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How Long Can You Use Lantus After Opening?

Lantus

Lantus

Lantus glargine by Aventis long-acting analog U100 Special, pH 4 Line new molecular entity Also known as Glargine (generic) Similar to Levemir, PZI[1] ultralente, Ultratard (duration) Action in cats varies by animal onset variable, asymmetric peak 5-14h (4-20 h as per Nelson)[2] duration 9-24h (10-16 h as per Nelson)[3] Action in dogs onset inconsistent, peak 0.5 to 6 hours, inconsistent, duration about 13hr but inconsistent-beef/pork PZI has longer duration (10-16 h as per Nelson)[4][5][6] Use and Handling Type clear Shelf Life refrigerate, until date on package When opened 28 days at room temp, up to 6 months when stored in the refrigerator (2C to 8C)[7] In pen 28 days at room temp Notes protect from light and heat do not mix with other insulins do not dilute do not prefill syringe discard if precipitate or cloudiness discard if frozen Do not use intravenously[8] Do not use intramuscularly[9] Lantus is the brand name for insulin glargine, an insulin analog made by Aventis[10]. Lantus is a very long-acting insulin (lasting up to 24 hours in humans) that uses pH reactions to form micro-precipitates under the skin, which create a time-release action. Because of cats' faster metabolism, long-acting insulins like Lantus (and perhaps Levemir) are gaining a good reputation in veterinary research for regulating cats for a full 12 hours at a time, often better than some of their shorter-acting cousins. Proponents of Lantus in feline use point out that it lasts a full 12 hours in many cats, has a very gentle onset, a negligible peak, and (some claim) less chance of triggering hypo or rebound than faster-acting insulins. The famous Queensland University studies[11] showed that a simple protocol (in a 24-hour monitored, veterinary environment, with a Low-carb diet) could bring ma Continue reading >>

Lantus Vials, How Long Are They Really Good For?

Lantus Vials, How Long Are They Really Good For?

Lantus vials, how long are they really good for? 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. Lantus vials, how long are they really good for? I have recieved the standard advice from my DE; throw away the Lantus vials after 30 days from the date you first open them. I still have half a vial left at that point and I have been using them longer (maybe 45 days) with no noticeable ill effects. Any input? You may end up hearing a range of answers on this. My own experience has been like this: so long as the vial is not exposed to extremes in temperature or sunlight, the insulin will remain good well beyond 30 days. During periods when my basal dose was 14 to 16u daily, I've used up the whole vial, meaning I have had vials last me over 60 days. As I understand it, testing insulin stability and viability is done over a period of 28 days, that is how long the pharmaceuticals conduct tests with standard protocols, but they don't test beyond that time period. Because of that, the vials can be guaranteed for 28 days but not beyond because there is no data. My own personal data does not qualify as being scientific in that regard. On the other hands, I would point out I feel it is a reasonably inductive conclusion to think that there is no real reason to think that the insulin would go bad 28 days after puncture because of the passage of time from day 28 to day 29. There may well exist some critical time period after opening when an insulin would go bad -- it's just that that rigorous testing protcols have never gone in search of that time period thus giving us the usual instructions by DEs for us to toss that vial after the 28th day. That's a good Continue reading >>

