do you use the entire ampule - Pernicious Anaemi...

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 do you use the entire ampule

EllaNore profile image
36 Replies

 I just got my first B12 ampules and when I drew up what I normally do there was still 2/3 of a bottle left. Do you guys use the entire ampule everyday? My syringe won't even hold the whole bottle. Thank you

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EllaNore profile image
EllaNore
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36 Replies
Pickle500 profile image
Pickle500

May I ask what dosage you're taking? Is it 1,000 mcg (1mg) in 2ml of liquid?

The general view is to inject it all since you can't really keep what's left over but also you may miss out on the full dosage.

EllaNore profile image
EllaNore in reply toPickle500

This is what I have. I wrapped all the bottles in foil. I was only taking 12cc. One of the bottles are 4 times that. Which is fine. I think my pharmacist may have calculated my dosage wrong. I can fill my syringe 2 times with one ampule. I will have to pee myself twice too use it all. No problem.

Ampules
EllaNore profile image
EllaNore in reply toEllaNore

Darn spell check. Not pee, jab. Lol sorry

Pickle500 profile image
Pickle500 in reply toEllaNore

😂

EllaNore profile image
EllaNore

I don't think I've been giving myself enough per pharmacist calculations. Maybe that's why I haven't felt that much better. I will jab the entire ampoule from now on.

Pickle500 profile image
Pickle500 in reply toEllaNore

It does sound like an unusually low dose you had.

You've got there 1mg in 1ml which is standard dose.

Are you able to get bigger syringes, maybe 1.5 or 2ml?

EllaNore profile image
EllaNore in reply toPickle500

I can get larger syringes. I was just trying to use the same ones I use for my dogs diabetes. I will just have to get larger ones.

wedgewood profile image
wedgewood

I found that a 1 ml syringe would not take all the B12 from a 1ml ampoule . I use a 2 mlsyringe with a long coarse needle ( 21G x 1 1/2 inches ) to withdraw the B12 . I pull out the plunger and inject air slowly into the ampoule . Then change to the injecting needle 25G x 1inch for an intramuscular injection .The whole ampoule of B12 will then be sucked into the syringe when the plunger is pulled out , along with some air . I eject the air out of the syringe by pressing on the plunger , until a tiny drop appears on the tip of the needle . Ready to go!

EllaNore profile image
EllaNore in reply towedgewood

This sounds really stupid but how do you open your ampoule? I think I did it wrong. I just broke the top off. I didn't know how else to access it.

wedgewood profile image
wedgewood in reply toEllaNore

Best to wrap the ampoule in a swab and break it at the weakest point , marked with a spot on the neck . After I cut myself badly , I invested in a sturdy metal ampoule snapper ( Amazon ) There are cheaper plastic ones , but as i have to inject life-long ( P.A.) I bought a strong one .

EllaNore profile image
EllaNore in reply towedgewood

Oh okay. I thought maybe you had a rubber cap or something. I know when I shoot air into my dog's insulin bottle the air adds pressure and pushes the insulin out into the syringe easier. That's what I thought you were referring to. Yes there was quite the sharp piece of glass left over after I broke it that definitely could have cut me pretty good. I have so much to learn thank you so much.

wedgewood profile image
wedgewood in reply toEllaNore

I bought a metal ampoule snapper , and it cuts off the top of the ampoule cleanly , not making any nasty shards .

EllaNore profile image
EllaNore in reply towedgewood

Great I will look into one of those. Thank you very much

EiCa profile image
EiCa in reply toEllaNore

I wasted 3 ampoules before I bought the sturdy metal ampoule snapper. It works like a charm and is well-worth the investment.

EllaNore profile image
EllaNore in reply toEiCa

Great thank you. Is it the one that looks like a small flashlight?

EiCa profile image
EiCa in reply toEllaNore

It is! It works great.

mountainice profile image
mountainice in reply towedgewood

Sorry, I can't follow that. I use a green needle to draw up, then swap to orange and inject. Don't understand about injecting air into the ampoule, sorry.

wedgewood profile image
wedgewood in reply tomountainice

I do that because it ensures that every last drop of B12 ends up in the syringe.

mountainice profile image
mountainice in reply towedgewood

Still don't get the method. You inject air in, does that make it go up the needle and into be the syringe? I am interested as I often have some B12 left in the ampoule.

wedgewood profile image
wedgewood in reply tomountainice

I can only explain like this . When I have opened the ampoule , and placed the extracting needle on the end of the syringe , I pull out the plunger , then put the needle to the very bottom of the ampoule . ( this will make the needle blunt and result in a painful injection . Then I gently depress the plunger, putting air into the ampoule. When I then pull out the plunger, every last drop of B12 is sucked up into the syringe . I used to have some B12 left in the ampoule , But I read about this tip on this forum , and have done this ever since . It works like a charm . No wastage of one drop of precious B12 ! Then I remove the extracting needle and replace it with the injecting needle . There will be some air in the syringe , which is remove by depressing the plunger until a tiny bead of red B12 appears on the tip of the needle . It’s not dangerous to inject a little air , but best not to .

