Ran out of test need advice

[Gossamer]

Ok, here's the situation. Cvs usually gives me four 1ml vials at a time. Each vial is enough for one week. So, I go back each month to get the next 4 weeks worth.

Last refill was a new prescription, which got filled on December 9. They didn't have the 1ml vials, so I got a 10 ml. Now I went to get my refill today, and I can't get the refill until March 5 (90 days controlled substance). I have 2 injections left. So, I'll be short for the last 2 injections until I wait for my refill.

Here's where I am: I inject Tuesday and Saturday. I have enough for tomorrow, and Saturday this week. Best case scenario, I get my refill on the following Saturday. So best case scenario, I only miss Tuesday next week.

What should I do? I've never missed an injection for over 2 1/2 years on trt.
Do I wait till Thursday, then Monday, postponing each injection by 2 days, to get me to that Saturday?
Do I just skip next Tuesday, and hopefully get my refill on Saturday to go back on schedule?

I'm trying to figure out what's best to not make me feel like crap.

And to add, I need to get a blood test in a couple of weeks for my appt. Is this going to throw off the results of the blood test?

 

[Massacre 2.0]

What a pain. Bro, just get your own stuff. You'll never have this problem again.

 

[daleb]

If you cant get more just figure out exactly how much you have left and divide it out evenly.

 

[halfwit]

No such thing as a 90 day controlled substance timer on testosterone. That's for schedule 2 or higher drugs (test is schedule 3).

You're likely either dealing with an inept pharmacy tech, or your insurance is playing games, or both. Do the math on your vials and make 100% sure that your timing is spot on - then present your case to the pharmacy MANAGER.

Testosterone is a medicine no different than insulin, and they need to recognize the importance of not causing you to go hypogonadal. If this is an insurance issue, this is when they can either go to bat for you, or offer to take cash payment until insurance foots the bill again.

I should warn you though, if you're bumping up your dose, and hoping nobody is keeping track (not accusing) - you are doing it very wrong. They do keep track, and have no problem notifying your doctor if this is the case. Mistakes do happen, but this is where you want to be damn sure you're in the right before proceeding.

My .02c

 

[Megatron28]

I agree with HW. I would wager money this is an insurance thing.

Just offer to pay out of pocket for your refill and use a coupon code from Prescription Prices, Coupons & Pharmacy Information - GoodRx. The 10ml vial will cost you about $45.

For the record, out of curiosity I once put in for a refill on a 10ml vial thirty days after getting my last one and they had it ready for me a couple of hours later. No questions ask. They don't care as long a your script still has refills available on it.

 

[Gossamer]

Thanks guys.

I went back and looked at the numbers again. I had 23 syringes filled with this vial. As far as padding my dose, here's what I do. Each injection is supposed to be .4ml. I fill a few ticks higher, to compensate for what gets left in the syringe. So, assume I fill to.43ml. .43 times the 23 syringes, brings me to 9.89 ml. And after I filled the last syringe, I had a little left in the vial(maybe.10ml).

Would you call this .43 padding my dose?

And, I've had issues before with this pharmacy giving me the runaround.

She did say I could "try" to come in on Sunday, and "maybe" the pharmacist could give me a dose to get me to the next refill. All I'd need is a 1ml vial. But I don't know if she was telling me that to get me to leave.

So, is bumping my .40ml dose to .43ml, frowned upon? Or is it within the range of what's ok? I want to make sure before I mention that to the pharmacist. I don't want to get in trouble.

Again,

Thanks for the help.

 

[Megatron28]

What gets left behind in the syringe is miniscule. Don't try to compensate for this. Just do .40ml.

If it really bugs you, try injecting with 29g 1/2" insulin syringes. Less seems to get left behind.

Also try moving your script to Walgreen's. I never have this type of issue with them.

 

[Gossamer]

What gets left behind in the syringe is miniscule. Don't try to compensate for this. Just do .40ml.

If it really bugs you, try injecting with 29g 1/2" insulin syringes. Less seems to get left behind.

Also try moving your script to Walgreen's. I never have this type of issue with them.

Thanks Megatron.

I'll keep it at.4 then.
I had the prescription at Walgreens before(my anastrozole prescription is still there), but they had quite a few "back orders" of test, so I was always cutting it too close when I had to refill, so I switched to CVS.

