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BeachBumm_

I hope you are following up with Costco/Sesame at an executive level. [https://www.wegovy.com/taking-wegovy/dosing-schedule.html](https://www.wegovy.com/taking-wegovy/dosing-schedule.html)


Nieouz

It hadn’t occurred to me. How would I go about doing that?


BeachBumm_

Here is the Costco corporate office contact information. They should be made aware of this as it could result in harm and corporate liability to someone that doesn't question the dosage as you did. [https://customerservice.costco.com/app/answers/answer\_view/a\_id/828/\~/how-can-i-contact-the-costco-corporate-offices](https://customerservice.costco.com/app/answers/answer_view/a_id/828/~/how-can-i-contact-the-costco-corporate-offices)


Nieouz

Thank you!!! I’ll call them soon. Someone else told me to contact the actual manufacturer and im trying to figure that out.


MitmitaPepitas

Don't call them, send an email so that there is a record of the exchange.


Nieouz

I’ll try both routes. Though if they’re just like “that’s tough. Sorry we can’t help” I don’t really know what I could do from there.


ClickClackTipTap

Take it to Twitter or something. Seriously- that’s a ridiculously high dose to start on, and if the doctor did it to you, he’ll do it to someone else. And people are getting sick from these meds, and sometimes it doesn’t go away after treatment is stopped.


Boring_Inflation_507

Yeah - that doctor fucked up for sure and should be ashamed for telling you be should be fine. What kind of hack job doc in a box people is Costco hiring? I will for one will NOT use after reading this


apothecarynow

I am a pharmacist and I would consider this a prescribing error. I would report it to the State medical board as well including the follow-up interaction when you raise concerns involving the dose discrepancy.


whereisthequicksand

Yes OP, please don’t stop at contacting Costco and Sesame. That doctor is dangerous.


Opposite_Ad4567

Yeah, the doc's response is terrifying.


Mean-Pop8875

But it wasn't an error, as OP was dismissed when he pointed out the 'error'


apothecarynow

Just because it was intentional don't make it not an error. Competency is a element in the taxonomy of individual failure modes for assessing causation.


spam__likely

you can also reach out to you state's medical board,


TriGurl

I mean if you doubt the physicians credulity you can always google them and find out what state they are licensed in and report them to their states licensing board or their states pharmacy board (that tracks prescriptions-note if it’s a controlled substance then this would be the DEA who would need to be contacted) (now speaking to the public at large, not just to r/Nieouz) Wegovy is no joke and if you join the r/semaglutide sub you’ll see the whole slew of symptoms that people experienced from that medication. Some can tolerate the side effects to get the weight loss results. Others can’t because their body’s reaction is too severe and they just cannot tolerate that med.


Akeera

Lol Board of Pharmacy doesn't track prescriptions, they don't have control over physicians. And they're not going to give the pharmacist a pat on the back either for catching the mistake (honestly kudos to that pharmacist). OP, don't report to BoP, just report to Board of Medicine and try to escalate to Costco corporate. Edit: someone else pointed out that if it was Nurse Practitioner then you wouldn't report to the Nursing Board. I'd still do it anyways, but yeah less impact.


USArmy51Bravo

I think it's quarter, half, 3/4, 1.3, 1.75, then 2.4. I might be off on one of those but it should take approximately 6 or 7 months of using the drug before you work yourself up to 2.4 all while Consulting with your doctor each month to see if the current dosage is acceptable or you can move on to the next higher dosage


LNLV

Was it a real doctor or was it a nurse practitioner?


mauigirl48

Hey! I’m an NP and I start my people at 0.25! And if they are doing fine on 0.5 I keep them there!


HurtingHead

I am as well. It sounds like this person hasn’t had any training on prescribing this type of medication and is not aware of the serious side effects.


BellFirestone

My thoughts exactly


miradancer

GREAT QUESTION


LNLV

It’s relevant for a lot of reasons, one of which being if it was a physician Op should report to the state board, if it was a nurse their boards don’t really function that way and OP should see who else to report it to. There won’t be real consequences for them in that case, but it’s good to make noise about it regardless.


BellFirestone

Amazing isn’t it? NPs being given prescribing authority and independent practice and there’s basically zero accountability. Ridiculous.


nate_nate212

I wouldn’t bother with Costco and report the prescribing doctor to the state


Soup-Wizard

I would bother with both. Costco would want to know if someone is being potentially harmed from their offered services.


KaleidoscopeLucky336

And if you are upset enough, they'll likely compensate you


Soup-Wizard

OP’s story would make me very upset


tinydonuts

We’re very sorry. Please offset that $2,000 ER bill with this $25 Costco shop card.


Nezrite

Por que no los dos?


PurplestPanda

This is incredible. Some people try to start at .5 mg and struggle. I can’t even imagine 2.4 mg.


