Tesamorelin bac ratio

[undersc0re]

I have 10mg vials of tesa, I am just going to start by adding 1.5 ml to my first vial and go with 1mg once a day until it is done. If things are good I will step it up to 2mg per inj and prob go up to 2.5 on the third vial and stay at that. I just have questions relating to this, I don’t really want to subq more than .2ml at a time, what is a suggested maximum subq volume amount for water/peptides? Can 10mg of tesa be ok with only .5 ml of bac or will there be a concentration/irritation and absorption issue?

 

[Ghoul]

I have 10mg vials of tesa, I am just going to start by adding 1.5 ml to my first vial and go with 1mg once a day until it is done. If things are good I will step it up to 2mg per inj and prob go up to 2.5 on the third vial and stay at that. I just have questions relating to this, I don’t really want to subq more than .2ml at a time, what is a suggested maximum subq volume amount for water/peptides? Can 10mg of tesa be ok with only .5 ml of bac or will there be a concentration/irritation and absorption issue?

Big mistake. The standard 2mg dose should not be diluted to less than .5ml. 3ml into the vial and .6ml doses even better.

 

[undersc0re]

well, I guess with one dose missing only the math will be easy. I didn’t think it had to be diluted that much, crazy. No burning, itching, or redness yet….but I am sure its more of an absorption over time issue.

 

[Ghoul]

well, I guess with one dose missing only the math will be easy. I didn’t think it had to be diluted that much, crazy. No burning, itching, or redness yet….but I am sure its more of an absorption over time issue.

Tesa is one of the most immunogenic peptides, and prone to aggregation. Those two factors make the risk of developing immunity to it very high.

The company that makes the name brand, Egrifta, tried to release a more concentrated version to reduce the injection volume, but the FDA put the brakes on it because they were concerned with immunity developing as I described.

 

[Ghoul]

https://www.theratech.com/news-releases/news-release-details/theratechnologies-submits-updated-tesamorelin-f8-formulation

 

[undersc0re]

Thats crazy, I guess I will just have to subq whats needed. I will do some more research, thank you so much for this information, the volume they suggest must be safe to inject then

 

[Ghoul]

Thats crazy, I guess I will just have to subq whats needed. I will do some more research, thank you so much for this information, the volume they suggest must be safe to inject then

I use .6ml daily without issue.

I also .22um filter, and backload into BD veo 6mm syringes for a painless injection, while reducing the risk of drug neutralizing immunogenicity from developing (by filtering out aggregates). I can feel the difference with filtered injections.

 

[undersc0re]

I use .6ml daily without issue.

I also .22um filter, and backload into BD veo 6mm syringes for a painless injection, while reducing the risk of drug neutralizing immunogenicity from developing (by filtering out aggregates). I can feel the difference with filtered injections.

I am working on the filter issue, hopefully have everything by the 3rd vial. Now I have to order insulin syringes larger than .3 ml lol. I was loving the .3ml syringes, they don’t get air in them nearly as bad as the others.
When you back load the larger syringes is air an issue, it seems like the .3ml don’t like the back fill, they get all sorts of air pockets, just doesn’t flow in smoothly in a small syringe…I can work the air bubbles out.

 

[Ghoul]

I am working on the filter issue, hopefully have everything by the 3rd vial. Now I have to order insulin syringes larger than .3 ml lol. I was loving the .3ml syringes, they don’t get air in them nearly as bad as the others.
When you back load the larger syringes is air an issue, it seems like the .3ml don’t like the back fill, they get all sorts of air pockets, just doesn’t flow in smoothly in a small syringe…I can work the air bubbles out.

Backfilling takes a bit of practice, I wish there was an easier way.

So I keep a needle attached to the filter, I don't put the 3ml syringe flush against the insulin syringe which allows liquid to flow better.

Once I reach .6ml. I put the plunger just barely into the insulin syringe. Flip it needle side up, whack it with my finger to knock the air bubble to the top, remove cap and push air out.

After a few times (and messes), I got it down perfectly.

A skill well worth learning.

 

[songsofpyramids]

Backfilling takes a bit of practice, I wish there was an easier way.

So I keep a needle attached to the filter, I don't put the 3ml syringe flush against the insulin syringe which allows liquid to flow better.

Once I reach .6ml. I put the plunger just barely into the insulin syringe. Flip it needle side up, whack it with my finger to knock the air bubble to the top, remove cap and push air out.

After a few times (and messes), I got it down perfectly.

A skill well worth learning.

This what I been doing with my hgh and it works well enough. I like it filtered right before injection. I do wish there was a filter spike for peptides that I could just put into my vial and stab an insulin needle into but all the ones I’ve seen require luer lock.

 

[Ghoul]

This what I been doing with my hgh and it works well enough. I like it filtered right before injection. I do wish there was a filter spike for peptides that I could just put into my vial and stab an insulin needle into but all the ones I’ve seen require luer lock.

There are "low dead space" 1ml luer lock syringes and "low dead space" needles in insulin syringe gauges that result in near zero wasted compound if you wanted to go that route.

