Information Regarding Insulin Storage And Switching Between Products In An Emergency
en Español Insulin Storage and Effectiveness Insulin for Injection Insulin from various manufacturers is often made available to patients in an emergency and may be different from a patient's usual insulin. After a disaster, patients in the affected area may not have access to refrigeration. According to the product labels from all three U.S. insulin manufacturers, it is recommended that insulin be stored in a refrigerator at approximately 36°F to 46°F. Unopened and stored in this manner, these products maintain potency until the expiration date on the package. Insulin products contained in vials or cartridges supplied by the manufacturers (opened or unopened) may be left unrefrigerated at a temperature between 59°F and 86°F for up to 28 days and continue to work. However, an insulin product that has been altered for the purpose of dilution or by removal from the manufacturer’s original vial should be discarded within two weeks. Note: Insulin loses some effectiveness when exposed to extreme temperatures. The longer the exposure to extreme temperatures, the less effective the insulin becomes. This can result in loss of blood glucose control over time. Under emergency conditions, you might still need to use insulin that has been stored above 86°F. You should try to keep insulin as cool as possible. If you are using ice, avoid freezing the insulin. Do not use insulin that has been frozen. Keep insulin away from direct heat and out of direct sunlight. When properly stored insulin becomes available again, the insulin vials that have been exposed to these extreme conditions should be discarded and replaced as soon as possible. If patients or healthcare providers have specific questions about the suitability of their insulin, they may call the respective manufacturer a Continue reading >>
Unrefrigerated Lantus Question
Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Went to the drug store, picked up new boxes of Lantus Solostar and Humalog Pens. Went home, got distracted, forgot to put pens in fridge for almost two hours. They were at room temperature, no sunlight or other warmth exposure. Did some research on the net and also called the manufacturers. Bottom line is this: Humalog should be okay with only very minimal efficacy difference (<1% difference), so I'm okay there. Sanofi Aventis tells me that the Lantus pens will only be good for 28 days, even though they were not opened. This translates to my having to throw out 2 of the 5 Solostar pens. Question- anyone have any experience with using unrefrigerated Lantus longer than 28 days? I always kept my Lantus at room temperature. I used it beyond the 28 days without a problem. I've had Lantus vials, being used, out at room temp for up to 60 days with no measurable signs of lost potency for me. Room temp in the summer time can be in the upper 70s for short periods. I don't see having left the pens out at room temp for 2 hours as a problem here. I keep my Lantus at room temperature. I only refrigerate vials if I know I'm not going to be using it any time soon. 1 vial usually lasts me about 45 days, so I'm guessing it fits in the "average use" range. I think your insulin should be fine after just 2 hours. Owlyn, I kept my Lantus that was currently in use at room temps and used it for more than 28 days with no problem. Leaving it out for 2hrs should not cause you any problems. Thank you everyone. BTW, my research found that the 28 day timing on opened bottles of any insulin was due to the growth of bacteri Continue reading >>
How Long Does Insulin Last Once It's Been Opened?