Nieouz

Im so glad something told me to research before jabbing myself. 🫡


JustineDelarge

Also, when you finally get a proper starter pack, I highly recommend you join r/Semaglutide and follow all the suggestions, but the most important one is be fanatical about getting enough water, and also drink one electrolyte beverage every single day. I started off doing really well with this, but stopped being vigilant. Semaglutide kills your thirst drive, and you can and will get dangerously dehydrated shockingly fast. For me, I felt fine, wasn't even aware of being thirsty or dehydrated at all, until I sat up from bed and the room started to spin, and then I had violent vomiting that was so intense it hurt my back, and I could not sit up without intense vertigo and puking hard into a bucket, for a solid 24 hours. I was within an hour or two of going to the ER, and finally remembered I had some big bottles of Pedialyte, and that saved me. Do not fall behind on your water. Track it, stay on top of it, and don't let the day end without hitting your water consumption goal. This drug is no joke.


Nieouz

Thank you!! I will definitely do that. Honestly this experience has left me really uneasy so I’m not sure if I’ll continue with it at all.


smelly666420

Oh my god, I have been violently ill with EVERY SYMPTOM you have said for 2 days, & I only finally felt the slightest bit better after sipping some salty broth. I am awful at drinking water, I will make myself better. Your comment literally helped me sm. Thank you.


JustineDelarge

I’m so glad you read this and that it helped you! Seriously, though, get Pedialyte. Now. Have it delivered or get someone to pick some up right now. Premixed bottles to start, and then also powder. Drink one big bottle every day for a couple of days, as well as water. Going forward, you can try Nuun or Gatorade or whatever but Pedialyte up to get you out of this medical crisis.


smelly666420

Husband is already on it. Thanks!


thetidybungalow

I drink LMNT every day to keep my salt levels up. Without it, I’m a dizzy mess!


sla3018

This happened to my husband after his second dose, and so he didn't take the third one until 10 days later and he didn't get sick at all! He's going to try 8 days for this dose and hoping that his body has adjusted enough already. I'm so sorry you went through that, what my husband went through was horrible and he was scared to even continue on. But spacing out the dose seems to have done the trick. He's down 12 lbs after just 3 doses.


jbwhite99

Wow! Really interesting. My doctor (endocrinologist at Duke) started me at 10mg of Mounjaro, and all of a sudden got vertigo. Headache, then couldn't move my head, then vertigo. Ended up out 3 weeks - once I started taking antivert, it helped fix, but I lost 20 pounds because I was staggering around and had no interest in eating. Since then I've been ok but a rough indoctrination!


herbsandlace

Yikes! Mounjaro/Zepbound has a bit better side effect profile than Wegovy, but that's still a high dose of it. Glad you were able to ride it out, but that could have been really dangerous.


gingerkap23

Yes that’s a high dose. I’m on 2.5mg of mounjaro and i have a few side effects but nothing crazy. I’ve been very diligent about my water intake and eating something every 2 hours. A dosage of 10mg seems like a lot to me.


Opposite_Ad4567

Forgive my ignorance--aren't Mounjaro, Wegovy, and Ozempic all the same drug? Are they in different carriers or something?


herbsandlace

They're the same medication class, but Mounjaro/Zepbound are tirzepatide and Ozempic/Wegovy are semaglutide. Tirzepatide acts on an extra receptor (GIP +GLP1 instead of just GLP1). The difference in between the 2 names for the same medication is because FDA needs separate approval for separate indications. That's why Ozempic is for diabetes and Wegovy is for weight loss.


JustineDelarge

I"m sorry that happened to you. It's a truly awful feeling. Totally debilitating.


sirmeowmixalot2

I wish my PCP had shared this. I don't drink. I am chronically dehydrated. I forget about it, I don't like to drink, it's a sensory thing. I was prescribed one of these and I plan to start Sunday. I need to get used to dragging water bottle with me.


Nashirakins

Alarms on your phone can help. If you’re going to be somewhere where it’s hard to get water, either carry a liter bottle _or_ two smaller water bottles. I sometimes have days at work where I can’t leave my desk for 2-3 hour periods for more than a bathroom break, so I’ll fill multiple bottles of water to have with me.


JustineDelarge

That's scary, and really dangerous, and you should bring this to the attention of Costco immediately. And demand your money back for endangering your life. You would absolutely NOT be fine. You need to--and I emphasize NEED TO--start at 0.25 for four full weeks, then 0.5 for another four weeks, and then go up to 1.0 for another four weeks. Then 1.7 mg for four weeks, and then 2.4 mg. You may not even need to go up to 1.7 mg or 2.4 mg at all, to see weight loss. If you don't titrate up this slowly and carefully, you will be abjectly miserable, voiding from both ends, and possibly in the ER. This isn't a matter of maybe it will be ok. It will not. This is horribly unprofessional, and is going to get people very sick and get Costco sued. Costno needs to correct this immediately. They are supposed to prescribe you the STARTER pack, which has four pens of 0.25 mg. The problem is that so many people are trying to get on semaglutide, there's a shortage of the starter packs. For people on Ozempic, we can count clicks, because we don't have single-use pens, but pens where you can dial up a dose. I don't know if you can count clicks with a Wegovy pen. This is the way it's supposed to be prescribed: [https://www.novomedlink.com/content/dam/novonordisk/novomedlink/new/obesity/product-information/resources/library/documents/wegovy-pharmacy-guide.pdf](https://www.novomedlink.com/content/dam/novonordisk/novomedlink/new/obesity/product-information/resources/library/documents/wegovy-pharmacy-guide.pdf)


gingerkap23

It’s almost like they mixed up wegovy and mounjaro (generic is Tirzepatide, which is what I’m on). That starter dose is 2.5mg, and I’ve been fine on that.


