Thanks for all the great advice so far. I've returned from a holiday in Spain, where I obtained ampoules of Megamilbedoce (hydroxocobalamin) and have been self injecting every 2nd day to address neurological symptoms. I've got a couple of questions:
1. Each ampoule contains 10,000 micrograms in 2ml and the dose I was having at the GP was 1mg/1ml. This means that essentially I'm injecting a small amount of an ampoule each time - the dose is much more concentrated that what we normally get in the UK. I'm ok with that, and have consulted the BNF, but how do people manage the ampoule doing so many doses? I'm currently filling a number of syringes at once but have heard varying opinions on this.
2. It's hard to SI a smaller amount of fluid. Any tips?
3. The pharmacist recommended a 3 part syringe manufactured by ICO (it's an ICO plus3), which has a painless needle. I have indeed found this to be mostly painless - have others used this needle? Any reasons not to use this needle?
Thanks for any tips you might have!
Olive
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Olive1977
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Ampoules of injectable drugs (or vitamins) are designed for single dose injections only. Once the ampolue is opened, the contents are no longer sterile and are therefore at risk of becoming contaminated. So storing the B12 in syringes for later use is not recommended. Most certainly, not by the manufacturers. Sorry, but anyone who says otherwise is wrong.
I would therefore strongly urge you not use any single dose ampoule for multiple dose purposes. It's just not safe.
The exception to this is if you have a multi-dose bottle. These have a rubber bung in the top through which the contents can be withdrawn, as needed - but even these have to be discarded 28 days after the seal is first broken. (It doesn't sound as if this is what you're talking about).
It’s worth nothing that 10000mcg (10mg) x 2ml ampoules of B12 are usually used by those with severe symptoms (including neurolgical damage) who may benefit from higher than usual doses of vitamin B12.
I'm a little surprised that the pharmacist recommended a 2.5ml syringe and suspect that this was done in the belief that you intended to inject the whole 2ml on one single injections - what that particular a pouke is designed for. To draw up a small amount - less than 1ml - the syringe to use would be a 1ml syringe. This is longer and thinner and the dosage markings are therefore easier to manage to get the right dose (since the markings are further apart, so that a precise dosage can be draw up).
Two ml syringes are appropriate for injecting the usual 1mg of Hydroxocobalamin in 1ml that are prescribed in the UK.
As to needle size...the 'G' measurement relates to how thick or thin the needle is - the larger the 'G' size, the thinner the needle. So, a 23G needle is fairly fine and okay (just) for IM injections. Wouldn't go any finer that that for and IM injection.
The needle length (just under 1”) sound okay - unless you have a large layer of subcutaneous fat. If so, a needle length of 1.5” would be more appropriate. The important thing is that the needles length is long enough to reach right down in to the muscle (rather than hovering in the subcutaneous layers (fatty tissue).
When injecting via the IM (intra-muscular route), it is more usual to have a longer and thicker needle (because the needle has to go down further and inject in to muscle).
So..needle length...I have an average amount of fat tissue and use a 1” for IM injections. For the gauge ('G'), I use 21G to draw up the B12 and 23G for the injection.
Sorry it's not what you want to hear about using your ampoules for multi-dose purposes but it's really not worth risking infection, injection site abscess, or worse...
Always better to buy and use single dose ampoules of B12 (easily available from online German pharmacies - approx £1 per injection if bought in bulk).
Thanks so much for this - I have followed up on this advice (much appreciated) and gone away and bought supplies. It's useful to hear of the reason why these large ampoules are sold when the usual dose is so much lower. Thanks for the time and giving me the context.
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NEEDLES FOR SELF INJECTING B12
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