Search volume for terms related to the “golden dose” of Mounjaro have by 7,611% in the last year, indicating a concerning trend amid the demand for weight loss injections. The Mounjaro pen has an excess of medication to ensure proper priming of the needle before administration and to make sure there is enough for the four doses following this each time.
Search term |
Search volume increase in the past 12 months |
|
Combined terms |
+7611% |
|
“Golden dose mounjaro” |
+5000% |
|
“Golden dose” |
+2400% |
|
“Mounjaro fifth dose” |
+150% |
|
“Extra dose of mounjaro” |
+61% |
However, instead of discarding this, trending social media videos have been circulating encouraging individuals to try out the “fifth dose”, ultimately to get more from their money. Pharmacists have warned that taking this dose can be “dangerous”, with the Mounjaro experts at Chemist4U sharing the risks of taking the “golden dose” in Mounjaro pens.
What are the risks of taking the “fifth dose”?
Risk of overdosing and pancreatic issues:
The “5th dose” or “golden dose” refers to a self-added dose to the pen’s standard four doses. It’s believed that this extra amount of liquid is added to ensure there is sufficient excess fluid to prime the pen.
The extra liquid is not a measured or intended dose, and its volume may be inconsistent, which can lead to underdosing or overdosing and even the risk of injecting expired medication.
Trying to extract a fifth dose can also damage the pen, increase the risk of side effects, and disrupt your treatment plan. For your safety and the effectiveness of your treatment, always use your pen exactly as prescribed and discard the pen after four doses, even if some liquid remains.
“The higher the dose, the higher the risk of gastrointestinal reactions such as nausea, vomiting, or diarrhoea as well as the potential for an increased risk of pancreatic issues.”
Ayesha Bashir, Prescribing Pharmacist at Chemist4U
Sterility and performance impact:
The Kwikpen used to administer Mounjaro must be discarded after the four doses, or after a period of 30 days after the first dose is used, as per manufacturer instructions.4 Continuing use beyond that may present unknown sterility and performance risks, including potential health issues.
If a user suffers side effects, dosing failure, or infection after using a pen beyond its approved use period, Eli Lilly (the manufacturer of Mounjaro) may decline responsibility, which could also undermine the legitimacy of any reported adverse event or claim.
Risk of bacterial contamination and infection:
Attempting to remove the medicine in a way not intended by the manufacturer, such as opening the Mounjaro KwikPen and extracting medication with a syringe, can compromise the pen’s sterile interior and introduce the risk of bacterial contamination or infection.
“We’re seeing an influx of social media posts with users recommending the ‘golden dose’ and showing users how to tamper with their pens, which can lead to bacterial contamination and infection. We are urging social media platforms to do more to remove this harmful content and protect their users.”
Ayesha Bashir, Prescribing Pharmacist at Chemist4U
A recent laboratory study of insulin vials from diabetic patients found that 6.2% of vials were contaminated with bacteria (mostly Gram-positive species) due to syringe reuse and poor storage conditions. This highlights how even non-clinical, household-level handling can introduce pathogens when sterile needles are tampered with or reused inappropriately.
Questions answered
Why do you think the golden dose is becoming a trend? What are the dangers of this?
“The ‘golden dose’ trend has emerged largely due to social media influencers sharing tips on cutting costs. Patients are attempting to extract residual medication from Mounjaro pens which some consider enough for a so-called “fifth dose” extending how long a pen will last and ultimately cutting expense.
This practice is not a safe one nor one I would recommend. There is a risk of administering a higher than prescribed dose resulting in unpleasant side effects such as diarrhoea. The pen device is designed for precise dose delivery and extracting surplus liquid bypasses the safety mechanism of the pen meaning an inconsistent dose.
Further to that, using non-sterile equipment or reusing needles increases the risk of infection and bacterial contamination.”
What impact do you think social media and trends around weight loss medication is having?
“There is no doubt that social media has amplified both awareness and misinformation:
Platforms like TikTok and Reddit have propagated off-label practices such as the golden dose, often without medical backing and other practices which can pose risks for patients.
Influencers may glamorize rapid weight loss, creating unrealistic expectations and encouraging unsafe behaviours.
On the positive side, social media has helped to destigmatize obesity treatment and helped some patients feel more empowered to seek help.
As a prescribing pharmacist, I find it crucial to counter misinformation with accessible, evidence-based education for people seeking weight loss treatments.”
Have you encountered any patients experiencing side effects from misusing or ‘stretching’ their pens?
“Absolutely. The pens and the once weekly dosing schedule are designed to give the optimal weight loss results whilst also minimizing the risk of side effects. Extending the gaps between doses prevents a consistent level of the medication working in your body.
People will experience more periods of hunger, resulting in overeating and hampered results. Also, when they next inject, their body will have to get used to a higher dose again, leading to potential side effects such as prolonged nausea.”
Is this issue being discussed among pharmacists or flagged by pharmaceutical companies or regulators?
“Yes, professionals and regulators are aware of the growing trend. The MHRA is monitoring it and it is discussed in professional forums. Pharmaceutical companies have also issued guidance against tampering with pens, emphasizing that they are single-use devices with built-in safety features.”
Is there a safe or medically approved way to optimise weight-loss results
while using Mounjaro as prescribed, instead of using the ‘golden dose’?
“Yes, there are clinically supported strategies to enhance outcomes safely:
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Adherence to titration schedules: Following the prescribed escalation plan minimizes side effects and improves tolerance.
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Lifestyle support: Combining weight loss treatments with nutritional counselling, physical activity, and behavioural therapy significantly improves weight loss outcomes.
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Regular reviews: Pharmacist-led check-ins can help adjust doses appropriately and address barriers to adherence.
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Patient education: Empowering patients with realistic expectations and safety information reduces the temptation to misuse medication.”
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