Random question about how those compounding pharmacies work. Can you order a higher dose and then just stretch it out by taking the minimum dose to save cost? Do they automatically bill you monthly or can you skip months?
That's kinda what I'm doing. They still send me enough for my max dose reached (1.5mg/wk), but I've titrated down (to 0.5mg/wk) since I'm at the weight I should be at, so I just use a vial for a month, and toss the remainder. They send me two vials at a time.
The vials have a 6 month use by date, though evidence indicates semaglutide is stable for 1 year. I can log into the portal and tell it to skip a month, but since it's a push system, I don't get automatically billed. I actually have to do a checkin and the doc has to approve the refill. So if I have extra vials, I just skip that month's check in.
There's some indication that you don't have to toss the vial after a month, the FDA set those limits assuming it was insulin that is used sometimes more than daily. 4 penetrations of the vial's membrane probably isn't enough to contaminate it, but I'd rather be on the safe side so I don't use the vial for more than a month at a time. My partner is a pharmacist, so that part of the influence for the safer approach.
I think which is usually they start you at a small dose, ramp you up in dosage, then ramp you down when its time to come off, that way you dont suddenly feel much hungrier when it goes away because you've slowly adjusted it.