Basaglar (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Basaglar (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Hormone secreted by pancreatic beta-cells of the islets of Langerhans and essential for the metabolism and homeostasis of carbohydrate, fat, and protein. Insulin glargine is a once-daily basal insulin analog without pronounced peaks. BASAGLAR, Lantus, Lantus SoloStar, Toujeo SoloStar BASAGLAR/Lantus/Lantus SoloStar/Toujeo SoloStar Subcutaneous Inj Sol: 1mL, 100U, 300U For the treatment of type 1 diabetes mellitus and type 2 diabetes mellitus. For the treatment of type 1 diabetes mellitus. Subcutaneous dosage (100 units/mL, i.e., Lantus, Basaglar) Initially, administer one-third of the total daily insulin requirements/dose subcutaneously once daily. Titrate dosage to achieve blood glucose control and A1C goals in conjunction with a short-acting insulin. Give the dose at the same time every day, at any time. Administration in the morning may avoid nocturnal hypoglycemia. When transferring from once daily NPH insulin, the dose is usually not changed. However, when transferring from twice-daily NPH insulin to insulin glargine, the total daily dose of NPH insulin (or other twice daily basal insulin) should be reduced by 20% and administered as single dose once daily. When transferring from once-daily Toujeo to once-daily Lantus or Basaglar, the recommended initial Lantus or Basaglar dose is 80% of the Toujeo dose that is being discontinued. Thereafter, the dosage of insulin glargine should be adjusted to response. Children and Adolescents 6 years and older Insulin requirements are highly variable and must be individualized based on patient-specific factors and type of insulin regimen. During partial remission phase, total combined daily insulin requirement is often less than 0.5 units/kg/day. Prepubertal children (outside the partial remission phase) usually require 0.7 to Continue reading >>

How Do I Store Unopened Insulin Bottles?

How Do I Store Unopened Insulin Bottles?

Store newly purchased, unopened bottles of insulin in the refrigerator in their original carton to keep them clean and protected from light. When you're ready to use a bottle of insulin, you can remove it from the fridge and generally keep it at room temperature (below 86 degrees F) for up to one month. But the sterility and potency of an opened bottle of insulin are affected by the number of insulin injections per day, the volume of insulin remaining in the bottle and exposure to light and agitation. For this reason, it's important to discuss your insulin dosage and storage—and review patient information available on the insulin manufacturer’s website—with the doctor treating your diabetes. You should also check opened bottles of insulin carefully for discoloration or particles. Never store insulin in the freezer or in direct sunlight and always be sure to check the expiration date. By Joyce A. Generali, M.S. FASHP, R.Ph., director of the University of Kansas Drug Information Center and the author of The Pharmacy Technician’s Pocket Drug Reference From our sister publication, Diabetes Focus, Summer 2011 Publication Review By: the Editorial Staff at HealthCommunities.com Last Modified: 11 Sep 2015 Continue reading >>

Information Regarding Insulin Storage And Switching Between Products In An Emergency

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 >>

Find Resources To Help You With Toujeo (insulin Glargine Injection) 300 Units/ml --including Samples, Videos, Published Clinical Studies, And Faq's.

Find Resources To Help You With Toujeo (insulin Glargine Injection) 300 Units/ml --including Samples, Videos, Published Clinical Studies, And Faq's.

This site is intended for U.S. Healthcare Professionals only. PLEASE NOTE: This reprint includes information that is not contained within the full prescribing information (PI) for Toujeo (insulin glargine injection) 300 Units/mL and is not intended to offer recommendations about Toujeo that are inconsistent with the PI. Please read the full indication, the Important Safety Information and the full Prescribing Information . Sanofi US does not review the information contained in this website and/or database for content, accuracy, or completeness. Use of and access to this information is subject to the terms, limitations, and conditions set by the website and/or database producer. Sanofi US makes no representation as to the accuracy or any other aspect of the information contained on such website and/or database, nor does Sanofi US necessarily endorse such website and/or database. You are about to leave sanofi site for U.S. Sanofi US does not review the informationcontained on this website and/or databasefor content, accuracy or completeness. Useof and access to this information is subject tothe terms, limitations and conditions set by thewebsite and/or database producer. This site might not comply with the regulatory requirements of US You are about to move to an Unbranded site Toujeo is a long-acting human insulin analog indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use: Toujeo is not recommended for treating diabetic ketoacidosis. Important Safety Information for Toujeo (insulin glargine injection) 300 Units/mL Toujeo is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or any of its excipients. Toujeo contains the same active ingredient, insulin glargine, as Lantus. The concentra Continue reading >>

How Long Should You Keep Your Open Insulin Vials?