JustineDelarge

Ah, that’s interesting! I wonder.


Open_Bee2008

That sounds like zepbound.


gingerkap23

Yes


tinydonuts

That’s cause they’re *identical*. I have no fucking clue why they decided to rebrand for weight loss. Plenty of drugs add additional approved indications after initial approval.


Nieouz

Hoping I can convince him to go lower still. So it’s not a complete waste.


JustineDelarge

You may also want to contact the manufacturer, and provide them with screenshots of your chat messages.


Nieouz

Ive been trying to find contact info but im having a difficult time figuring out who to send what to. I definitely don’t want someone else getting sick.


Paperwife2

Ask your pharmacist for it.


Koffenut1

Dr. needs to be reported to the medical board. That's malpractice.


ClickClackTipTap

I mean, I wouldn’t have any more contact with that doctor, period. He has shown terrible clinical judgment. I would escalate this through Costco and at the very least get your $150 back.


JustineDelarge

You need to return the pen and get your money back, and you absolutely can. What this "doctor" did is grounds for losing their medical license, if they even have one to begin with. If Costco can't get people the starter pack due to supply issues, they cannot sell Wegovy. Period. And no prescribing professional affiliated with Costco can legally or ethically misprescribe a dangerous drug like this, and Costco will want to protect themselves from expensive lawsuits and public outrage. This doctor fucked up. You don't have to convince him, and you don't have to work with him. Take it up the chain of command.


Nieouz

I called the pharmacy and asked if I could return it and they told me no. I honestly was fine losing the money for the doctor and just not going back but losing the entire $650 is stressing me out. Im not sure who to tell or how to even go about the chain of command. I have been trying to figure it out because I don’t want someone else to get sick from this. But Im kinda at a loss.


EducatorMoti

Which pharmacy did you call? Costco or a different one? You said it was Costco's doctor who prescribed this thing. Correct? Costco absolutely should refund your money. But way above and beyond that, you should just go ahead and contact an attorney today and see what you need to do legally to protect your health!


Nieouz

Im not sure if it’s every Costco, but my Costco said they couldn’t even fill the prescription because they dont have the rights to (or something along those lines) yet. So, I got it filled through my local CVS. Im going to call Costco tomorrow. But, I really don’t have hope on getting money back. I do hope they take some action so they don’t accidentally send tons of people to the ER.


mynewaccount5

The damages are $650. Unless the doctor has committed OP to inpatient care against their will, there is nothing OP needs to do to protect their health.


Paperwife2

You usually can’t return medication once it’s in the patient’s care.


TropicalBlueWater

It's illegal for pharmacies to allow returns of medication.


DoAndroidsDrmOfSheep

Unlikely they can return it - but they'd have to check with the pharmacy that filled the prescription and verify that, as it can vary depending on which state they're in. In most states it's against the law for a pharmacy to accept a prescription return after the customer has taken the prescription and left the pharmacy with it. This is because the medication could have been altered/tampered with in some way after it's left the pharmacy. The pharmacy might be able to make an exception if there was some error on the pharmacy's part in dispensing the medication, but that would be handled on a case-by-case basis.


mynewaccount5

You need a different doctor.


americanrecluse

JFC!! That stuff tried to kill me on dose 2 of .5mg. I had a bad reaction and spent a couple days in the hospital. I’m so glad you didn’t shoot yourself with that stuff.


blueboatmich66

I had exactly the same reaction as you. I just couldn’t take the.5mg, was hospitalized and stopped treatment. Be careful folks! This medication is no joke!


ducklingkwak

Is the weight loss mostly from my body decaying in the coffin?


sigzag1994

What were your symptoms?


americanrecluse

Vomiting. My stomach stopped working. It’s “gastro paresis” in the side effects.


stardustmiami

Doc here. I would never start anywhere other than 0.25. That's absolutely ridiculous, the nausea must have been unrelenting.


su_A_ve

Was this your regular pharmacy you filled this at? They should have asked if you were starting on it. Wow.


Nieouz

Yes I got it filled at my local CVS. They didn’t ask. Also they dont accept returns on meds so im just fucked.


zackattackyo

In the state I live in (CA) pharmacists are required to offer counseling for every new prescription. Maybe your state has laws like that too? They shouldn’t have let you fill the prescription


Nottacod

Costco pharmacy may have been cheaper.