A fellow caregiver asked... My mother has type 2 diabetes and needs help with her insulin injections. After I open a new bottle, how long does insulin last for, how should I store it, and how do I know whether it's gone bad? Expert Answers As a general rule, most bottles of insulin are good for 28 days once they're opened. Of course, how quickly a person goes through a vial is highly individual. Some may go through a bottle in a week or two. Others, on a lower dosage, may not use all the insulin within four weeks. But the drug's stability and potency is only guaranteed for 28 days. Opened insulin pens typically last 14 days, though some last only 10 days. If you're uncertain, check with your mother's pharmacist to find out how long her insulin should last. When either of you opens a new vial or pen, make a note on the calendar -- and note the date when you'll need to throw out any remaining insulin. It's best to store an opened bottle of insulin at room temperature, even though manufacturers often recommend refrigeration for opened containers. It's usually less painful to inject insulin when it's at room temperature than when it's cold. Store unopened insulin vials and pen cartridges in the fridge, though, where they should last until their expiration date. Insulin shouldn't be exposed to extreme temperatures, so don't leave it in the car, next to the stove, in the freezer, or in the bathroom. If the bottle freezes, it must be discarded. Two typical signs that insulin has gone bad: poor performance and unusual appearance. If your mother is following her treatment plan and her glucose levels stay stubbornly, inexplicably high, her insulin may have lost its potency. Insulin that's cloudy when it's supposed to be clear or that contains particles, crystals, or small clumps Continue reading >>
How To Use Your Lantusâ® Solostarâ® Pen A Step By Step Guide To Using Your Lantusâ® Solostarâ® Pen
For single patient use only This quick reference guide is a short version of the instruction leaflet. It is designed to help make it easier to learn the steps. Reading this guide will help to make sure that you inject the right amount of insulin every time. Otherwise you may get too little or too much insulin, and that can affect your blood sugar levels. These instructions are supplied as a guide only. Read the full instruction leaflet accompanying this pen before you use Lantus® SoloSTAR® for the first time. To help ensure an accurate dose each time, follow all steps in the leaflet. Important Safety Information for Lantus® SoloSTAR® Lantus® SoloSTAR® is a disposable prefilled insulin pen. To help ensure an accurate dose each time, patients should follow all steps in the Instruction Leaflet accompanying the pen: otherwise they may not get the correct amount of insulin, which may affect their blood glucose Please click here for full Important Safety Information and here for full Prescribing Information for Lantus®. If there’s anything you don’t understand or if you have any questions, ask your healthcare provider. You can also go online to Lantus.com or call the support line at 1-800-633-1610. GETTING TO KNOW YOUR PEN AND ITS PARTS The Lantus® SoloSTAR® pen was designed with a simple-to-push injection button and large dosing window. Ou te r n ee dle c ap Inn er n ee dle c ap Pr ot ec tiv e se al Ru bb er se al Ins uli n re se rvo ir Do se w ind ow Do se se lec to r Inj ec tio n bu tto n Pe n ca p Ne ed le 2 Lantus.com Please click here for full Important Safety Information and here for full Prescribing Information for Lantus®. View a step-by-step video on how to inject at Lantus.com. CHOOSING AN INJECTION SITE The three possibl Continue reading >>
Helpful Hints In The Use Of Insulin
How to store insulin Although manufacturers recommend storing your insulin in the refrigerator, injecting cold insulin can sometimes make the injection more painful. To counter that, you can store the bottle of insulin you are using at room temperature (36-86º) for about one month. Do not keep bottles in a hot place like near a heater or in direct sunlight. Also, do not keep them near ice or in places where the insulin may freeze. If you buy more than one bottle at a time, store the extra bottles in the refrigerator. Then, when needed, take out the bottle ahead of time so it is ready for your next injection. Unopened bottles are good until the expiration date on the box and/or bottle. Do NOT use insulin after it has been kept at room temperature for longer than a month. Also, do not use insulin after the expiration date printed on the bottle. Examine the bottle closely to make sure the insulin looks normal before you draw the insulin into the syringe. Insulin aspart, lispro, regular, or glargine should be clear and not cloudy. Check for particles or discoloration of the insulin. NPH, ultralente, or lente should not be “frosted” or have crystals in the insulin or on the insides of the bottle, or small particles or clumps in the insulin. If you find any of these in your insulin, do NOT use it. Return unopened bottles to the pharmacy for exchange or refund. Syringes Most people use plastic syringes, which are made to use once and then throw away. Some people use a syringe two to three times. If you reuse a syringe, follow the steps below: Flush the syringe with air to prevent the needle from clogging. Do not wipe the needle with alcohol. This removes the Teflon coating. Recap the needle when not in use. Store the syringe at room temperature. Keep the outside of the sy Continue reading >>
How Long Should Insulin Be Used Once A Vial Is Started?
Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>
Tracking Insulin's Health In The Summer Heat
Sunscreen: check. Water bottle: check. Beach ball: check. Insulin cooler....? Yep. For those of us who use insulin, summer heat creates an extra level of complexity and worry. The real question we all ask ourselves in the heat of the summer is whether our fun-in-the-sun will cook our insulin and leave us having-not-so-much-fun in an air conditioned ICU unit? There's a whole industry of solutions dedicated to helping us keep our insulin cool, ranging from cooling packs such as the ReliOn and others, to portable fridges, to high tech cooling crystals. Hell, we're even running a Giveaway contest this week in which our readers can win some of these products! With much of the U.S. suffering under a stifling drought-baked summer, the question of just how hot insulin can get is on all our minds. But you have to wonder if these products are serving an important need or just preying on our fears. To find out, we asked the manufacturers themselves, some leading insulin experts, and the American Diabetes Association — and guess what? The answer isn't as clear as you might like. Not Your Grandma's Insulin First, a bit of history: Didn't grandma keep her insulin in the fridge all the time? Well, only if she read the label. The original pork and beef insulin formulations were supposed to be kept cold all the time. As cold insulin stings like hell to inject, the move to being able to keep the newer human insulin and later analogs at room temperature was a great victory (!) for those of us who are human pin cushions. But wait a minute... whose room temperature are we talking about? My father used to get annoyed with me when I'd shovel ice cubes into my glass of red wine. "Wine is supposed to be consumed at room temperature," he'd huff. "Yeah, in the frickin' French Alps,where room te Continue reading >>
Insulin Use Tips
Before each use, take a moment to inspect the insulin prior to drawing it into the syringe; clear insulins should appear not discolored and clear; suspended insulins should be uniform in their cloudiness[1]. Do not use the insulin if: The bottle looks frosted[2][3][4][5][6][7]. Clear insulin that looks discolored or has turned cloudy, contains particles or haze[8]. Cloudy insulin that appears yellowish or remains lumpy or clotted after mixing[9][10]. If you made a mistake and forgot to put the insulin back into the refrigerator, even for several hours, there should be no problem. Many keep their insulin (see instructions for your brand) at room temperature all the time[11]. When comparing it to insulin which is in the fridge except when used, it may be more likely to have slight potency loss. If the insulin was exposed to heat or direct light for a while when it was out of the refrigerator, or shaken vigorously or dropped a long way, the best thing to do would be to start with a new vial[12]. Injecting cold from the refrigerator insulin[13] can sting, regardless of what species, type or brand. Bringing the insulin to room temperature by removing it from the fridge before actually using it can help avoid painful injections. Warming the capped insulin syringe with your hands can have the same effect. Some people tuck the capped and filled syringe under their arm for a few minutes to warm it before use. Do NOT attempt to warm insulin using a stove, microwave, etc.; you may destroy the insulin by doing so[14]. Do NOT wipe the needle with alcohol as it removes the protective coating which makes injection easier and less painful[15]. Injecting any insulin at the same site repeatedly over time can cause a lipodystrophy: either lipoatrophy[16] or lipohypertrophy. Either makes a Continue reading >>
Can Insulin Go Back In The Fridge?
After removing insulin glargine (Lantus) from the refrigerator for use, can it be refrigerated over and over again after having warmed to room temperature, or does this degrade it? Continue reading >>
Insulin Pens Are Welcome Back To The Fridge!
