not need to make sure every last little tiny air bubble is gone. This is virtually impossible and if you continue to push and pull back push and pull back, you'll waste a ton of testosterone . Draw the testosterone out, remove the needle from the vial, pull the plunger back a little more, flick the side of the syringe with your finger, push the plunger and let a few drips come out of the needle. You should not have any significant air bubbles left.
*If you have a 10ml bottle and are prescribe to take 1ml per week, this means your bottle is required to last 10wks. If it is not lasting 10wks you shouldn't contact someone to help you.
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08-02-2013, 09:12 AM #19
Not to be argumentative, but unless you backload the syringe with an air bubble and account for this, you will never get 10 full 1ml shots out of a vial filled with exactly 10ml if you are using a standard syringe. There will always be a little stuck in the neck and pin. Therefore, to reach a full 1ml shot, this will require a little over 1ml.
Unfortunately the law/medical community does not recognize this. I find that using insulin syringes helps to minimize waste.
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08-02-2013, 09:35 AM #20
First off most people change needles after the draw so it is not lubed. Like I said not every one is a expert. I myself do not care about a few small bubbles but some might.
I just did mine shot 30 min ago. Even though I pushed down hard on the plunger while pulling out. There was exactly .07ml left in the syringe. I only lost .03 from lubing and getting rid of large bubbles. That is still .1ml while being extra careful. That would be a full 1ml in 10 weeks.
Don't get me wrong I understand your point on refills. Just saying you will not get a full amount out. My doctor and others I have talked to said that to me. Plus, I refill mine with insurance at 7-8 weeks in without issue. I get a 10ml/200mg per vial and take .75ml per week.
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08-02-2013, 11:36 AM #21
I've been on TRT for 3yrs. I started at 200mg/wk and I never had an issue with running out early. Not one single time. Now I run 125mg/wk which last me exactly 16wks. Sure, sometimes I'm slightly short, as in that last 125mg shot is only 100mg or that last 200mg shot was only 175mg but that's not enough to be upset about.
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08-02-2013, 07:47 PM #22
I get a 10ml bottle of 200mg/ml. It get refilled every 28 days. That is how long they say I can draw from that 10ml bottle. I am only using 520mgs (130mgs/week) out of 2000mgs/bottle.
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08-02-2013, 09:33 PM #23Associate Member
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What I am about to say doesn't pertain to those folks that are coming up a little short or accidentally pinned too much a few times. It's aimed at those individuals who are being completely ignorant and screwing around with a scheduled substance.
Please stop fvcking around. PLEASE. This kind of behavior is one of the things that makes getting good TRT treatment so hard. Many of us are dealing with hypogonadism because we screwed up at a young age with steroids . Now, we've got to walk into a doc's office, tell them our nuts don't work because of what we did and ask to be treated using the same substance that we abused in the first place. All it takes is a one doctor having a bad experience with someone abusing the treatment to make it a mess for those that just want to feel normal.
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08-02-2013, 09:45 PM #24
Disregard - my phone is acting up.
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08-08-2013, 03:45 PM #25~ HRT Specialist ~
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Guys, come on now let's all be smart grown adults.
*The doctor know what he prescribed you.
*The pharmacy knows what you were prescribed
*The pharmacy knows when you received your meds
You're not going to fool the pharmacy. For example, if you have a 10ml bottle of testosterone and you are prescribed 100mg/wk, it is impossible to run out 6-10wks early unless you are squirting testosterone into the air.
*No, pharmacies are not under-filling your bottle. That is beyond against the law in the U.S.
*Squirting out large amounts due to air bubbles is not a legitimate reason to run out early
Guys, use common sense.