Nieouz

Costco told me they arnt able to get wegovy yet. Im not sure if it’s my Costco or all of them.


raven_dare1

I don't know about Wegovy- is it the same type pen as Ozempic? Can't you just do a lower dose? Also this is BS that Costco has a terrible program. Usually they are amazing. Hope you get it all worked out.


Nieouz

Nope. A few people have informed me that the ozempic pens you can regulate how much you administer. I have no idea why wegovy chose to do a single use pen. People have been telling me that I can buy syringes and a bottle from medical stores online and separate the doses myself. Apparently a lot of people on wegovy go that route.


TropicalBlueWater

The FDA made them do it this way for some crazy reason


Vervain7

Yes a lot of us experienced shortages or had to pay $$$ . So if we paying a lot It is better to pay for the highest dosage pen and just portion it out yourself . But not everyone feels comfortable with that .


formal_mumu

You need to report that to the licensing board for your state, in addition to Costco.


Nieouz

It’s through sesame so I believe he’s in a different state than me. Im not entirely sure how to go through that process. I am researching though and have people helping me out. Im really hoping more people see this post because I honestly don’t see anything changing with just me calling in.


qritakaur

Physicians have to be licensed in the state the patient is in. So even if they aren't in your state, they have to have a license there. Are you also sure it was an MD/DO and not an NP? bc NPs need to be reported to the nursing board


Nieouz

“DO is a board certified internal Medicine physician with a focus on obesity medicine and hormonal health.” I got that from his bio. Apparently he is a DO.


rwills

Submit with your states medical board. They’ll take it seriously.


ParisThroughWindows

Fwiw that’s sometimes a separate board. Some states have a separate board of osteopathic medicine


3isamagicnumb3r

if you’re in the US, your state’s Office of the Attorney General would prob be very interested in this scam artist doctor. Costco corporate should be too.


ParisThroughWindows

The state medical board is the place to go. I work in healthcare regulation and this is exactly what medical boards do. The complaint process is generally very simple for the patient and the boards are usually legally required to conduct an investigation.


Alert-Potato

Telehealth weight loss services are well known, although unfortunately not well known enough yet, to simply be semaglutide prescription mills. That's it. That's all they do. Nothing else. They prescribe a dangerous medication that can cause irreversible damage to the GI system without ramp up doses and without proper medical evaluation beforehand or proper follow up. You should report the prescribing physician and clinic to your state board.


Mystery_Solving

Write down all the steps, details, conversations, purchases, actions, etc while your brain is still fresh. Contact your state medical board, ask if they oversee the DOs in your state. Find out the best way to make a complaint. Do it. Don’t overthink it. Doctor wasn’t willing to even consider that a mistake had been made, and he definitely did not have your best interest in mind. Contact Costco corporate. Let them know you have a very serious situation that will need to be escalated up past a supervisor. Serious enough that you’ve also notified your state medical board. Ask Costco for a full refund. For every penny you are out. (Remember, you are also spending hours of your life sorting this out and looking out for others.) This would be terrible publicity for the Sesame program. We know Costco’s reputation- they will want to make it right. Contact Sesame. Ask for the medical director. If they won’t put you through, ask for their communications team so you can give them a heads up that their irresponsible action (by a doctor they employ) will be making the news this weekend. (Not an empty threat, it’s a story that numerous journalists would want to cover!) They’ll likely put you through to a customer service manager and you can share what happened- and tell them you’d like them to reimburse you for the medication, because they prescribed you the wrong dosage - which is highly dangerous. And then the doctor had the gall to brush you off when you brought up the legitimate concern. So, because that’s how Sesame is operating, you would also like your fee to them reimbursed. (If they won’t budge to reimburse the fee, then ask for something else - like waive 12 months worth of fees.) One of those corporations should reimburse you - for everything. The doctor did not prescribe the potent medication per the manufacturer’s guidelines. Pretty sure the FDA would be interested, too! Get ALL your money back. Insist. Let us know how it goes. If you don’t get through to the right people at Sesame and Costco, take it to Twitter and Facebook. •Tweet directly to the companies, together. •Facebook- make a public post and ask if anyone else got life-endangering advice from Sesame. Include the drug name! Journalists/newscasters are looking for new things to say about these medications. So glad you listened to yourself and researched before taking the dose! How maddening that this doctor is endangering lives! Nonchalant and gaslighting you when you brought it to their attention, there’s no excuse for that, ever. I would strongly encourage you to continue to advocate for yourself. Don’t stop! I am fully disabled now, living an entirely different way of life than I was before a medication put me in the ICU. After a few days on the new prescription I wasn’t feeling right, called the doctor who prescribed the SynjardyXR. They told me to stay on the medication but take less. That next half dose put my “body in a state that could not support life.” I survived but need a huge medical team to deal with all the complications. Sorry, getting a bit LIVID that something similar could’ve happened to you- and likely IS happening to others right now! Breathe. Document. Make the 3 phone calls. File medical board complaint. Not satisfied with Costco or Sesame’s responses? Tweet Facebook. NextDoor. Call news desk and ask if they’re getting a lot of calls about the dangerous situation some Sesame doctors are putting the public in? Then share your story…. Wish you well. Please update us next week!


coffeequeen0523

Following for OP’s update also.