We all know that unopened insulin must be kept in the refrigerator. But once in use can we put it back in the fridge to protect it from excessive heat? The answer to this simple question is not as easy as one might think. All manufacturers explicitly recommend to ‘Not refrigerate’ insulin pens in use. This guideline that causes confusion among users is now being revoked by one manufacturer. Let’s try to understand the reasoning behind it and what it means for users now. What? I shouldn’t put my insulin pen back in the refrigerator? When it comes to storing medications, it is recommended you follow the leaflet or packaging instructions. For insulin in particular, there are two different situations: storing and in-use. · Before Opening: When insulin is to be stored long-term and has not been opened, keeping it in the fridge ensures it lasts until expiration date. · During Use: Once a vial, a cartridge or a new disposable pen are used for the first time, the insulin can be kept at room temperature. But it needs to be used within weeks. It makes sense: higher temperatures and an open product mean a shorter shelf life. But there is one extra sentence on insulin pens packages, which has caused quite some confusion: Pens in use — ‘Do not refrigerate.’ What does ‘do not refrigerate’ mean for users? Let’s take a trip back to 2003, when the recommendation to not refrigerate opened insulin first appeared. Take Lilly’s Humalog for example, for which the label was first altered 14-years ago: What was the reason behind this? People started to speculate this warning was a result of preventing any kind of temperature extremes from affecting the insulin once it is in use. Many insulin users know from experience that high temperature can lower the effectiveness of Continue reading >>
How To Store Insulin
Insulin is measured in units. Most bottles, cartridges, and pens of insulin sold in the United States have 100 units of insulin per milliliter of fluid and are labeled U-100. Different strengths, like U-500, also are available in the U.S. Different strengths are used in other countries. It's important to know the type of insulin you take and whether it should appear cloudy or clear. When you prepare to use a bottle, cartridge, or pen, check the insulin: NPH should look uniformly cloudy after you gently roll the bottle or pen. All other insulin should look clear. If your insulin doesn't look right, don't use it. Take it back to your pharmacy. Don't shake your insulin. Gently roll it. Don't toss it around or handle it roughly. If you don't handle your insulin correctly, it's more likely to clump or frost. Don't use the insulin if you can see clumps after you gently roll the bottle or pen, or if the sides look frosted. Storage Guidelines Take steps to store your insulin correctly, or it might not work. Keep your insulin away from heat and light. Any insulin that you don't store in the refrigerator should be kept as cool as possible (between 56°F and 80°F.) Never let your insulin freeze. If your insulin freezes, don't use it, even after it's thawed. Keep unused bottles, cartridges, and pens of insulin in the refrigerator (between 36°F and 46°F). If stored properly, these will be good until the expiration date listed on the insulin. Keep insulin cartridges and pens that you're currently using at room temperature (between 56°F and 80°F.) Expiration Guidelines An open insulin bottle, cartridge, or pen is only good for a limited time. Follow these guidelines for discarding insulin: Glargine (Lantus): Discard opened bottles, pens, and cartridges 28 days after you've starte Continue reading >>
Insulin Basics | Diabetesnet.com
Thu, 11/18/2010 - 15:14 -- Richard Morris Store insulin you are not using in a refrigerator. It is a protein dissolved in water, sort of like a soup stock, so keep it cold to prevent it from spoiling. Keep it between 36º and 46º F. If it gets colder it will freeze. If the insulin freezes, when it thaws it will separate and clump and will no longer be usable. If it gets warmer it will be ok for awhile but will eventually spoil. If it starts to spoil, bacteria growing in it breaks down the insulin. It won't hurt you to use this. However, its not as effective so your blood sugar will be higher than you expect even though you took the right amount of insulin at the right time. It is ok to keep a bottle of insulin you are using at room temperature for up to 28 days (room temperature is 59º to 86º F). The preservative in insulin keeps it from spoiling this long. Insulin at room temperature injected into the skin is more comfortable for many people. Also, it may be easier to get rid of air bubbles in the syringe when it is at room temperature. If you live in a hot climate and your room temperature is above 80º, keep your insulin in the refrigerator. Insulin in a pen can only be kept at room temperature for 2 weeks before it begins to spoil. Check with your pharmacist, the package insert or the manufacturer's websites. Insulin used past 28 days at room temperature or past the expiration date on the box may still be good. However, using it may cause control problems and is not recommended. Lantus, Humalog and Novolog seem to spoil faster than Regular and NPH. If you can't afford to buy insulin and insurance does not cover it, you may be able to get it free. Check the website www.helpingpatients.org or call 202-835-3400. The doctor who prescribes your insulin can help you g Continue reading >>
