TL;DR: How much of an infection risk is it for me to mix single-dose vial Mounjaro with bacteriostatic water or bacteriostatic saline at home outside a clean room so that I can use it as a refrigerated multi-dose vial subcutaneously within a month?
Long Read: Informatics RPH here with previous inpatient experience background SEVERAL years ago looking for advice from other pharmacists with more recent sterile compounding experience. As you may know, the GLP-1 drugs like tirzepatide (Mounjaro/Zepbound) and semaglutide (Ozempic/Wegovy) are typically not covered for weight loss without a diabetes diagnosis. So, I’m paying out of pocket about $500 a month in the USA with the coupon already factored in. I’m currently on a 5 mg weekly dose of Zepbound/Mounjaro, which is already working well to bring my weight out of the clinically obese range. A Mounjaro 5 mg vial (in Canada) or a pen (in the USA) costs around the same as the 15 mg dosage form. Several people in the Mounjaro subreddit recommend combining the 15 mg single-use dosage form with bacteriostatic (benzyl alcohol) NS or bacteriostatic water so they can continue using it as a refrigerated multi-dose vial. There are even videos on how to open the USA pen to withdraw the drug solution easier. If I stay on the 5 mg weekly dose long-term, this hack can save me $4000 a year but I’m worried if that’s worth the infection risk. How much of an infection risk is it for me to do this at home outside a clean room?
Long Read: Informatics RPH here with previous inpatient experience background SEVERAL years ago looking for advice from other pharmacists with more recent sterile compounding experience. As you may know, the GLP-1 drugs like tirzepatide (Mounjaro/Zepbound) and semaglutide (Ozempic/Wegovy) are typically not covered for weight loss without a diabetes diagnosis. So, I’m paying out of pocket about $500 a month in the USA with the coupon already factored in. I’m currently on a 5 mg weekly dose of Zepbound/Mounjaro, which is already working well to bring my weight out of the clinically obese range. A Mounjaro 5 mg vial (in Canada) or a pen (in the USA) costs around the same as the 15 mg dosage form. Several people in the Mounjaro subreddit recommend combining the 15 mg single-use dosage form with bacteriostatic (benzyl alcohol) NS or bacteriostatic water so they can continue using it as a refrigerated multi-dose vial. There are even videos on how to open the USA pen to withdraw the drug solution easier. If I stay on the 5 mg weekly dose long-term, this hack can save me $4000 a year but I’m worried if that’s worth the infection risk. How much of an infection risk is it for me to do this at home outside a clean room?