Everyone on Forteo discard after 28 days?

Hi @redlo, the instructions in the Foreto Website says this:
“Inject FORTEO one time each day in your thigh or abdomen (lower stomach area). Talk to a healthcare provider about how to rotate injection sites.

Do not use FORTEO after the expiration date printed on the delivery device and packaging.
Throw away the FORTEO delivery device 28 days after first use.

The FORTEO delivery device contains 28 days of medicine. Throw away the FORTEO delivery device 28 days after first use, even if it is not completely empty.
Do not inject all the medicine in the FORTEO delivery device at any one time.

It’s appears there should only be enough medication for a total of 28 days taken at the proper dosage. If there is liquid remaining it may not be enough for a complete dose of the medication and should be discarded.

Companies err on the side of including a few extra doses in something like a pen rather than risk underfilling a pen. Standard practice.

There are definitely more doses in the pen. I believe the 28-day limit is because they can't guarantee the effectiveness of the preservative that is added to the medication. It's not as if day 28, the medicine works, and day 29, suddenly it doesn't. Same story with Tymlos.

Others here have said that they've gotten away with using the pen for a couple more days, and in some cases, the doctor said it was ok. I don't think a day or two is going to matter, in my opinion.

@loribmt, I don't know anyone who tosses that extra dose of liquid gold. I've heard of people refridgerating the pen especially when they have to miss a dose or two.

I got rid of the Forteo pens after 28 days use, with 2 exceptions - on one occasion the shipment was late, and with the very last pen. When using the pens beyond 28 days, I made sure the liquid is clear and colorless. Each pen does have at least 3-4 extra doses. The problem is there isn't anything available to read about the stability of the liquid other than to follow manufacturer's instruction. The only relatable reference I've encountered is about the stability of lyophilized teriparatide after reconstitution.

I don't believe the 28 day limit came from tests of potency loss after 28 days. After all, if you note the expiration date on the box it'll typically be about a year. It may be from testing how many times new needles can be reliably poked into the injector's rubber end.

But in my opinion it would neither be necessary or desirable to discard the injector after 28 days. Nor dangerous to keep using it. There is if I remember right enough in it for something like about 32 days

Here's the OTHER ridiculous thing about that stated 28 day limit.: When Lillycares has the pharmacy they use what is on there own records per the prescription they are filling a "one year" supply, they ship over the year 12 injectors. If they are only useable for 28 days, the comes to only 336 days... not a year's supply. I suspect many if not most Forteo users us the pen past 28 days. If they really expected the patient to stop at day 28 they'd have to ship 13 pens to fill one year's prescription.

I took Forteo for 2 years and injected the full pen. I ignored the 28 day thing. No problems!