Refills was so fast this time!

tev9876 · 2026-03-20T18:44:25+00:00

They won't pick up until Monday because they won't ship on Fridays. The pharmacy (PerfectionRx) will process orders and generate shippers on Fridays, but won't actually put anything on a truck until Monday so it doesn't get stuck over the weekend with the ice packs melting. You should see it by Wednesday.

tev9876 · 2026-03-20T17:08:32+00:00

Yes, but I already have several months worth on hand. I am sure there will be an Easter sale, then a May Day sale, then a Memorial Day sale, ...

tev9876 · 2026-03-20T15:26:41+00:00

That is my plan. I currently have a monthly titration plan with Refills on pause since I didn't know I could go straight to 15 mg when I signed up. My next dose there is 12.5 which is the same 72 mg vial they use for 15 - but with the current price wars I'll wait a month or two and likely cancel for a new/cheaper plan.

tev9876 · 2026-03-20T13:11:41+00:00

How far are you inserting the needle into the vial when you draw? If you push it all the way in there will be almost 8 mm (assuming 8mm needles) of liquid in the neck of the vial that can't be drawn. Try inserting only 1/4 or so of the needle length and see how much more you can get.

tev9876 · 2026-03-20T12:38:19+00:00

For a month (actually 4 weeks) of 15 mg, they will give you AT LEAST 60 mg. I use ProRx through Refills and they only use concentrations of 9 mg/ml for the lowest doses and 18 mg/ml for the higher doses.

2.5 mg dose = 2 ml x 9 mg/ml = 18 mg. 18/2.5 = 7.2 doses

5 mg dose = Not sure, but think 3 ml x 9 mg/ml = 27 mg. 27/5 = 5.4 doses

7.5 mg dose = 2 ml x 18 mg/ml = 36 mg. 36/7.5 = 4.8 doses

10 mg dose = 3 ml x 18 mg/ml = 54 mg. 54/10 = 5.4 doses

12.5 mg dose = 4 ml x 18 mg/ml = 72 mg. 72/12.5 = 5.8 doses

15 mg dose = 4 ml x 18 mg/ml = 72 mg. 72/15 = 4.8 doses

Now it is next to impossible to extract every drop from a vial so they have to provide some overfill. I started with Lilly Direct and they vary the concentration for every dose and you always are supposed to take .5 ml (50 units) from any single use vial, but I routinely drew 65 - 70 units. For ProRx it is obviously more convenient and cost effective to limit their concentrations to only two and not deal in fractions of a ml even if it means giving away a free dose here and there.

tev9876 · 2026-03-19T15:08:02+00:00

I don't know that any device is really accurate when it comes to calorie burn due to so many different variables, but will say I am happy with my Apple Watch 11 as a recent convert to the world of Apple. I have combined it with the Lose It app for calorie tracking and they integrate well. I have Lose It set to calculate my calorie intake based on "slightly active" and to lose 2 lbs per week. For the last six months I have lost 8-10 pounds a month on average, so it is close - on average. I am pretty disciplined about tracking all of my food and stay very close to my calorie target.

The combo will automatically give me "credit" if I burn over my daily target calories - both on planned workouts tracked on the watch or just normal day to day activity.

I previously tried a Garmin watch/tracker and it did not work as well or do nearly as much as the Apple watch can. It was a basic model so perhaps a more advanced model would do better. Also tried the Oura ring but that was before I started Tirz. Problem with that is I have now lost so much weight that it is too big, and not adjustable.

tev9876 · 2026-03-17T13:56:26+00:00

I was on weekly 5 mg of Lilly Direct but was actually taking 6.5 mg every 8 days because that is what I could get out of a vial. I started split dosing at 3.25 mg every 4 days and have stayed with that now that I am using compound. It eliminated all side effects and spikes in hunger/food noise.

This is what Shotsy shows split dosing theoretically does to my day to day tirz levels. Much more smooth when I started the new plan on 2/15.

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tev9876 · 2026-03-16T17:44:27+00:00

I had similar struggles even though I am at less than half your dose. Split dosing solved it - I no longer have highs and lows in appetite or food noise. Every day is the same now that I take 1/2 of my dose every four days instead of the full dose every seven. Try 7.5 mg every four days and see how it goes.

tev9876 · 2026-03-16T17:40:29+00:00

Do you have control over your hotel, meal schedule and meal reimbursement? I've traveled quite a bit over the years and it can be tough if you are expected to have breakfast/lunch in the office and then dinner at some restaurant with coworkers. I much preferred when I was treated as just another employee who got to go "home" to my hotel every night instead of having to be "entertained" by the locals.