How Long Should You Keep Your Open Insulin Vials?

With so many different insulin and insulin-like products out there these days it can be hard to keep track of when your vial should be tossed. Depending on your dose, you may still have insulin left in your vial by the manufacturer-recommended time to throw it away. If this sounds like a familiar situation, know that it is important to throw away your vial regardless of whether you have any leftover. You might think it is wasteful to throw out what you may consider “perfectly good insulin,” but using the medication past the recommended time can actually do you more harm than good. You may notice that if you continue to use insulin from a vial past the manufacturers discard date, your blood glucose could be higher or a greater dose may be needed to achieve a normal blood glucose reading. There are several different types of insulin and a variety of other injectable diabetes medications, and the recommendations for how long they keep varies. For a quick overview, the different categories of insulin are: Rapid-acting Short-acting (regular) Intermediate-acting Long-acting So how long can you hold on to your insulin after you start using a vial? Rapid-acting insulin Short-acting insulin Humulin R: use within 31 days after puncturing vial Humulin R U-500 concentrated: use within 31 days after puncturing vial Intermediate-acting insulin Long-acting insulin Other injectable diabetes medications in vials A glycated hemoglobin (HbA1c) is a preferred screening test for diabetes. Done easily with a fingerstick in your physician’s office, it eliminates the need for fasting (not eating) prior to the test. The diagnosis of diabetes is confirmed if two consecutive A1c levels are greater than or equal to 6.5. What is the HbA1c? Red blood cells are permeable to glucose (sugar)—so Continue reading >>

Can I Use My Insulin Past Its Expiration Date?

Can I Use My Insulin Past Its Expiration Date?

A certified diabetes educator answers whether older insulin is still safe to use. Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. Insulin Nation hosts a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community. Q: Should I really worry about using insulin after its expiration date? What about using it for more than 30 days? I think the insulin companies promote that just to make us throw out good insulin. A: When it comes to insulin, we have to make darned sure that the stuff is at full potency, or blood glucose levels can go dangerously high. The insulin manufacturers are required to test their products rigorously before bringing them to market. They can more or less guarantee that their products will work as indicated if used within the expiration date and for not more than a month after the seal on the vial, cartridge, or pen is broken. This is, of course, assuming that the insulin has been stored properly and not exposed to extreme heat, freezing cold, or direct sunlight. sponsor Does this mean that insulin suddenly goes belly up at the stroke of midnight on the expiration date, or 28 days after being put into use? Hardly. Many people, including clinicians with diabetes, have used insulin beyond the “deadlines” without a hitch. It simply means that the manufacturer has not tested their product beyond the dates indicated, so there is no guarantee — no way of knowing exactly how long the insulin will remain at full strength. Read “Can I Get Insulin Over the Counter?” This is where common sense comes into play. For those with good insurance coverage and plenty of insulin on-hand, it’s best to follow the rules and discard i Continue reading >>

How To Store Insulin

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 >>

Beware Summer Extremes With Insulin

Beware Summer Extremes With Insulin

Living with diabetes blog With summer arriving in Minnesota and many other places, I'd like to talk about how to manage insulin storage in extreme temperatures such as this season brings. A number of years ago, I met with a client who used a rapid insulin pen for meal dosing. She shared with me a story of how she attended the county fair on an exceptionally hot day, and had placed her insulin pen in the back pocket of tight jeans and walked around the fairgrounds all day. She used the pen for covering meals eaten at the fair, and her blood sugars were running higher than normal, but she related this to all the junk food. The next day her blood sugars continued to run high and when she took her (rapid) insulin, it didn't seem to affect her blood sugar level at all; in fact, it was like she was taking water instead of insulin. She wondered if the heat had affected her insulin, so she switched to a new insulin (disposable) pen, and soon after her blood sugars started to drop. Has this or something similar happened to you? I looked at insulin manufacturers' websites and found that for the majority of all types and brands of insulin, the maximum temperatures recommended are as follows: Opened room temperature insulin should not exceed 86 F (30 C) with the exception of Lantus, which should not exceed 77 F (25 C). Most manufacturers of insulin recommend discarding insulin if it exceeds 98.6 F (37 C). Other non insulin diabetic injectable medications: Glucagon and Byetta should not exceed 77 F (25 C). Symlin should not exceed 86 F (30 C). Avoiding potential problems Temperatures exceeding manufacturer's recommendations for insulin/medications Store your insulin in the refrigerator, in an insulated case or cooler with a freezable gel pack, or use a cooling wallet. Cooling wallet Continue reading >>

