So I had an appointment with my doctor a few months ago and he told me the pharmacy wasn't giving me the right dosage. They are giving me vials that are good for ONE exact dose. While he is prescribing a 10ml bottle. He told me that they are stealing my money...They are a wonderful pharmacy (Publix pharmacy) and so I just waited to discuss the issue. And so today I called because my refills are almost done. She told me the reason is because Florida has a new law that prevents them from giving these bottles because once these bigger bottles are punctured, they are only good for 28 days and after that they should be discarded. I've looked it up online in a few other places and they seem to be saying the same thing. I'm just curious that I've never heard of this and apparently my doctor hasn't either. I left him a voicemail and I'm waiting to hear back but I want to know if anyone else has encountered this situation? My friend who works with me is also trans, just started T and he got the 10ml vial. So I'm just like...

That is a new one on me.  As a Paramedic we had multi-use vials on the truck for a couple of months after being punctured. As long as they are kept properly (temperature, light, etc.) they should last until their expiration date. Good grief if we threw out all multi-dose vials every 28 days I would have had to have a pay cut just to afford replacement all the time. Hmmmm, weird! 

I think I read somewhere that the air being pushed into the vial is not sterile and that is the issue. I'm really not sure. If it was an issue I think someone would have been affected by now but I guess these are new things they are trying to acknowledge.

Quote from: androidnick on September 17, 2014, 10:47:33 AM
I think I read somewhere that the air being pushed into the vial is not sterile and that is the issue.

It is not sterile in E.R.s as well, but they sure do not throw theirs out every 28 days. I have seen multiuse vials with so much dust on them we had to call an archeologist to exhume they so we could use them! 

I would say ask your doctor.

My husband last couple vials said the 28day. He asked our GP and she said it will be fine if he keeps it stored as described.

It seems to be something new the 28day ?

I disagree as if your on the little vials people often get shorted on the last one every vial vs being shorted once with a 10mL vial. Also no one has died to my knowledge or had reduced effectiveness from HRT from the full vial.

The main thing is that vials are only tested for safety through 28 days.  It's not a date that means that the drug is ineffective after four weeks, but it means that we don't know exactly what will happen after that.  It is possible that the vial may become contaminated, and I would not want to risk a patient injecting something we don't know is safe. In this case I do the same thing that your pharmacy does and dispense 10 1mL vials rather than 1 10mL.  It generally saves people money to use just the required dose than to toss out the remainder after the 28 days.  When you refill next, try calling your pharmacy and asking them to check the price on a 10mL vial and a month's worth of 1mL.  Depending on if/how your insurance covers them, the price may be different, but in general the copays are the same for the same volume regardless of the size of vial being dispensed.  If you're paying out of pocket, it may vary.

Our group had a whole presentation re: safety, harm reduction, and so forth. They never mentioned this at all. Though they talked about wiping off the vial with alcohol beforehand and so forth.

--Jay

When I had insurance, the copay was per vial, not per volume. I paid the same for a 10 ml and as 1 ml vial.  That makes a major difference in cost and waste.

I know this is different, but my vials of insulin also say discard after 28 days.. I have always used them up anyway, usually 8-10 weeks.. I keep them well refrigerated, and never shake them, always gently roll them between your palms.. I've never had any problem with insulin, but I know it may be different..? This is probably of little value..? Sorry.

I actually have a large bottle of T I got a few months ago. It was the cheapest option at the time. Well, I went back to refill another prescription and they were like "Sorry, we can no longer dispense a supply that lasts longer than 90 days." or something like that. Soooo...I still have half the bottle and now you're giving me the same supply in smaller two dose bottles?

I swear 90% of the laws they make up now make no sense.

I keep the bottle in another bottle (the big yellow prescription medication bottle type thing) and wipe the top off. I also never inject air that didn't already come out of it. Hasn't given me trouble yet, but then I suppose I wouldn't know right up until it did.

sounds like a trick to make more money out of patients.
not sure who gets or saves the money though, maybe the insurance company?
the new 90 day law sounds like a money machine has gotten in place too.

still, there is a chance that some statistics have spoken on the safety of using the same bottle for over 90 days.
so instead of having to deal with infections which are expensive, they'd rather have the patient pay a little more for the medicines.

and the 28 days is probably to make sure you won't start suing if you get infected on the 29th day.
a company can only guarantee what they have tested after all.
seems to me like a "use it after 28 days at your own risk".

it's mostly up to your wallet and doctor's advice.
until the company that produces the product find a ways to make the contents spoil after a month.
they do that to tvs and phones already, so why not medicines too.