Global shortage, Pegasys

[FG251]

Given the global shortage of Pegylated Interferon till July 2025, I, like others, have been asked to increase my dosage but decrease the frequency of my injections.

I was previously administering 45mcg a fortnight and was told to increase this to 90mcg every three weeks. Personally I’m happy with this as my counts are stable: it utilises the whole syringe and it’s more convenient to do fewer injections. However, the 90mcg syringe (which comes in a box labelled ‘90mcg’) seems to have quite a lot of excess liquid ABOVE the 90mcg black line. Does this mean there is actually around 135mcg in every 90mcg syringe, and that I inadvertently injected more than I needed to?

I’d appreciate an answer from someone who has definitive knowledge of this, rather than an educated guess!

[Mazcd Partner MPNVoice]

Hi, I would advise that you contact your haematology clinical nurse specialist to ask her/him about this. Best wishes, Maz

[LucyAshtonGeering]

Hi,

I’ve been taking Peg for the past four years at varying dose/frequency, and now am taking the 90mcg dose once a month. Whatever size dose I’ve taken, I’ve always discarded any excess into my sharps bin, as advised by my care team. This also gets rid of any air bubbles in the needle. As Maz says, best to check with your healthcare team; in my experience, you should be taking the dose prescribed as exactly as you can.

[FG251 in reply to LucyAshtonGeering]

But on your 90mcg syringe, is there liquid ABOVE the black line of ‘90’ that you discard each month?

[LucyAshtonGeering in reply to FG251]

Yes, there’s always excess liquid to be discarded even at the 90mcg dose. I don’t know why there’s excess of it, but my medics have always said to discard what I don’t need.

[FG251 in reply to LucyAshtonGeering]

Many thanks!

[OZland]

I am unsure as am using 135mcg syringe, and since am injecting 67.5mcg am always picking syringe upwards and displacing air and liquid to 67.5 mark and then inject

[Anag]

as I have observed, when we do any injection, there is always a bit left over in the syringe. Same with Besremi.

[Mike1974]

Hi,I was on peg until August but can't get it since then so I am on a wing and a prayer at the minute but I always had to empty the excess before injecting.

The Same way as you would push the air out before injecting only keep going slowly until you hit the required amount.

[Wyebird in reply to Mike1974]

Are you in the UK?

[FG251 in reply to Wyebird]

Yep!

[Wyebird in reply to FG251]

Have you been put on an alternative drug or are they watching your condition closely?

[FG251 in reply to Wyebird]

No, they’re just rationing it nationwide and we’ll see in March at my next appointment what the availability is.

[SimonBosse]

Hi, I take the 90mcg every week. I put on the needle, and than push the plunger till a little drop appears on the needle, so all air left the syringe, the plunger is than always near the 90mcg mark. After injection the plunger is on the 0 mark, but there is still some liquid left in the top of the syringe and needle. It is not possible to use that.

I also used the 180mcg syringe (when there where no 90mcg 's available), and did twice 90mcg injection (with decontamination while alcohol). Same thing there is 180mcg of usable liquid.

So there is a little more liquid in the syringe but certainly not so much that you get 135mcg.

[Wyebird]

what a brilliant observation. I’ve been on peg for over two years and never noticed that so I just checked and mine too is over 90mcg I use the whole syringe.

Maybe it’s 90 mcg then another agent added.

[FG251 in reply to Wyebird]

That was my thought/worry. There seems a huge amount to discard and yet the pacakaging and syringe both read ‘90mcg.’

[Wyebird in reply to FG251]

Well I hope you take solace that I’ve always taken the lot.

Merry Christmas

[FG251 in reply to Wyebird]

In a way, yes! I know we need to view these things over the long term, so one smaller extra dose won’t be harmful, but I’d rather not over-medicate. My platelets were at 295 last FBC and have been stable ever since I started PEG three years ago, so I’m not worried about little fluctuations.

Merry Christmas to you too! 🎄

[AndyT]

I use 90mcg syringes and there’s normally some air but not extra liquid in the syringe. Like you, I’ve recently moved from 45mcg to 90mcg doses at extended intervals, which seems to be working OK.

I hold the syringe with the needle upright to expel the air and as soon as the first drop of liquid appears on the tip of the needle the plunger is on the 90mcg mark.

Yours sounds different so it’s probably worth checking with your clinical team.

[light]

Hi, just say that there is no global shortage of Peg, since USA never was in shortage of this medication and Australia, for rest of us, is till autumn of 2025. Wishing you well.

[Wyebird]

different to what I’ve been told. I usually come away with 6 months supply. I’m being kept on it because I need a small amount. ( 1 every 5 wks) however I’ve been waiting for nearly 4 weeks for one dose which will come via the post. I do still have one which I will take on the 31st of December. I’ll start worrying after that.