Traveling With Insulin
Wouldn’t it be wonderful if you didn’t have to bother to refrigerate your insulin when you travel? I’m sure that in the past the need to have a refrigerator nearby kept many of us from adventure travel in the third world. Gel keeps insulin cool for 48 hours. While you do have to keep your insulin cool, you don’t have to strap a portable refrigerator to your back while you attempt your first ascent of Mt. Everest. Paddling down the Amazon can also be a bit inconvenient with a refrigerator. There are many more likely trips where you might think you need to have a refrigerator for your insulin. For example, I recently booked a short vacation in a cottage on Northern California’s Russian River. My wife, who uses both insulin cartridges and vials, insisted that we get a kitchenette so she could refrigerate the insulin. The kitchenette with its refrigerator wasn’t necessary, as we later realized. We could have used an insulin carrying case that included a cold pack. Our experience, however, had been only with those carrying cases that were tethered to refrigeration. The packs stay cold only until the ice in them melts, requiring repeated visits to the fridge. We were not familiar with a British company, Frio UK Ltd., which until recently had only limited representation in the United States. Frio’s cooling wallets keep insulin cool and safe for up to 45 hours—up to five times longer than ice packs—even if the temperature outside is 100°F. You activate the wallet by immersing it in cold water for 10 to 15 minutes. That makes the crystals in the panels of the wallet expand into a gel that will remain cool for several days with Frio’s patented process. Even though it makes use of evaporation to stay cool, the Frio wallet will remain dry to the touch after you Continue reading >>
Lantus (insulin Glargine) Side Effects
What Is Lantus (Insulin Glargine)? Lantus is the brand name of insulin glargine, a long-acting insulin used to treat adults and children with type 1 diabetes mellitus and adults with type 2 diabetes mellitus to control high blood sugar. Lantus replaces the insulin that your body no longer produces. Insulin is a natural substance that allows your body to convert dietary sugar into energy and helps store energy for later use. In type 2 diabetes mellitus, your body does not produce enough insulin, or the insulin produced is not used properly, causing a rise in blood sugar. Like other types of insulin, Lantus is used to normalize blood sugar levels. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual dysfunction. Proper control of diabetes has also been shown to reduce your risk of a heart attack or stroke. Lantus is meant to be used alongside a proper diet and exercise program recommended by your doctor. Lantus is manufactured by Sanofi-Aventis. It was approved for use by the Food and Drug Administration (FDA) in 2000 as the first long-acting human insulin administered once a day with a 24-hour sugar-lowering effect. Lantus Warnings You will be taught how to properly inject this medication since that is the only way to use it. Do not inject cold insulin because this can be painful. Always wash your hands before measuring and injecting insulin. Lantus is always clear and colorless; look for cloudy solution or clumps in the container before injecting it. Do not use Lantus to treat diabetic ketoacidosis. A short-acting insulin is used to treat this condition. It is recommended that you take a diabetes education program to learn more about diabetes and how to manage it. Other medical problems may affect the use of this Continue reading >>
Insulin Use Tips
Before each use, take a moment to inspect the insulin prior to drawing it into the syringe; clear insulins should appear not discolored and clear; suspended insulins should be uniform in their cloudiness. [1][2] Do not use the insulin if: The bottle looks frosted. [3][4][5][6][7][8] Clear insulin that looks discolored or has turned cloudy, contains particles or haze. [9] Cloudy insulin that appears yellowish or remains lumpy or clotted after mixing. [10][8] See Insulin problems for more information about "bad" insulin. Damaged Insulin: Insulin that is getting too old, or has been dropped or shaken or mishandled, or exposed to a lot of light or heat, will be less effective than before. Freezing [11] destroys the molecules of ANY insulin; any that has either been frozen or is suspected of having been frozen should not be used. Insulin which has been frozen will not be able to do an effective job of controlling blood glucose. [12] Check for discoloration or floating objects in the insulin -- it may also be contaminated. It's also possible that the new or newer vial from the pharmacy may be flawed. If you've recently started it and are having problems, this might be the case. Taking down the lot number and getting a new vial that has a different batch/lot number should take care of this. Frosted insulin: If insulin is subjected to temperature extremes, such as freezing or overheating, the insulin can precipitate [13] on the vial's walls, giving it a frosty or frosted appearance.[5] Another term used to describe this is flocculation. [7][14] In the photo above, the insulin vial on the right is a visual example of what a frosted vial would look like. You can see the precipitated insulin clinging to the sides of it. The problem seems to be a particular one with R-DNA/GE/GM NPH Continue reading >>
