Important Refill Note

[Bliggity]

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?

[powerlifterty16]

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?

if the bottle is 200mg/ml .5cc is 100

[Bliggity]

OK, that clears it up - my bottle is 100mg/ml.

Thanks!

[FRDave]

Disregard - my phone is acting up.

[Low Testosterone]

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.

[Low Testosterone]

[phaedo]

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.

[LT75]

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.

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.

[Low Testosterone]

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.

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.

[FRDave]

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.

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 ;-)

[phaedo]

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.

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.]

[2Sox]

Love it! This should be a sticky.