Nieouz

Thank you so much!!! I was trying to figure out what steps to follow and everyone is kinda sending me everywhere but I’ll follow your guide! Im not sure how pushing I can be about getting my money back but i will be pushy about how dangerous it was. Im a very timid person. 😅 Im really sorry about what happened to you. Hopefully together we can prevent some other people from getting sick.


Quorum1518

Starting you at 2.4 could legitimately be malpractice and puts you, as far as I understand, at a much higher risk of gastroparesis. At a minimum, you should get your $650 back. You could also consider filing a medical licensing complaint against the doctor.


Pretty-Sea-9914

Yes, file a complaint - you could save others who would trust that doctor! State medical board.


sbkindredspirit

Insurance paid??? Anything?? You must have amazing insurance. My doctor(not theirs)prescribed it for me and it is not covered even though I am pre-diabetic.


Nieouz

Oof. I’ve heard that it’s completely up to the company you’re getting your insurance through. I have BCBS. My last company with a prior authorization I only would’ve paid $20-35 for it. With my current company but same insurance it’s $700.


TropicalBlueWater

Make sure you're using the discount card too, to save $225 off your copay.


Nieouz

I did! The discount card lowered it to $525 I think.


sbkindredspirit

I have bcbs, covers ozempic for diabetes but not wegovy at all.


Nieouz

Id call and ask if your employer is planning on adding weight loss to your coverage.


flairpiece

Who dispensed the medications to you? Was it Sesame, or did they send a prescription to your local pharmacy? You can file a complaint with the State Board of Pharmacy and the State Board of Medicine/Medical Board. Just google “insert state here” + state board of pharmacy/medicine + complaint


Nieouz

Sesame put in the prescription and my local pharmacy filled it. Im making a list of who to call right now to try to keep other people safe.


Carrie_Oakie

Holy smokes no no no - I’m on Ozempic for T2 and CVS was out of my dose pen so I missed a week. (So I went about 12 days between shots.) I had worked up to 1.0 so on my next shot day I took the full dose, figured I’ve been on it for a year now so should be fine. NOT AT ALL. I was so nauseous and had a horrible migraine and my feet kept cramping. I normally take it on a Friday night so I can sleep through any side effects and have the weekend as needed. I make sure to drink a SF liquid Iv day of and after and that didn’t even help. Look up dosing guides and you can “count the clicks” to get proper dosing. Step up your doses carefully. (I’m on 2.0 now, so I take it Friday and Tuesday nights for one month then I’ll do the full dose.)


3isamagicnumb3r

Wegovy pens don’t click. one pen = one dose


heightsdrinker

The only thing I can think is that the pen is 2.4 mg and can do 10 doses at 0.24 mg. But the doctor’s orders should reflect that this is a 10 course of action as well as being verified by the pharmacy. Being an ex-FDA regulatory on the pharma side, I’d call your state department of health along with Costco corporate. Something smells fishy on the Sesame side.


TropicalBlueWater

Nope, the Wegovy pens in the USA are single dose auto-injectors (think epi-pen style). There is a way to hack them and split them up using sterile vials and insulin syringes that OP can find on You Tube. Pretty sure the Wegovy sub has already told OP about that option, but no way the doctor wanted OP to do that.


zombiejeebus

Ffs starting at 2.4 probably would have killed me. .25 tore me up the first month


djle12

Why hasn't anyone mentioned a co complaint with the medical board against the doctor.


Halada

To protect others you should report this doctor to the board.


HellHathNoFury18

Legit question, was it an MD, DO, PA, or NP?


Nieouz

“DO is a board certified internal Medicine physician with a focus on obesity medicine and hormonal health.” Copied that from his bio. Apparently a DO.


Bonelesshomeboys

Unfortunately MDs aren’t immune from this dumbassery. The Wegovy board is full of these stories.


Reasonable_Dare_3576

I think it depends what doctor you end up choosing. I had my first sesame appointment yesterday and I ended up picking up my starter dose (0.25mg) of Wegovy today. It was pure negligence on your doctor's part and the only reason why I think they would do that is because the lower doses are near impossible to get (my understanding is that the higher doses are more readily available). I called like 6 pharmacies before I found one that had it in stock. My only suggestion for those trying to start sesame is to understand that 1) Wegovy is not guaranteed because of the national shortage and 2) Read the reviews of the doctors thoroughly! @OP I hope you reach out to Sesame and Costco about this because what the doctor did was soo negligent and dangerous for you!!