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08-08-2013, 03:50 PM #26~ HRT Specialist ~
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08-08-2013, 05:32 PM #27
I think, largely, the reason many clients found participating on this board run out of medication early is due to the general disposition of the audience: overly detailed, slightly obsessive, and surely pedantic that, for better or worse, have a more abstruse motif to "over think" the injection process (me included!). I would wager most patients on injectable forms of TRT never even recognize this potential of "wasted testosterone ." I mean this:
As it's been voiced in this thread, part of the confusion and consequent early refill derives from whether to "compensate" for the dead space in the needle hub and testosterone not dispensed after the plunger is fully depressed. With interchangeable needles on a standard syringe, the "wasted" or leftover drug accounts for about ~ 0.04 - 0.06 mL, dependent on the needle length and gauge.
Medical equipment manufacturers have acknowledged what's trapped within the needle hub**, albeit in clinical settings dealing with large volume of injections. In other words, the "overhead" or wasted testosterone is minute, and in the long run, negligible for individuals.
If you inject 100 mg every week, where a 10 mL vial is prescribed to last you 10 weeks, and you aggregate a "wasted" amount of 0.5 mL, your measured testosterone levels (labs) reflect the overhead regardless. Blood tests account for the amount injected, and what is not injected, or leftover, is consistently left out. In business parlance, this is metaphorically similar to a "fixed cost."
** Terumo, for instance, sales the SurSaver syringe with a permanently attached needle, minimizing the dead space. Since TRT requires needles to be changed between draw and injection, the SurSaver line is an optimal choice.
As "Low Testosterone " alluded: don't make common sense hard.Last edited by phaedo; 08-08-2013 at 05:39 PM.
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08-08-2013, 06:27 PM #28
Completely agree and that is what I was saying. With the waste you will fall a week short( .5ml-1ml) and maybe slightly more depending on the low level of expertise of some people.
Mike your reading into the bubble comment too much. People prime the syringe and use detachable needles with dead space. That causes testosterone loss. No way am I saying that you will cut out half the bottle, let's get real, but you will absolutely not get a full run out of a bottle. Well unless your the guy in the post a few above this one.
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08-08-2013, 10:00 PM #29~ HRT Specialist ~
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Even if you run a week short and legitimately, there's still no reason for you to be out. You don't have to wait till the day your bottle is supposed to be empty for an RX to be refilled. A refill can be submitted 2wks before the bottle is supposed to be empty with 3 of our pharmacies. With one of our pharmacies, they have a policy that calls for 1wk but we are working on that.
The true problem, saying you're out 6+ weeks before you're supposed to be out. Many who are prescribed 100mg/wk call and ask for a refill at wk 10. A few are prescribed 200mg/wk have actually been very upset when they could not get a refill 6wks into treatment. This does not represent the vast majority of our clients, but it's enough to make this thread warranted. Yes, there are instances where legitimate mistakes are made, but they are rare.
A few more important notes and excuses that will not fly:
*I dropped the bottle and it shattered: This isn't possible, the glass is tempered and if you smash it with a hammer it will crush like a car windshield, it won't shatter if you drop it. I have personally stood on top of a bottle and it didn't break.
*My bottle leaked a lot: Not possible.
*My kids got into my testosterone and spilled it: Not possible for it to leak and you shouldn't be leaving your testosterone out where your kids can get it.
*They only sent one bottle: One of the pharmacies splits the order into two smaller bottles of testosterone rather than one. The ordered is filled and then sent to shipping where it's checked and packed. Once packed it's checked by a third individual. 3 people would have to mess up to only put one bottle in there. Further, when the doctor submits the RX, the pharmacy has an electronic and hard copy. The doctor would have to incorrectly write the RX twice. If for some reason the two copies do not match, the pharmacy will not ship it until the talk to the doctor.
One more very important note many may not be aware of. When a bottle of testosterone is filled, it's done so by a machine that calibrates the exact amount to put in there. It's the same in every single bottle. There is no variation between one bottle and the next. The only way it could vary is if the tech manually changed the calibration. More importantly, all pharmacies take into account loss, they do not put in 10ml exactly, they put in more than enough to take into account loss.