Oh, the joys of being dependent on drugs!

 

[Megatron28]

I always put me refill order in a couple of weeks before I am due to avoid any such issues.

A 10ml vial lasts me for 10 weeks at 200mg/wk so I reorder around the Week 8 point.

 

[IMT staff]

No such thing as a 90 day controlled substance timer on testosterone. That's for schedule 2 or higher drugs (test is schedule 3).

You're likely either dealing with an inept pharmacy tech, or your insurance is playing games, or both. Do the math on your vials and make 100% sure that your timing is spot on - then present your case to the pharmacy MANAGER.

Testosterone is a medicine no different than insulin, and they need to recognize the importance of not causing you to go hypogonadal. If this is an insurance issue, this is when they can either go to bat for you, or offer to take cash payment until insurance foots the bill again.

I should warn you though, if you're bumping up your dose, and hoping nobody is keeping track (not accusing) - you are doing it very wrong. They do keep track, and have no problem notifying your doctor if this is the case. Mistakes do happen, but this is where you want to be damn sure you're in the right before proceeding.

My .02c

Yup^^^^

 

[IMT staff]

I always put me refill order in a couple of weeks before I am due to avoid any such issues.

A 10ml vial lasts me for 10 weeks at 200mg/wk so I reorder around the Week 8 point.

2 weeks to be safe absolutely agree.

 

[Gossamer]

Well,

I went back to cvs today, and asked if there was anything they could do, if I paid cash, instead of going through insurance. Yesterday, The lady at the counter suggested that they may be able to give me enough to get to my refill. Well, I guess that was bs. The pharmacist said it had nothing to do with insurance. She couldn't, by law, refill my prescription before the 90 days, because it's a controlled substance. The way the prescription was written, meant I had a 3month supply. Period. She suggested that I ask my dr. to up the dose on the prescription, which may help in the future. I wouldn't even ask my dr. to up my prescription. I feel great with what it is now.

And the worst part of all this, is while I was there, I was trying to find a way to get her to get me the 1ml I need to get to the next refill.

As I was walking away, it hit me. I'm dependent on this fucking drug. I literally felt like an addict begging for a fucking fix. It was a humbling experience.

If there were any other way for me to keep my test level in the normal range, besides relying on a drug for the rest of my life, I'd gladly do it.

 

[halfwit]

Well,

I went back to cvs today, and asked if there was anything they could do, if I paid cash, instead of going through insurance. Yesterday, The lady at the counter suggested that they may be able to give me enough to get to my refill. Well, I guess that was bs. The pharmacist said it had nothing to do with insurance. She couldn't, by law, refill my prescription before the 90 days, because it's a controlled substance. The way the prescription was written, meant I had a 3month supply. Period. She suggested that I ask my dr. to up the dose on the prescription, which may help in the future. I wouldn't even ask my dr. to up my prescription. I feel great with what it is now.

And the worst part of all this, is while I was there, I was trying to find a way to get her to get me the 1ml I need to get to the next refill.

As I was walking away, it hit me. I'm dependent on this fucking drug. I literally felt like an addict begging for a fucking fix. It was a humbling experience.

If there were any other way for me to keep my test level in the normal range, besides relying on a drug for the rest of my life, I'd gladly do it.

Junkie? No. Person with a medical condition, yes.

Transfer your prescription, you're dealing with uneducated idiots.

 

[Gossamer]

Junkie? No. Person with a medical condition, yes.

Transfer your prescription, you're dealing with uneducated idiots.

I know it's a medical condition, but the feeling was there nonetheless.

I'm thinking of switching back to Walgreens. I just don't know if I should get my next refill on March 5, from cvs, and then transfer the prescription. Or transfer it now.

 

[halfwit]

I know it's a medical condition, but the feeling was there nonetheless.

I'm thinking of switching back to Walgreens. I just don't know if I should get my next refill on March 5, from cvs, and then transfer the prescription. Or transfer it now.

You'll be out of testosterone by March 5th, no? Why wait?

Transfer, refill, stay stable. There's absolutely NOTHING to be embarrassed about. I take between 5 and 8 shots a day, I promise you that the last thing I'm thinking is how much of a junkie I am.