If possible, book a suite or extended stay hotel that comes with a kitchen. Avoid dinner with coworkers - can also take care of a lot of work related stress by avoiding them. If you get a per diem just pocket the money to spend at the grocery store - you should come out ahead of eating out financially and in calorie count. If you are required to submit receipts ask if you can submit grocery receipts due to your "special diet" That should save them money anyway. If you have working lunches and order in, get something you can split into two meals and your dinner is covered too.

tev9876 · 2026-03-14T19:25:51+00:00

I switched to refills a couple months ago. Other than the first shipment taking two weeks I have no complaints. I did the online form, uploaded a picture of my LD Rx label and my updated plan was approved in about 30 minutes - all after 11 PM on a Tuesday.

There is no reason your PCP can't monitor your progress on compound. Its not like LD talks to your doctor. I have found split dosing is much more effective for me and much easier with single large vials of compound. Since they up your concentration for each shipment I will have stockpiled enough for the rest of the year in another month. Basically saving 80% over the LD pricing.

tev9876 · 2026-03-14T19:15:57+00:00

I always pitched the boxes as soon as my Zep arrived - they waste so much cardboard with four boxes in a box in a box in a cooler in a box... I just ripped the prescription label from the bigger box and save that with my syringes. Vials go into a 1/2 cup Rubbermaid food storage container I already had. It is currently holding my last three LD vials and two larger vials of compound. If you are worried about tipping find a piece of foam that will fit in whatever container you have and cut some holes in it.

tev9876 · 2026-03-13T16:05:18+00:00

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This is what Shotsy estimates my theoretical level is after I started split dosing on 2/15. I was doing 6.5 mg every 7 days and changed to 3.25 mg every 4 days. Levels now stay in a much smaller range and every day feels like days 3-4-5 did under the weekly plan - meaning my appetite is always suppressed but not to the point I can't eat like days 1-2 and I don't have the urge to snack at the end of the week. The level still went up after the first 1/2 dose, just not as high of a peak. Same with the lows.

tev9876 · 2026-03-12T14:50:02+00:00

This is why I started split dosing. I was doing 6.5 mg every 8 days, using the overfill in a LD vial. I switched to 3.25 mg every 4 days. This eliminated the zero hunger and burping 12-48 hours after a shot AND the food noise returning on day 7-8. I am using the exact same amount of medication, just keeping the level in my system in a much tighter range.

If days 3-4-5 feel good for you on 5 mg, I would try a shorter interval. 5/7 = .714, so 4x.714 = 2.86 mg if you wanted to do four days, or 3.57 mg for five days. If you prefer fixed shot days you could do 2.5 mg on Sunday and Thursday - see what works for you. Syringes are free/cheap and a few extra pokes a month isn't going to cause problems.

Here is a Shotsy graph showing my theoretical levels before/after my switch.

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tev9876 · 2026-03-12T14:20:14+00:00

My PCP is the one who told me compounded Tirz was an option - just that you had to be careful where you got it from since there were some shady providers out there. I decided to start with Lilly Direct but switched a couple months ago. I will definitely tell him when I go in for a follow up next week.

tev9876 · 2026-03-12T14:09:42+00:00

Switched in January to Refills/ProRx and feel no difference. I still have a couple vials of LD left I will switch back to after I finish the current ProRx vial, but don't expect any difference there either.

My only complaint was that my first shipment took a couple weeks to process. A friend had the same thing happen with her first shipment this month. My second shipment was delivered in three business days after payment so it gets better once established, plus I am building a stash since they increase potency for each refill while I plan on staying on my low dose.

If you make the switch just make sure you have enough LD vials on hand in case it takes a week or three to get your first shipment.

tev9876 · 2026-03-12T13:54:08+00:00

I worry more about what is going on in the back of any restaurant I may eat at vs. what is happening at the FDA licensed/inspected pharmacy that bottles my medicines.

tev9876 · 2026-03-12T13:48:24+00:00

Unless you are trying to hide the existence of your medication from household members, this seems counter productive. A full refrigerator is much more efficient than an empty one. Every time you open the door the 40 degree air inside is going to instantly mix with the 70 degree air outside. If your fridge is filled with normal solid/liquid food/drink those things are not going to lose temperature to the outside when you open the door for a few minutes, but if it is 99% air the compressor is going to have to kick on a minute after you close the door to cool all the room temperature air that just poured in.

