Just go ampules from Germany, need guidance please

[Iheartb12]

Hi, currently on 1000mcg/1ml methycobalimin SI that comes in 10ml vial. Wanted to change due to cost.

Ordered 1ml ampules of hydroxocobalimin from Pasco in Germany. It says 1ml per ampule and 1500ug. Pic of what I received.

From what I understand mcg and ug are the same measurement so seems the Pasco ampules are stronger. Am I right? I think it's ok to increase my weekly dose or should I inject less of the Pasco? If so how much less?

I looked for videos online about how to use ampules. The one decent video I found showed breaking the top of the ampule then turning upside down like you would with a vial. None of the liquid poured out? Is this how the ampules work? I'm questioning because I see that some of the amule tops are filled with b12 so doesn't look like the liquid stays in the base of ampule.

Also, doing subcutaneous, the needle is so small, not sure how I'd get all the b12 out if thers no seal where I can turn the amule upside down and put the needle in. Pic of vials so you can see b12 at top.

It's probably simple but I feel overwhelmed.

Eta not sure it will let me post 2 pics

[Nackapan]

Most that use Pascoe use it all.You can shake the ampoule so b12 at the bottom.

I use a snappit device to break the top.

I use a 21G needle to extract tge b12 .

I don't turn it upside down just draw it up. .

The flick tge sides of tge syringe to get rid of any bubbles.

Push syringe uo until a tiny blob of b12 and flick it off .

I then change needle to a 30G

27-30 G suitable for sc .

[Nackapan in reply to Nackapan]

You line the dot up with dot on snappit device Ot if using a tissue snap back with dot at the front

[Iheartb12 in reply to Nackapan]

Thanks for walking me through it. May I ask what is the purpose of changing the needle gage? Is the length different between the 21 and 30 gage you use?

I'm sure it's an unfounded fear but worried about tiny glass slivers getting into needle.

[Nackapan in reply to Iheartb12]

Im not reliable enough not to let the needle touch the glass when withdrawing the b12 .Higher guage quicker and easier too.

If it does touch the needle blunts .

I.e painful injection..

21G isonger 1"

It's finally pushed through the fine needle.

Nurses use 23G to 💉 Inject.

The breaking of top is a clean snap.

I have no worried with this sterile regime I've been doing for 6 years now

[wedgewood]

Yes , the individual ampoules are capable of being turned upside down without spilling their contents . But you need to flick them at the top of the ampoule to get all the contents into the bottom of the ampoule before you open them . You can use an ampoule cutter to do this safely( obtainable from Amazon ) This can save you from bad cuts . The spot on the neck of the ampoule shows you where the weakest part of the neck is .

i find this quite tricky , so I extract the contents with a long 1 1/2 inch withdrawing needle into a 2ml syringe . Then , if injecting subcutaneously, I change to a short needle of 30 gauge x 1/2 inch or if injecting Intramuscularly, I use a 27 gauge x. 1 inch needle Then expel any air that is in the syringe until a drop of red B12 appears on the top of the needle . The higher the gauge , the thinner the needle .

I hope that this helps you .

Best wishes

[wedgewood]

It is not necessary to use a filter needle to extract the B12 , but if you are really scared of shards of glass you can obtain such long needles. They are quite expensive compared to the usual needles . Search for “ Filter Needles “ from your supplier . That should put your mind at rest . But as I said , not necessary. But peace of mind is important . Best wishes .

[Jason_h123]

for snapping the top off it is very easy to remove the plunger from a spare syringe and use the inverted body over the top of the ampoule.

[Bellabab in reply to Jason_h123]

Yes it is and I use that method. I also hold the body of the ampoule in a length of aluminium tube which is just wide enough to slip the ampoule into it. This gives me extra leverage so makes the cracking easier.

[Cherylclaire Forum Support in reply to Bellabab]

I use the wrapper of the syringe to break off the top of the ampoule - learnt that from a video. I liked the dual purpose ! Snap cleanly away from you with dot facing you. Draw up with a longer needle, which will then be blunted on the glass bottom of ampoule so needs changing.

I have heard here many times that you can turn the ampoule upside down but never actually wanted to try, just in case I wasted valuable B12.

If you keep B12 in the fridge, don't allow it to freeze. When you take an ampoule out allow it to warm up first before using (hands/bra/pocket). It is then more liquid and more at blood temperature - so easier and less stingy.

If using an antiseptic wipe, allow skin to dry out first - less stingy.

It should not hurt.

If intramuscular injections : use smaller blue needle (I now use 1") when injecting, flick syringe to ensure no air bubbles trapped in liquid, use plunger to expel air from needle - if a drop appears on tip of needle, flick syringe to remove it as it can sting a bit otherwise. Then inject into middle third of outer part of thigh. If you tense muscles, you can see where a good place might be. Relax muscles and give yourself plenty of time. Then relax more ! Slowly and smoothly with the needle, and then with plunger even slower. Otherwise can feel a bit like lead going in if too fast, even when warmed up.

I try to do alternate left/right leg - but often do right leg more often, as right-handed and easier for me. Bit lazy ?

If subcutaneous injections: ask Nackapan !

[Doris11]

you need to flick the top so it’s goes into the vial and snap off top where the dot is. Be careful when snapping top! off! if you are right handed hold vail in left hand the dot should be facing you. Use a tissue folded ( I use syringe paper) then snap away from you. Use you syringe and green needle to draw up liquid then swap needle to orange small needle and inject (SC) subcutaneous under skin.

[Bellabab]

I inject Pasco 1500 ug ever third day. It saves me money & time and I find it works very well and the average dose is very similar to 1000 ug every other day.

[Hockey_player]

Someone else was telling me I should use 2 needles. If I had B12 like that I think I would. My B12 comes in a bigger 10 dose vial with a rubber seal on top of it. It is easy to get one dose out of the vial without bumping the tip of my needle on it. Because I am not breaking glass, there is no worry about getting glass in the needle. I see now what they may have been saying...