Low dead space needles minimize waste and enhance precision.

TSK’s low dead space needles minimize hub space, reducing waste and ensuring precise, cost-effective injections.

www.tsklab.com

 

[songsofpyramids]

There are "low dead space" 1ml luer lock syringes and "low dead space" needles in insulin syringe gauges that result in near zero wasted compound if you wanted to go that route.

Low dead space needles minimize waste and enhance precision.

TSK’s low dead space needles minimize hub space, reducing waste and ensuring precise, cost-effective injections.

www.tsklab.com

Have not seen these before, very interesting.

 

[JuiceStick]

Backfilling takes a bit of practice, I wish there was an easier way.

There is an easier way. It's called pen cartridges. Holds 3ml and takes exactly 5 seconds to remove from the fridge and pin.

 

[Ghoul]

There is an easier way. It's called pen cartridges. Holds 3ml and takes exactly 5 seconds to remove from the fridge and pin.

Not if you want "bedside filtration", ie, filtration immediately prior to injection.

Aggregates form with time, so the 5th injection after filtration will have significantly more aggregate formation than the first,

With a peptide that's notorious for triggering an immune response, like tesamorelin, which induces an uncomfortable site reaction nearly every time, I can feel a clear difference. If I filter a vial's worth only the first injection immediately after filtering is painless. The last is as if I never filtered at all.

I've since switched to filtering each dose using the backfill method.(but I plan to improve this protocol using another technique).

It's not redness and irritation I'm concerned with, but building up drug neutralizing immunity to peptides.

Some pharma peptides now require filtration immediately prior to administration, and it's a common practice at the worlds most advanced hospitals,

https://jpharmsci.org/article/S0022-3549(18)30457-X/abstract

 

[JuiceStick]

Not if you want "bedside filtration", ie, filtration immediately prior to injection.

Unless you are backloading your syringes under laminar flow hood, you throw your bedside filtration out of the window by exposing solution to non-sterile air. I get that you'll remove aggregates larger than 0.22um, but Tesamorelin peptide is two orders of magnitude smaller than the filter pore size, so you you could still have aggregate polymer chains with hundreds of tesamorelin peptides slip through the filter, which I think is the concern you are trying to alleviate. In addition you are risking introducing bacteria which is filtered out by the filter by backloading the syringe.

I see no benefit in this approach compared to using a cartridge without exposure of the filtered solution to non-sterile air.

 

[Ghoul]

Unless you are backloading your syringes under laminar flow hood, you throw your bedside filtration out of the window by exposing solution to non-sterile air. I get that you'll remove aggregates larger than 0.22um, but Tesamorelin peptide is two orders of magnitude smaller than the filter pore size, so you you could still have aggregate polymer chains with hundreds of tesamorelin peptides slip through the filter, which I think is the concern you are trying to alleviate. In addition you are risking introducing bacteria which is filtered out by the filter by backloading the syringe.

I see no benefit in this approach compared to using a cartridge without exposure of the filtered solution to non-sterile air.

As I said, I plan to improve the technique, backfilling, while common, has never been ideal,

However, the presence of aggregates is nearly certain in every peptide, particularly UGL produced since they contain no aggregate inhibiting excipients, The consequences of potentially contaminating while backfilling is real, but as someone who isn't immunocompromised, nor are bacteria able to reproduce in the bacteriostatic reconstituted solution, on balance I find the risk of brief exposure minimal vs the cumulative benefit of minimizing immunogenicity.

.2um filtration has been demonstrated to remove the largest aggregates most closely associated with immunogenic responses.

Where do you get sterile cartridges for your pen? It's been a subject of much discussion, since none seem to be available for purchase.

 

[JuiceStick]

https://www.aliexpress.com/item/1005006427464838.html

There's a recent post of test results on Peppys - test server sent a batch of carts from this vendor to Janoshik for sterility testing. They passed.

 

[Ghoul]

https://www.aliexpress.com/item/1005006427464838.html

There's a recent post of test results on Peppys - test server sent a batch of carts from this vendor to Janoshik for sterility testing. They passed.

Yet they aren't sold as sterile, and the two indicators for successful sterilization are both negative.

I'm not sure how sterility would be accurately measured in a device like this, but even if a few samples test as sterile, clearly they're not being offered as such, so it's a clear risk.

 

[JuiceStick]

It's true that it is only as sterile as the last sample and the indicators for EO and steam are in initial state, but these are not the only sterilization methods - sterilization by radiation is a common method which doesn't impact EO or steam indicators.

Before the test results I was sterilizing the cartridges from this vendor in autoclave (also from AliExpress), but now I am skipping this step. It wasn't very risky with subq to begin with, and now with testing I feel like the additional steps are just not worth the time. I inject peptides through a filter right into the cartridge, remove air by purging the pen and it's good to go until it's fully used. I'll need to read up on effects of aggregate size on immunogenicity. For some reason my intuition tells me that smaller aggregates more similar to bacteria which slip through 0.22 filter are more likely to attract immune cells than bullet size chunks, but I have no data to support it, need to do some research on it to support or contradict my theory.