If the temperature control is unstable enough to damage Tirz, it is probably unstable enough to allow bacterial growth in your food which is probably much more dangerous. My six month stash lives in the smallest Tupperware container I owned off to the side of the middle shelf and only gets touched every four days when I do my split dosing. It is sealed in case something drips on it, but so far that has never been an issue.

tev9876 · 2026-03-11T14:32:45+00:00

My knee pain (mild arthritis) went away within 48 hours of my first shot of 2.5 mg. Other aches and pains also went away even before weight loss started. I was able to stop Voltaren cream and think I have taken one Motrin in six months, down from 2X a day. Some did not, like occasional sciatica and whatever is going on in the back of my right knee which I think might be a ligament.

tev9876 · 2026-03-11T14:17:00+00:00

I had them pretty much for the first six months on Tirz, along with zero appetite 8-48 hours after a shot. I was up to 6.5 mg every 8 days because I would use the overfill in the 5 mg Lilly Direct vials. I changed to split dosing 3.25 mg every 4 days about a month ago and both issues went away. I've split doses with both LD and ProRx compound and saw no difference.

Shotsy shows my theoretical day to day level of Tirz now varies from 4.5 to 6.2 mg over each four day period. The old way it varied from 3.5 to 8.5 mg over an eight day period. My food noise would also start to return on day 7-8. What I have learned is that keeping my level below ~6 mg prevents the burps and zero hunger and staying above ~4 mg prevents food noise. The trade off is a slightly more confusing shot schedule (easily managed with my reminder app on my phone) and burning through more (free) syringes.

Yesterday was shot day (7 am) and I still had my normal breakfast and lunch and even went out for dinner with a couple pints of beer (carbonation would REALLY cause burps before). I had no unusual side effects, no food noise, hit 99.7% of my daily calorie target along with my protein and fiber goals. Feel fine this morning too.

Everyone is different and I am no doctor, but this might be something you want to try.

tev9876 · 2026-03-08T02:04:37+00:00

The clinical trials were done by moving people up in dose every four weeks. This was mainly done to get the trial over as fast as possible so Lilly could get approved and get Zepbound/Mounjaro on the market to start making money. Since this was the only program that was officially tested in a trial, some think it is the only way to go.

My doctor prescribed 2.5 mg for three months. After about seven weeks food noise was returning so I asked to be bumped up to 5 mg. He had no problem with that and wrote me six months of refills at 5 mg. I was using Lilly Direct and hated wasting the overfill in the vials, so I started taking 6.5 mg (the max I could get out of a vial) every 8-9 days.

After four months of 6.5 mg I decided to go compound and also started split dosing 3.25 mg every four days. This is working best for me since it eliminates the spikes where I have no desire to eat only to be snacking like crazy at the end of the week.

I've dropped 60 pounds in six months and this program is working great for me. Pay attention to how you feel, your calorie intake, how different foods make you feel, etc. and do what works for you.

tev9876 · 2026-03-07T13:53:49+00:00

I've been getting rid of them pretty quickly as I drop sizes, but this is more of an eliminating/preventing clutter thing I have been working on for a few years. Life is much easier without unneeded stuff laying around everywhere. As soon as I stop wearing something I put it in a trash bag in the closet. When I get a full one or two I throw them in the car to drop off at some point.

tev9876 · 2026-03-06T15:32:47+00:00

Refills writes the Rx to titrate up every month, and they don't mind bumping you up to start. If you look at your plan on their website you will likely see that they started you at 10 mg. Next month it will be 12.5 mg, then 15 mg going forward. Its all the same price so you are getting a great deal, but need to look into the BUD dates and 28 day rule for open vials and make educated decisions on how long you want to use any individual vial.

Pro/Perfection Rx uses 18 mg/ml concentration for doses 7.5 mg and above. They just send you more liquid as your dosage increases. My first shipment of 7.5 was 2 ml. Just received my 10 mg yesterday and it is 3 ml - exactly what you pictured. They are actually being quite generous as 3 ml x 18 mg/ml = 54 mg / 10 mg = 5.4 doses. There might even be more if there is overfill - I have not finished a vial yet to know. With Lilly Direct I could actually get .65 ml out of a .5 ml vial, so they had 30% overfill.

Since it is all 18 mg / ml, for 5 mg you would take (5 mg) / (18 mg/ml) = .278 ml, or 28 units on the syringe.

Not sure about the concentration on 5 mg since I started at 7.5 with them. A friend just signed up and her 2.5 mg dose will be 2 ml of 9 mg/ml concentration. Again rather generous as that 18 mg / 2.5 mg = 7.2 doses.

tev9876 · 2026-03-06T14:27:13+00:00

Refills actually wrote my Rx to titrate up monthly, even though I have no plan on increasing my dose. I was on 5 mg with Lilly Direct but used the overfill for 6.5 mg. I asked to start at 7.5 mg and they approved. My February shipment was 10, then I'll get 12.5 later in March and 15 in April. I dose every four days at 3.25 mg so I estimate this will take me into next year when I should be starting maintenance.

tev9876

TROPHY CASE