Coming back to post #27, because the follow-up matters more than the original answer.
Careful with the language on completing a dose. "Not detected" and "not present" are different findings and the first is a statement about the method.
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Practice · Administration · continued
Completing a dose with a second syringe, and the dead-volume arithmetic posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
PSundberg, post #8: Post #6 put the caveat in the right place and I want to underline it. Something worth flagging about completing a dose: the strongest-sounding claims in this thread are the ones with no source attached, which is the usual pattern and not a coincidence. Go to post
Post #31 is right about the mechanism and I think understates the practical bit.
Completing a dose: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know which.
Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection.
I would rather say I do not know than round it up to an answer.
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m.ramos, post #5: If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life. Go to post
Confirming post #35 from a second method, which matters more than confirming it from a second person.
Adding a small correction to the completing a dose summary above rather than a disagreement with it. The substance holds; one of the figures is out by a factor that matters.
Post #35 describes the usual case. This is about the unusual one.
Air in the syringe is a much smaller problem subcutaneously than the anxiety about it suggests, and it is still worth expelling because the bubble occupies volume you meant to be liquid.
Nothing above should be read as advice about what anyone else should do.
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I have been on both sides of the completing a dose argument in this category within eighteen months, which should tell you how strong the evidence for either side is.
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If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
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m.eriksen, post #25: Building on post #22 rather than restating it. A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.… Go to post
Noted, and I have changed what I was going to do on the strength of it.
If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
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f.chowdhury, post #22: Where I part company with post #20, and it is a narrow parting. If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life. Worth checking against a second source before it gets quoted onward. Go to post
Adding a reference point for completing a dose. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.
Collapsed as off-topic by two members at trust level 3 or above
Post #44 answers the question as asked. The question underneath it is different.
I have no financial interest in anything named in this thread and I want to say so before I comment on completing a dose, because it is the sort of subject where it matters.
A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.
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h.amankwah, post #28: Note the site alongside the dose. If a local reaction appears three weeks later you will want to know where the previous four injections went. Scoping that to what I have actually seen rather than what I have read. Go to post
Useful. I had the fact and not the reason, which turns out to be the important half.
The version of completing a dose that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and those conditions are where the interesting cases live.
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CSagredo, post #23: Air in the syringe is a much smaller problem subcutaneously than the anxiety about it suggests, and it is still worth expelling because the bubble occupies volume you meant to be liquid. Go to post
If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
y.eriksen, post #12: If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life. Go to post
Taking post #53 at face value and following it one step further.
A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.
Narrowing post #53, because the general version has more than one answer.
I would keep completing a dose and the decision it usually gets used for separate in this thread. They are related and they are not the same question, and merging them is why the last one went badly.
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If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
If anyone can point at the primary source I would be grateful.
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y.eriksen, post #7: Building on post #5 rather than restating it. If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life. The confident version of this sentence would be wrong, so here is the hedged one. Go to post
Note the site alongside the dose. If a local reaction appears three weeks later you will want to know where the previous four injections went.
sterile_table, post #6: A new needle for each injection is not fussiness. A needle blunts on first use and a blunted needle is the reason the second injection hurts more than the first. I would put the burden of proof on the interesting explanation, not the dull one. Go to post
Grateful for the specificity. Vague answers to this question are what sent me looking.
The arithmetic in post #57 is right; the assumption feeding it is the part to check.
Having read the whole completing a dose thread before replying: the question in the first post has not actually been answered yet, and three of us have answered a nearby one instead.
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