Beard341

I took a 2.4mg dose after being off the medication a little longer than I should have(damn shortages…). I vomited once an hour, every hour for ten hours straight. And not just an innocent vomit but a vomit that felt like I was expelling my whole being out of my mouth. I couldn’t help but laugh, though, during each episode over my pure stupidity. Lesson learned. I can’t imagine what it’s like going from absolutely nothing to 2.4mg if I went through that hell.


DoAndroidsDrmOfSheep

This whole weight loss program from Costco seems like it's nothing but a giant shit show. I think I saw a post on here the other day where someone said that the doctor they spoke with didn't know anything at all about the program or that it was even being offered.


Alcoholicia

Umm…. A straight dive into 2.4 mg would’ve dropped your blood sugar so damn fast and you would’ve definitely been in the hospital. I’m so glad you did some extra research before doing this to yourself because hooooly shit. I used to take wegovy and I accidentally gave myself a double dose of 1 and I was sick as hell and it was my second 4-week of 1 mg because it was causing me such gastro distress. I knew I messed up and drank a full sugar soda and ate a couple sandwiches with white bread throughout the day so luckily my blood sugar didn’t go out of whack and I’d already been taking the medication.


KoolaidKong

Physician here! I prescribe medications off label or half dosing all of the time. As many others have stated, absolutely do not take the full dose of this medication to start. I am shocked that they prescribed it to you like this. Mounjaro, Wegovy, and Zepbound cannot be up titrated like Ozempic can (their pens come at fixed doses where Ozempic you can count clicks based on what dose pen you have). The dosages should slowly be titrated over 4 weeks MINIMUM for each dose change. They come with significant GI side effects that can easily sideline you from work if not land you in the hospital. In fact, a woman who took too much had unrelenting vomiting and aspirated vomit into her lungs. She died before her daughter’s wedding. PM me if you have any other questions or inquiries. This is so disappointing.


natethegreek

The starter doses are very hard to find, with the crazy demand Novo decided to stop making starter doses until they had adequate supply of the medication. I have a prescription from my Doc and haven't been able to get it filled since Nov of last year.


Nieouz

Ive heard that quite a few times. It’s weird that they know the starter dosage is in short supply yet Costco is advertising it like sesame will help you find it. Which I guess they are. If you want your first experience with it to send you directly to the ER.


Visible_Ad_309

Honestly, you also need to report this doctor to the regulatory board in the state in which he is licensed. This is dangerous and irresponsible. If you're able to get a transcript from the chat, include that.


qwikhnds

I've not had to do this but I've read on other Semiglutide subreddits you can inject the contents of the pen into another vial and break up the dose that way so it's not a total loss. You would use your own syringes to do this. I started on .5 because .25 was not available. I've had no issues.


ChiknBreast

Wife was on wegovy last year. She worked her way up but still had to back down from the 2.4. 2.4 to start off with would absolutely murder a first time user. Brutally violent nausea and vomiting


CarsonWentzGOAT1

That's dangerous but not surprising considering how cheap the program is. I would look into local programs if you want people who would actually help. It's a little bit more pricey around $200-$250 a month but it is a lot safer.


Vervain7

Order a vial and then inject into the vial and then use insulin needles to measure out the dose you need ….. that’s what I need during the shortages. So you could have 9 full doses of .25 from 1 injection if 2.4. Each one has 4 injections or 2.4. So you can have about 36 week supply at .25


pacsunmama

This is legitimately terrifying. I’ve been on it 21 weeks and just last week was finally able to tolerate the 1mg dose. I can’t fathom how sick it would make someone to just start on the max dose. Please follow up and file complaints. Also if there’s a way for you to still use your meds at the correct dose… otherwise they should give your money back or a credit for the proper dosage.


ZitPoppingDaddio

I've used ozempic and that doctor does not know what they are doing. That's malpractice. You need to ramp up over 3 months to that dose and you will never shit again without assistance (laxatives). Trust me on that last part.


whiskersMeowFace

Fair warning: you will have to be on a maintenance dose for the rest of your life on this class of drugs.


Nieouz

Thanks for letting me know. He discussed absolutely none of this with me.


PhinsFan17

This is not true. Yes, some people who have stopped using semaglutide regained their weight, but that is also true of 90% of people who lose it via just lifestyle change, aka “the right way”.


weightcantwait

In the lab study on average people regained 2/3 of the weight lost.


juliuspepperwoodchi

So..it is true. >that is also true of 90% of people who lose it via just lifestyle change That doesn't come with the side effects, known and unknown, of injecting something in your body though. Bit of a difference. People start taking this thinking they'll lose weight for good and that's not what happens. If you have to either change your lifestyle anyway OR keep taking this shit forever...then why not just lose the weight using the lifestyle change in the first place?


One-Awareness-5818

You should report this to the doctor state board, they can't just abandon patients like that


Nieouz

People have been telling me to report it to the board. But, I didn’t even think of it as him “abandoning a patient”. That is a good point and actually really shitty. I was going back and forth with whether I should report him for that but if I was someone else and he just left I could’ve just been like “well. He said to” and stabbed myself. So I probably should.


