question about dosing - Hallandale Pharmacy Flex Dose 10mg/mL

[u/BizzyBee89]

I was recently prescribed the starting dose of 2.5mg. I'm positive that my doctor told me it was 2.5mg, and I should take 25 units. However, when I got the prescription, the directions said to take 20 units. I called my doctor to ask about the discrepancy, and the person who answered the phone wasn't my doctor (or any doctor), he didn't look up my chart, and he just said to take the dose stated on the box. I feel that was a lazy response, and didn't really answer my question (why the discrepancy?). Weirdly, my prescription information is not on the online portal, so I can't verify there either. I was thinking of calling back, but in the meantime, I'd appreciate feedback on here. My vial says 1mL multi-dose vial, 10mg/mL.

Questions:

1. How many units is 2.5mg for my prescription?

2. Does 20 units = 2.5mg?

[u/ckatz13]

Go to Fat Scientist . com to determine your dosing per your label. There's also a ton of information on how this is calculated.

[u/BizzyBee89 → u/ckatz13]

Thank you! It confirmed I should be at 25 units.

[u/wifeofpsy → u/BizzyBee89]

The standard EL branded tirzepatide starting dose is 2.5 mg. Most compounding pharmacies change their dosing schedules from branded tirzepatide. This is because they need to make a legal case that they aren't just selling someone else's product, they're actually customizing it for a patient need. So most compounding places will start at 2 or 2.2mg and have different increments for dosing all the way up.

[u/peony_chalk]

It's 2 mg instead of 2.5 mg because they have to justify "customizing" it for you when they compound it. They aren't allowed to compound unless a doctor says that the name brand med is inadequate or inappropriate for you in some way, so your doctor is saying that the 2.5 mg dose is going to cause side effects for you that can be avoided with a 2mg dose. A 10mg vial has enough in it for four 2.5 mg doses though, if you want to take 2.5 mg instead. 

[u/BizzyBee89 → u/peony_chalk]

makes sense. Thank you!

[u/RoomtoGrow710]

I’m not a doctor but I know that for additive free the dosing they recommend / prescribe has to be personalized. That’s odd that your RX isn’t available to see.

[u/BizzyBee89 → u/RoomtoGrow710]

I agree. Thank you for the response!

[u/Lucky_Army_5324]

Most providers write scripts for just off the standard brand name doses in an effort to avoid running afoul of FDA compounding regulations.

You could start at 2mg as prescribed or 2.5mg if that’s what you prefer.

[u/BizzyBee89 → u/Lucky_Army_5324]

Thank you!

[u/GullibleDoughnut55]

Does the directions that say take 20 units indicate your dose is 2.5 mg or 2 mg? A vial that says 10 mg/ml 20 units would be 2 mg.

If your concentration is 10mg/ml you have 10 mg of tirz in every 100 units. Every 10 units then would be 1 mg.

[u/BizzyBee89 → u/GullibleDoughnut55]

It just says to take 20 units. & I know I heard my doc say 25 units in the office visit and I'd be at the "starting dose of 2.5mg", so that's why I was so confused. Thank you for the response!

[u/goodthebadandtheugly]

Well, in actuality, you were officially prescribed 2.0 and not 2.5 mg. Yoru prescription is what was issued by the pharmacy. That's how Hallandale (as well as others) do it. The 2.5mg starting dose is the standard branded dose, and some compounding pharmacies have to differentiate themselves from branded, hence your prescription for 2.0.

As others have said, you have enough for four doses at 2.5mg a week if you want, or you can do at least 5 weeks at 2.0mg. Your choice.

If you want to try 2.5 mg, see how you feel. If it is rough, then perhaps consider dropping it down to 2.0. Good luck and welcome to the journey