What to do if injections are missed?

[FrankUnderwood]

Im currently on an E3.5D (Monday morning/Thursday evening) 80mg/.4mL shot schedule (160mg weekly).

Due to travel and a prescription refill delay, I missed last Thursday evening and this past Monday morning injections. I also skipped my AI and HCG as well. My prescription refill has arrived in 2 5mL vials from Empower.

What is the recommended strategy for resuming having missed 160mg over the past week? Do I resume my normal dosage tomorrow (Thursday evening) with a normal .4mL shot, or do I double it up (.8mL) for this single injection to get back to baseline then move back to .4mL?

 

[Superman]

curious as well. i'm going out of the country and would rather not drag medicines along so I will end up doing about 11 days between injections when I normally go 3.5

 

[Jackie Treehorn]

curious as well. i'm going out of the country and would rather not drag medicines along so I will end up doing about 11 days between injections when I normally go 3.5

I wouldn't do that...no reason to really.

I travel international for a living, and always bring along my Test, HCG, and Sermorelin. I keep my supplies (insulin pins and alcohol wipes) in a hard plastic container in my main (checked) suitcase. I carry my Test, along with my HCG and Sermorelin in my carry on bag. The HCG and Sermorelin are kept in a cold pack that can hold (2) 10mL vials, and keep them cold for many hours.

I've been to China, Japan, South Korea, Malaysia, Singapore, the Philippines, and have never had any problems. I make sure that I have all the original labels that identify the med, and have my name on it. I also carry a travel letter from Defy. I've never had to explain anything, nor have I ever them even look at my meds. The only place I've had someone pull out my cold pack was in San Diego. As soon as they saw it was an injectable med, they carefully put it back, and didn't say a word.

 

[Virginian]

I take meds along when I travel. No problem with that. But last month it didn't work. I got called out of the country to go on a week-long trip with only a few hours notice. I brought along 1 pre-filled syringe. I take test e4d. Should have been enough.

But the week-long trip lasted 3 weeks. I took my one dose 8 days after my last injection. Then nothing until I returned home. The nice thing is that I felt fine. No ill effects. Of course, I usually run at 1200 ng/dL, so I probably never got very low 2 weeks after my last injection.

 

[Jackie Treehorn]

I take meds along when I travel. No problem with that. But last month it didn't work. I got called out of the country to go on a week-long trip with only a few hours notice. I brought along 1 pre-filled syringe. I take test e4d. Should have been enough.

But the week-long trip lasted 3 weeks. I took my one dose 8 days after my last injection. Then nothing until I returned home. The nice thing is that I felt fine. No ill effects. Of course, I usually run at 1200 ng/dL, so I probably never got very low 2 weeks after my last injection.

Personally, I think it's just as easy to bring your Test vial, and a bag of pins, than to deal with pre-loading syringes, and risk leakage, etc. Very easy, and doesn't take up any room.

 

[FrankUnderwood]

I wouldn't do that...no reason to really.

I travel international for a living, and always bring along my Test, HCG, and Sermorelin. I keep my supplies (insulin pins and alcohol wipes) in a hard plastic container in my main (checked) suitcase. I carry my Test, along with my HCG and Sermorelin in my carry on bag. The HCG and Sermorelin are kept in a cold pack that can hold (2) 10mL vials, and keep them cold for many hours.

I've been to China, Japan, South Korea, Malaysia, Singapore, the Philippines, and have never had any problems. I make sure that I have all the original labels that identify the med, and have my name on it. I also carry a travel letter from Defy. I've never had to explain anything, nor have I ever them even look at my meds. The only place I've had someone pull out my cold pack was in San Diego. As soon as they saw it was an injectable med, they carefully put it back, and didn't say a word.

so let me get this right - you keep your supplies in a checked bag, that has a high likelihood of getting lost on an international trip? and into countries that you may very well find it impossible to buy replacement syringes due to local regulations?

in addition, you have a possibility of breaking a vial in your destination country (or even worse, having it stolen by people that have access to your hotel room) and being completely screwed if you didn't bring pre-filled syringes.

while i congratulate you on the logistics and taking what amounts to a small pharmacy with you internationally, you would have significant issues if you flew into Norway or Sweden and these items were found in your possession as you are bringing in more than a 10-14 day supply.

lets focus on the original ask - how do we safely/responsibly restart a temporarily paused protocol due to travel issues that caused a patient to be away from their medication longer than expected.

 

[FrankUnderwood]

But the week-long trip lasted 3 weeks. I took my one dose 8 days after my last injection. Then nothing until I returned home. The nice thing is that I felt fine. No ill effects. Of course, I usually run at 1200 ng/dL, so I probably never got very low 2 weeks after my last injection.

likely because of half life of the medication. you still had "some" in your system from that dose 8 days into the trip until the time you returned home.

 

[CoastWatcher]

What is the recommended strategy for resuming having missed 160mg over the past week? Do I resume my normal dosage tomorrow (Thursday evening) with a normal .4mL shot, or do I double it up (.8mL) for this single injection to get back to baseline then move back to .4mL?

Don't double up. Simply resume your normal protocol. Your system will settle back in quickly.

 

[Vince]

I agree with CW, don't double. Resume your protocol.

 

[Jackie Treehorn]

so let me get this right - you keep your supplies in a checked bag, that has a high likelihood of getting lost on an international trip? and into countries that you may very well find it impossible to buy replacement syringes due to local regulations?

A high likelihood of getting lost? I don't know what airlines you fly on, but I've never lost a bag yet, and I fly a lot. In the event that my pins were lost, I would go to the local pharmacy, and buy some. If the country requires a script for pins, I'd go to a doctor that deals with expats in that country and get the script. Problem solved.

in addition, you have a possibility of breaking a vial in your destination country (or even worse, having it stolen by people that have access to your hotel room) and being completely screwed if you didn't bring pre-filled syringes.

Again, I've never broken a vial, or had anything stolen from my hotel room. I stay at nice hotels, so that's never been a problem for me...ever.

while i congratulate you on the logistics and taking what amounts to a small pharmacy with you internationally, you would have significant issues if you flew into Norway or Sweden and these items were found in your possession as you are bringing in more than a 10-14 day supply.

Thanks, but I don't exactly call an insulin cold pack, some pins and alcohol wipes a small pharmacy. I've never been to Norway or Sweden, so I can't speak to their customs practices. Any other international destinations that I've traveled to, it's been a non issue.

lets focus on the original ask - how do we safely/responsibly restart a temporarily paused protocol due to travel issues that caused a patient to be away from their medication longer than expected.

Ok...I concur with Coastie and Vince. Simply resume your protocol.

 

[Vince Carter]

The advice on ANY medication to is too resume at the next dose, no doubling up or anything like that.

 

[crash1270]

I once had an eye condition called Central Serous Retinopathy. I was traveling every other week. At the time I was with a well known clinic in my area Low T center. My doctor doubled my dosage because I was not going to be around for the next scheduled appointment. Within a week I had a serious vision problem with one of my eyes. I did have several other contributing factors to the Retinopathy like age, stress, etc. but my retina specialist added me to a group study where several other patients were on TRT. After some research I found other cases of Retinopathy in TRT users where exogenous levels were higher than normal. Better to be safe and keep levels in normal range or lower than in the higher levels and risk side effects. Just my humble opinion.