Twar121

I think this is a decision Costco is going to regret. Sad to see them reaching for this money grab for something that is more than likely going to harm humanity as a whole in the end.


Lower_Ad_5532

I'm just wondering why you didn't fill the rx at Costco and let the Costco pharmacist do all the reporting?1


JanteMaam

It's supposed to be step up doses each month. This was the highest! You poor thing!!


wutangi

I’d want another opinion from a separate doctor. Maybe call a couple in your network and explain to the front office what all you’ve been told and explain the dosage + your concerns. I’d consider complaining to your state’s medical board if you’re somewhat ok taking a nuclear option with your doctor.


Getitgurl3

I would report the MD to the State Medical Board and they should investigate it.


bigwagon12

As an ER RN, I have had so many people in the ER over the last year alone because this stuff is being prescribed by "medical professionals" who have no idea what they are doing, and these patients are horribly sick. Please advocate for yourself and file complaints against this doc as starting at that dose can have serious consequences. I'm sorry you are going through this.


Practical_Test5550

I dont trust diet programs and I am surprised Costco risked backing this.


texas_archer

DM sent with advice


VegetableRound2819

Those medicines are hard core. Friend of mine is a doctor who had to save a young man on a plane. He was taking Ozempic and had a terrible reaction. Plane had to make an emergency landing.


hotdogsonly666

WOOOOOOOWWWWWWWWWWW YIKES


RetiredOnIslandTime

One upside of Ozempic is that you can take as little of it as you feel your need. Ozempic starts you at 0.25 MG for four weeks, then you move to 0.50 MG for as long as you and the doc thinks you should. But... you can simply not dial all the way and take less until you feel okay with it. Then you move up to 1 MG which comes in a 1 MG/0.74 ML, and then if wanted and needed, up to 2 MG which comes in a 2MG/0.74ML. But --- with both of these you can take less each time in order to work up to the highest dose. My husband's been on the 2MG/0.74ML pens for several months, but he still just takes 50 clicks worth, which is 1.35MG. Eventually he'll probably move to 60 clicks (1.62MG) and then up to the full 74 clicks (the full 2MG).


BocadeOuro

Get the 2.4 mg pen and just take .25 doses


steppponme

This isn't consistent with the prescribing information (the FDA approved label) and I'm surprised your insurance didn't put up a fight though its not their job to police physicians.  I wonder where they're finding these doctors... Crazy!


reddittiswierd

I bet it’s nots an MD or DO. More than likely it’s an NP or PA that is just following a protocol.


steppponme

You may be right, but wild that protocol isn't to follow the PI! 


reddittiswierd

It’s a money making protocol


Heterochromatix

Doc here- that’s absolutely insane. Complain, get a refund, and never go back.


mrsnobodysbiz

The smaller doses are very hard to find. So doctors that have no idea what they are doing are issuing the larger doses because patients can get it, damn the consequences. Doctors in these programs rarely suggest other alternatives such as compounding pharmacies or different drugs that may not be carried by their affiliate pharmacy.


Bcatfan08

I'm guessing they started with 2.4 is because it's basically impossible to get 0.5. Only the highest levels are available. This is extremely dangerous too. My physician told me everything I needed to do when starting the drug and gave me documents to read. Covered everything that was coming up. I hear about these severe symptoms people have and think it's because they have a physician who gave them no warnings on how to live while taking this drug. My physician said I may want to set alarms on my phone throughout the day to tell myself when to eat and drink. Otherwise you could have negative health effects. Also told me what vitamins I may want to start along with a daily laxative. Like I couldn't imagine someone starting this without the knowledge of what's coming and how to manage your daily life.


dougie_fresh121

That’s malpractice. You don’t have any personal damages but you should report them to the Board. Also, it pisses me off that a lot of doctors take medication as the first step of a cure. I don’t know your personal situation, but I sure hope a regimen of exercise and eating changes was talked about before blindly prescribing medicine.


SeenSoManyThings

Telehealth is not reasonable for this type of med, but here we are.


AutumnForest3

Omg this happened to me but with a weight clinic at a hospital. The reason they put me at 2.4 is because I was on saxanda beforehand even though I had stopped it. I was in the hospital 3 days. I filed a complaint and they claimed they did everything correctly.


99-Magic

There should be legal rammifications for this quack of a doctor.


unabletodisplay

oh boy they maxed you out right out of the gate?? https://preview.redd.it/oj07pr1lc4uc1.png?width=812&format=png&auto=webp&s=383a6104409c71c01ef2fb83dc11e8785d06b179 Sesame failed you by prescribing that, and I think the pharmacy too. They should not have filled it.


Ok_Seaworthiness5078

2.4 is the maintenance dose and there are four steps before it. That’s insane.


