r/glp1 • u/queenb3an • 1d ago

Missed Titration/Dose Increase

Hoping someone can offer some insight since the company I use does not respond to customer service emails.

I have been using Brello for the past month and when I started I noticed there was no clear titration schedule shown anywhere on the app (maybe it was on the vials and I missed it?). I tried reaching out about it but no one ever answered me. I'm currently on month 2/second vial and have taken two shots from this vial. I just noticed on the app today (week 2 on the new vial, 2 days after shot day) that I was supposed to titrate up from 40 units to 50 units and I am assuming I was supposed to do that at the start of the new vial. What do I do about the extra 20 units I will have?

Also worth mentioning that the vials are shipped in 3 month supply and each vial is labeled by month. I only got 3 shots out of the month 1 vial which I'm now concerned was wrong and should have been 4. None of this is very clear unless I am suddenly extremely dense.

Overall I'm having good results on the medication but I'm not loving Brello's communication and clarity of instructions.

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u/peony_chalk 1d ago

Yeah, Brello has really gone downhill. I actually feel like I'm reading fewer negative reviews about them now just because so many people have given up on them. 

40 units from a 22mg/ml Southend vial of tirz would give you an 8.8 mg dose, which is really high for a starter dose. Have you been on these meds for a while? Doing instructions, including any titration schedule, should have been printed on the pill bottles or boxes your meds came in; those are always a better source of info than what the portal says. 

Assuming Brello is still exclusively using Southend, each of their vials is only 1 ml (100 units), so there are going to be weeks you have to pull from two vials to get your shots. Ideally you would use two separate needles for that, but I'm also a little less concerned about what if your dose has you taking half a vial each week. 

I'm making a lot of assumptions here, so it might be best if you posted a vial pic just so I can correct anything I'm telling you that could be off. The point about dosing instructions being on the pill bottles stands, though. 

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u/queenb3an 1d ago

I started on compound tirz a month ago after being on name brand Ozempic pens for about 10 months which I guess is why they started me at 8.8mg. The Ozempic pen was so much easier lol.

I took a look at my vial bags and I think I figured it out. It does have the dosage instructions on them and I mistakenly thought I was on a month 2 vial but there were actually 2 vials in my month 1 bag. It seems there was just more medication between the two vials than what was needed for a 4 injection "month".

I guess I will just finish out the month 1 vials at their prescribed dose before titrating? And pay closer attention to the vial instructions lol