I can’t explain this any better !

EllaNore profile image
EllaNore in reply towedgewood

Thank you Wedgewood. I guess you're extracting syringe plugs the whole enough to block the air from escaping around it. Mine must not be large enough. My air just escapes around my needle. I think I need larger syringes. Mine don't even hold an entire ampoule. Thank you for being so patient.

wedgewood profile image
wedgewood in reply toEllaNore

I have found that I need a 2 ml syringe for a 1ml ampoule. , otherwise I could not get all of the ampoule contents into the syringe ! Best of luck !

mountainice profile image
mountainice in reply towedgewood

I understand now, and will try this on my next jab. Thank you! (I too swap needles)

mountainice profile image
mountainice in reply towedgewood

I tried it this morning, perfect !Thank you

EllaNore profile image
EllaNore in reply tomountainice

If your needle has an airtight fit in the opening of the ampoule and you push air into it, it will create pressure and when you pull up on the plunger the air pressure will push all of the liquid into the syringe. But it has to have an airtight seal for it to work. As far as I can tell.

mountainice profile image
mountainice in reply toEllaNore

thanks, as per wedgewood I will try this method next time.

birdsforme profile image
birdsforme in reply towedgewood

I'm sorry I do not understand all of this. When I watched the technique on how to give the injection it never mentions using two different needles. How do you get the B-12 from the needle used to withdraw and then to the needle to inject? I am in the US and new to all of this. I am a lot older and have just found out that I have the MTHFR and 677TT. Plus the Ehlers Danlos Syndrome.

EllaNore profile image
EllaNore in reply tobirdsforme

I'm confused about that too. I also heard of filter needles to make sure there are no glass ampoule fragments floating around in your medicine. But I don't understand how to get it from one syringe to the other.

birdsforme profile image
birdsforme in reply toEllaNore

Thank you for your reply. I still don't get it. Switching needles and I thought they were all one unit. Nothing I have watched on giving injections indicates any of these procedures. I am new to all of this.

wedgewood profile image
wedgewood in reply tobirdsforme

I am in the U.K.

Most people use two needles when they are using the single use B12 ampoule here in the U.K.. I know that in the USA , many people use the multi-dose vials , that are rather frowned upon here in the U.K. . This is because the multi -use vials present a greater opportunity for contamination once opened .in a domestic situation where it can take quite some time to use up the contents. When using the single use ampoules , the withdrawing, extracting needle will touch the sides or the bottom of the glass ampoule . This will make the needle blunt, resulting in a painful injection. The extracting needle can be coarse and long . It is put on the end of the syringe . This needle can be put right onto the bottom of the ampoule, extracting every last drop of precious B12 . If this needle is used to inject air into the ampoule , not one drop will ever be missed . I used this method when I found that a few drops were always left in the ampoule ! Injecting air prevents this .

Now you have the B12 liquid in the syringe . Remove the extracting needle — Fit the injecting needle onto the syringe , and expel any air in the syringe by pressing on the plunger , until a tiny drop of red B12 appears on the tip . Now you are ready to inject . I inject using the Intramuscular method ( injection needle 25G x 1inch .) . I have found this to be a fool-proof way of injection using single use ampoules.

If you use multi use vials , I expect you have a different technique. We don’t use the multi-use vials because of the safety aspect .

Best wishes .

birdsforme profile image
birdsforme in reply towedgewood

Thank you for your reply. I have ordered hydroxocalabamin from mycare-de and it will not get here until August 18th. I thought the needles were all one unit. It seems as if you have to by syringes and then the needles separate. I am new to all of this so am confused.

EllaNore profile image
EllaNore in reply tobirdsforme

Right I just realized myself that they just switch out the needle tip. How silly of me. 🤪

EllaNore profile image
EllaNore in reply towedgewood

Thank you. I feel silly not realizing you just exchange needle tips. I'm going to feel even more silly I'm sure, when I ask, how do you shoot the air in it if it's not a sealed bottle? In my dog's multi-use rubber top insulin bottle, I can shoot air in there and it adds pressure which helps to pull out the last drops. But I guess I'm not understanding the air with an open top. How does it make pressure? Sorry for being confused.

Aidan_ profile image
Aidan_

I am not on any B12 I do not know why my name was used here

Cattywampus profile image
Cattywampus

If you’re using insulin syringes then the measurement will be in units which do not equate to millilitres (ml). You need the correct syringes which you can buy or your gp can prescribe

EllaNore profile image
EllaNore in reply toCattywampus

Thank you. I think I will order them from Canada with my b12. Plus an extraction filter needle! I'm learning so much here. ☺️

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