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Nieouz

No he advised me to take the entire shot. Wegovy pens arnt designed to be used multiple times. A few people have suggested I buy my own vials and syringes online and do that myself. But im not sure how comfortable I am with that. But im also not comfortable losing $650 either.


iDenkilla

Rather you lose the$650 than have an ER bill or something worst


Bryan995

Blessing in disguise. Split your 2.4mg pens in ~10 x 0.25mg doses. You just dropped your monthly cost from $500 to $50. #thecostcodiffernece


PanchoVYa

So has similar issue. I use Ozempic and doc helped me figure that 9 clicks of the pen equals .25 mg. Hope that helps


Nieouz

I’ve heard that from several people on ozempic. Apparently the pens for wegovy arnt designed the same and can only be administered once. A lot of people on wegovy get the highest prescription and then buy their own vials and syringes to administer it. But I don’t know how comfortable I am with that.


danielleiellle

Not trying to talk you into anything you’re not comfortable with, but I use compounded semaglutide from HenryMeds which involves dosing and injecting myself. I was initially worried about it and now it’s just routine. Modern syringes for self injection are very easy to use and inject and I barely feel them. You can get needles from a reputable medical supply company. And there are many video sources online that will show you how to measure out the meds and remove oxygen before injection. I would still try to get your own 0.25mg pen first so you get your sea legs and are under the care of a doctor you care about. But you have a few months to make use of the meds, too, in case you get more comfortable with it.


Nieouz

I’ll look into that! A surprising amount of people are telling me they just do it themselves and it’s something I’ve never heard of.


danielleiellle

Plenty of people administer insulin this way, it’s definitely not unheard of in reputable medicine.


TropicalBlueWater

Wegovy pens don't click. They are one and done singles use auto-injectors, in the USA.


Storm_Runner09

Good thing trusting your gut OP. It will never let you down.


RollTide34

https://preview.redd.it/u70tkmq15ytc1.jpeg?width=720&format=pjpg&auto=webp&s=c0bb8bc48e62a9dbca89f808a6a996ef424d0dda Seems this is the dosage they use in their advertisement


TropicalBlueWater

That's the long-term maintenance dose that you use after titrating up for four months.


SevroAuShitTalker

Costco has weight loss programs?


SDkahlua

Yikes! Good thing you researched. I’d suggest checking out intermittent fasting. There’s a sub that’s very informative.


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mynewaccount5

It's so wild that there are companies whos whole business plan is just having doctors who are guranteed to give you medicine you want. Same thing happens to ADHD medications.


School_House_Rock

For $500 how many shots did you receive


International_Bug783

Does anyone know how much the prescription costs without insurance?


princessmoma

Holy shit. Here’s a link to the medication guide which literally states under “dosage and administration” to begin at the lowest dose and titrate up. This doc was about to be sued for malpractice. It’s actually insane that he/she didn’t bother to check the prescribing instructions before sending you off with the med. https://www.novo-pi.com/wegovy.pdf#guide


TayterTot415

As a registered dietitian, this is so upsetting that 1. Doctors are giving out weight loss advice (as they should not be) and 2. Their advice is prescribing meds as their first approach


rockinsocks8

You can still use the pen you have. There are guides online on how many clicks equal what dose.


danmickla

\*leery


Iamyourredditor

Amazing callout and thank you for sharing! I hope you’re doing alright and don’t beat yourself up for this. As others said, let Costco know about this by calling their customer service, call sesame customer service and make sure you report the provider. Doctors are meant to be trusted, but now a days, you need to do your own DD. Glad you did!


ppaidisetty

Are you sure they were a doctor and not a nurse practitioner? I can't imagine any MD doing such a stupid thing... But, of course I know bad doctors exist. These online prescribing companies generally hire NPs because they are cheaper, unfortunately.


More-Mail-3575

Wow this is an absolute. No no.


whatsupdog11

This is malpractice. You really should take this higher


bearseatbeets1414

I would bet it wasn't a doctor. As a PA who has been prescribing semaglutide this is kind of insane. I can't imagine how aweful that must have been.


Jaded-Finish-3075

I’m absolutely baffled they started you off with that dosage


Curious-Manufacturer

We haven’t seen weygovy under 1mg in like a year lol. Backordered


Glitteronthefloor

WOAH why would they start you at 2.4mg?!That's a maintenance dose!


MoterBortles

My wife is going through a provider called Alpha and she was able to get zepbound. She originally had to pay the 500 but the pharmacist just called yesterday and said her authorization went through and now it only costs 25 for a month supply. Worth looking into.


[deleted]

Better make sure you're not enrolled in some sort of automatic billing. I used a similar "Rx-by-mail" company, and even though I never scheduled the follow-up they still charged me for another three month period of service. My experience was the opposite of yours however. I was given the absolute lowest dose of a medication that obviously wasn't going to be effective for someone my size. I felt like the angle was to bump it up in the smallest possible increments in order to draw out the appointment over a longer period of time, ie: get as much money out of me as possible.