If you're running out early, you're taking more than you're supposed to. If you're running out early months in advance, you're more than likely doing it on purpose. Testosterone is a controlled substance, Schedule III and no doctor or pharmacy is going to risk their safety so that someone can have more testosterone just because they want more testosterone. That's not the purpose of TRT.
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08-08-2013, 10:11 PM #30
I see what you're saying, but the point still remains: the prescribed amount is accounting for the tiny bit of testosterone left behind in the syringe.
If you're prescribed 100 mg every week and do not try to compensate for the dead space, you're really injecting 98 mg. But your blood tests are still drawn from the 98 mg of testosterone injected every week, and your physician still medicates based on that amount.
Does that make sense? Essentially, it's a relative argument, and what the physician prescribes must be carried out in accordance with law.
[Now should the pharmacy account for what wasted drug is left in the syringe and needle? Maybe or maybe not. That's a different argument and independent of current federal regulation.]Last edited by phaedo; 08-08-2013 at 10:13 PM.
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08-08-2013, 10:16 PM #31Originally Posted by Low Testosterone
I don't know if you guys have some special bottles but I dropped a bottle of prescription Watson test cyp on my kitchen tile and it shattered, making a huge oily mess.
On another occasion I got home to open up my bottle of Watson test cyp and the whole inside of the box was covered in oil where it had been leaking out the seal. I took it back to Costco and they replaced it with no issues so I was good.
Just wanted to throw it out there and these supposed excuses do indeed happen. I'm sure they are rare, but I have only been on TRT about 8 months now and have encountered 2 of your excuses that would not fly. If I were a patient, you best believe I would be pissed if you were to deny me a new bottle calling me a lair ;-)
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08-09-2013, 12:22 AM #32
I've dropped bottles on a tile floor and they didn't crack. I'd imagine the type of bottle can vary depending on who makes it.
Anyway, I'm sure those excuses are possible, rare but possible. Still, I'd be willing to bet a lot of guys try to use those excuses when they're not true more often than not. If you're the pharmacy or LowT what are you supposed to do in that case? Should you just take everyones word for it and give people testosterone any time they say they have a problem? I don't know what the answer to that is. It's a controlled substance and that makes it a tough question.
BTW, I agree with the comments about a bottle running weeks short...doesn't happen, not legitimately.
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08-09-2013, 07:46 AM #33
Hmm, I wonder if you could provide pictorial evidence or something, like filing an insurance claim when you wreck your car? lol I've dropped a bottle a couple of times on tile and it bounced like three feet high, but never shattered. All mine are Pfizer though -- wonder if different companies have different vial construction standards...
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08-09-2013, 10:06 AM #34
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08-09-2013, 10:21 AM #35
FWIW, I just started injecting and I have no problem drawing out a little more to compensate for the air bubble in the syringe. If it's true that the machine that fills these vials takes into consideration and calibrates for "spillage", there shouldn't be a shortage.
FYI: I just called my pharmacy and asked when I could bring in a new script and they gave me a date 7 days sooner than the full month since I had originally filled. They explained that they give "leeway" for Test. Nice to know. This is NEW YORK CITY - the place that gave us the Rockefeller Laws for drug "crimes".
Check with your local pharmacy. I'll bet it's the same. If it's the case, there should not be any great anxiety for refilling if you find yourself short.
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08-09-2013, 10:54 AM #36Originally Posted by 2Sox
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08-09-2013, 12:22 PM #37~ HRT Specialist ~
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Yes, NY has very strict laws. It's the only state where testosterone is Schedule 2 instead of 3. But all pharmacies allow for a refill to take place prior to the exact date of when you're supposed to be out. The problem is when you're trying to get a refill 4 to even 10wks before you're due.
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08-09-2013, 06:56 PM #38
Simply fill the syringe to the required mark for the dose and inject. Follow the same procedure everytime and adjust if necessary by what the blood tests indicate. Just be consistent in how you perform your injection and don't over think the process...
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