I do wish that I didn't have to inject every day for the rest of my life, but it beats the alternative - the long dirt nap. Don't EVER let someone think they're better than you or can hold this over your head, ever. A lot of guys don't even realize they're slowly dying a crippling and disgusting death - you're ahead of the pack by taking care of it, I assure you.

 

[cybrsage]

For the record, out of curiosity I once put in for a refill on a 10ml vial thirty days after getting my last one and they had it ready for me a couple of hours later. No questions ask. They don't care as long a your script still has refills available on it.

I was told to throw away a bottle after using it for 30 days due to the increased risk of contamination from all the air you push in to prevent vacuum lock. I told my doctor that I faithfully do this without question...

 

[cybrsage]

As I was walking away, it hit me. I'm dependent on this fucking drug. I literally felt like an addict begging for a fucking fix. It was a humbling experience.

Would you ever look at a diabetic as an addict, or look down on him due to him being dependent on insulin? Of course not, you would not think twice about it and, in fact, you would call the diabetic a fool if they did NOT take the medicine they need to live. Testosterone is a substance you need to live. If it gets low enough, you become anemic and, eventually, you could die. It is nothing to feel ashamed about. Here is something to scare you into making sure you get your needed meds:

Low testosterone increases risk of mortality, anemia, reduced ESA response

Testosterone deficiency is common in many patients with chronic kidney disease (CKD), but the treatment of this deficiency and associated side effects have not always received much attention.

The prevalence of CKD patients with low testosterone is estimated at 50%-70%. Testosterone has effects on hemoglobin levels as well as lean body mass accrual. Several recent studies have elucidated more connections between testosterone and pertinent clinical parameters. After multivariate adjustment, these three groups also exhibited significantly shorter survival time. Kidney dysfunction, albuminuria, and CKD were associated with a 40%, 38%, and 42% increased risk of all-cause mortality, respectively. These associations were much stronger in patients aged 29-69, in whom kidney dysfunction was associated with a twofold increased risk of all-cause mortality, and albuminuria and CKD were associated with a 62% and 66% increased risk, respectively. Additionally, kidney dysfunction was associated with a 2.0 and 4.3 times increased risk for cardiovascular mortality in the entire cohort and the 29-69 age group. Patients with kidney dysfunction, albuminuria, or CKD had shorter survival when they also had low total testosterone. In subjects with low total testosterone, kidney dysfunction was associated with a 2.5 times increased risk of all-cause mortality in the entire cohort and a 17 times increased risk in the 29-69 age group.

Another group of investigators aimed to find associations between anemia, resistance to erythropoiesis-stimulating agents (ESAs), and testosterone levels. In multivariate analysis controlling for age, body mass index (BMI), diabetes status, cardiovascular disease, albumin, PTH, CRP, and eGFR, the researchers found a significant association between hemoglobin and testosterone. Anemia was five times more likely to be found in testosterone-deficient patients. Of the patients taking ESAs, testosterone was negatively associated with ESA dosage in multivariate analysis.

Low testosterone increases risk of mortality, anemia, reduced ESA response - Headlines in Urology Treatment

So testosterone replacement therapy is every bit as vital to someone with low T as insulin replacement therapy is to a diabetic (ok, a bit of an exaggeration - you will not go into shock and die quickly if you miss several test shots, unlike insulin, but you get the idea).

If there were any other way for me to keep my test level in the normal range, besides relying on a drug for the rest of my life, I'd gladly do it.

You and me both, brother. If there was a way, a great many of us would gladly do it as well.

 

[Gossamer]

Just wanted to update...

Since CVS told me that they couldn't refill until 3/5, would it be safe to assume they'd have it ready for me on the 5th? I even called two days before, to make sure they had it ready. Well, I went in on the 5th, and wouldn't you know it, they don't have any in the pharmacy. They called around and found a cvs that had some, so I picked it up there.

Here's what I ended up doing, since I was going to miss one injection day. I injected on Saturday, as usual. Then went 5 days, instead of the usual 3.5, and injected on Thursday. Then waited 5 days again, and injected on Tuesday, to bring me back on schedule. I didn't feel any different, except for the last day before my injection. I felt more tired, and a little cranky. Other than that, it wasn't too bad.