How many doses does an 80mcg Tymlos pen have on average?

Posted by healthmatters @healthmatters, Sep 6 8:25pm

And has anyone ever considered injecting near the buttocks? I ask this because I have read some persons reporting an increase of belly fat when they inject Tymlos on their belly.

I did search and read that someone was injecting near their buttock area.

I pondered the many reasons injecting near the buttocks may or may not work - reaching the area to inject easily, vascularity, different or slower absorption? I also wondered if the absorption needs to be immediate or delayed to work and if a slow release might diminish the fast heart rate some of us might experience.

So much to consider!

I mean once the medication is under the skin where does it have to go but through the subcutaneous fat on the belly's and buttock's capillaries.

I would think the buttocks are not as highly/densely vascularized at the belly fat but .... is that the case?

As far as reaching the area, and IF the absorption is complete even if slow, I would find a way to inject in the buttocks if it would avoid the belly from becoming fat. If I did it, I would actually alternate sides.

Maybe there is a study which can explain it.

I am 5'6" and 102 pounds so there is not much fat on my buttocks ;( - it would seem it would absorb there just as well as my belly.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

To confound the issue, Lily says in their medication guide that Forteo may be injected into abdomen or thigh. Very similar medications.

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I'm sure injecting into your buttock should be okay.

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I think thigh is a better alternative.

I have a kid with type 1 diabetes. I know that insulin is absorbed better and faster in the abdomen. Thigh is next option. But pump insertions are often in the buttock which means insulin can go there too. I assume the same would be true for Forteo or Tymlos but it is easier to do tummy or thigh.

For me the issue of "belly fat" was not an important concern. I wanted the best absorption. It is true my belly got a little puffy but as soon as I stopped after two years it was fine. The puffiness did not affect my clothing fit or anything like that and it was minimal for me. I wanted the best health outcome and belly was the best site in my view, though a couple of times I did try thigh. Up to you!

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The absorption rate for a subcutaneous injection in the abdomen is faster than in the buttocks:
Although this information is about Insulin, it is probably the same for our injections:
Abdomen: Insulin enters the bloodstream most quickly after an abdominal injection.
Upper arms: The body absorbs insulin at moderate speed but slower than an injection in the abdomen.
Thighs: Insulin enters the bloodstream less quickly than the abdomen or arms.
Buttocks: Insulin enters the bloodstream most slowly from this site.

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I had a slow response to teriparatide and wondered if it was because I was injecting in the thigh. I found this
" the average lymph flow rates from human anterior trunk, arm/shoulder, and thigh are 2.8, 2.0, and 4.2 cm/min, respectively [8]. In addition, SC adipose tissue blood flow (ATBF) in abdominal region is higher than that in femoral region, especially under postprandial state. Abdominal ATBF is maintained at >30% higher than femoral ATBF (4.0 versus 3.0 mL/min/100 g adipose tissue) for at least 6 h post a meal [9]."
And then this:
"The bioavailability of SC administered drug product can also be affected by presystemic catabolism (proteolysis or macrophage clearance) that occurs at the injection site or/and during lymphatic transport. "
https://www.sciencedirect.com/science/article/abs/pii/S0168365921003369?via%3Dihub
Now I'm injecting in the belly.
I do think the buttock is safe. Most injections there are long needled enough to reach the muscle

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First, EXCELLENT rundown.

Second, you wrote "I do think the buttock is safe. Most injections there are long needled enough to reach the muscle."

So Tymlos can be injected both subcutaneous and intramuscularly?

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@healthmatters

First, EXCELLENT rundown.

Second, you wrote "I do think the buttock is safe. Most injections there are long needled enough to reach the muscle."

So Tymlos can be injected both subcutaneous and intramuscularly?

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Tymlos is for subcutaneous injection and each pen has a 30 day supply of 80mcg (full dose).
https://radiuspharm.com/wp-content/uploads/tymlos/tymlos-prescribing-information.pdf

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Each 80mcg pen, if fully injected, is good for 30 days, although there was always a bit left in the pen at the end of that time period. I always injected in my belly, rotating the area. I did encounter increased belly fat with Tymlos but I had a 15% gain in my spine and 3.5% in my hips after 2 years, so I’ll deal with the extra fat for now. I finished my protocol in June and the belly fat is still there. Hoping it decreases as time goes on. With osteo and the med choices, there are positives and negatives. This journey is full of decisions and we do the best we can with what we are given. Every drug comes with potential side effects. We are all different and if a med causes a side effect, we have to weigh the risks versus the benefits. I’m glad I stuck with the full 2-year protocol. Wishing you a positive experience. 🌹

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@windyshores

Tymlos is for subcutaneous injection and each pen has a 30 day supply of 80mcg (full dose).
https://radiuspharm.com/wp-content/uploads/tymlos/tymlos-prescribing-information.pdf

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I was having a lot of bubbles appear in the Tymlos pens mid-cycle. When I called Radius, they said each pen has 6 extra doses at 80mg. For bubbles, they said to release injection straight up as in starting a new pen. And I could do this up to 6 times each pen. Bubbles were only in that one pen and I did the releases and had plenty to finish at full 80
for 30 injections.
Hope this is helpful!

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@esb13

I was having a lot of bubbles appear in the Tymlos pens mid-cycle. When I called Radius, they said each pen has 6 extra doses at 80mg. For bubbles, they said to release injection straight up as in starting a new pen. And I could do this up to 6 times each pen. Bubbles were only in that one pen and I did the releases and had plenty to finish at full 80
for 30 injections.
Hope this is helpful!

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When you first prime it, flick the pen with your index finger to get air bubbles up to the top. Then do a full dose into the air to release the air bubbles. Air bubbles of course affect dosing.

My kid has type 1 diabetes and air bubbles have a serious impact on insulin delivery and can result in very high blood sugars, whether in a syringe, pen or pump line. I have gotten pretty good at flicking them up to the top!

@esb13 I am curious how air bubbles made their way into your Tymlos pen mid-month. I am not clear on how this is possible but if it is, it could be a concern for a lot of users.

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