Lantus (insulin Glargine) Side Effects

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 >>

How Long Should Insulin Be Used Once A Vial Is Started?

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 >>

How Do I Get Lantus Insulin Less Expensively?

How Do I Get Lantus Insulin Less Expensively?

November 2, 2013-- How do I get Lantus Insulin Less Expensively? DCIN receives this question a few times a week from US caregivers of diabetic cats. I am often amazed by the question because of the “good” insulins for diabetic cats, Lantus can be the least expensive per unit. The problem often lies in knowing how to find the insulin inexpensively. (The hints I give also apply to Levemir, another human insulin often used by diabetic cats.) Your vet gave you a prescription that probably read “U100 Glargine/Lantus 10ml vial.” Lantus is the brand name for the generic insulin Glargine. Lantus is an insulin for humans and is only available from a human pharmacy (although some vets do hold some in stock). The company Sanofi makes Lantus, and no other companies currently make a generic Glargine because Sanofi still has an international patent on the insulin. That may change in 2014, and by then Sanofi may have developed a “second-generation” Lantus that is patent protected. Lantus is a U100 insulin, which describes the concentration of the insulin in the liquid suspension. A 10ml vial is the insulin’s containment device. It is a small glass bottle with a rubber stopper at the end that you pierce with a syringe. At a US retail pharmacy, a 10ml vial of Lantus can cost about $180 to $200. WOWZA! That does seem cause for sticker shock. A 10ml vial of U100 insulin holds 1000 units of insulin. At $200/vial, that is a price of $.20/unit. If your cat gets 2 units of insulin twice a day, that is $.80/day for its insulin (if you could completely use a vial of Lantus insulin). It would cost less each day to give your cat its life-saving medicine that to buy a soda from a vending machine. However, the problem with buying Lantus in a 10ml vial is that, properly handled, Lantus Continue reading >>

Q & A: How Long Can Glargine And Detemir Insulins Really Be Used Once Vial Is Started?

Q & A: How Long Can Glargine And Detemir Insulins Really Be Used Once Vial Is Started?

Our pharmacist is telling me that determir insulin (Levemir) expires after 30 days. He claims that this is because of the risk of contamination. At $112 a bottle, this short expiration date would make detemir cost prohibitive for my clients. Is detemir insulin actually stable for longer periods if kept refrigerated, as has been found with glargine insulin (Lantus)? My Response: Glargine is marketed for human use with a 28-day shelf-life at room temperature after opening. Similarly, detemir is marketed with a 6-week shelf-life at room temperature after opening of the vial. The recommended shelf-lives for both detemir and glargine are relatively short, not because of lack of efficacy, but because of the increased risk of bacterial contamination with these multiple-use, injectable medication vials. The FDA believes that the insulin vials may have a high probability of becoming contaminated with microbes by the daily multiple punctures needed to withdraw medication when used past the insulin's expiration date. For veterinary use, we generally recommend that both insulins be kept refrigerated, although the antimicrobial preservative in these insulins may actually be more effective at room temperature. Owners of diabetic cat or dogs use refrigerated glargine or detemir routinely for up to 3 months without evidence of problems occurring. The insulin should be discarded immediately, however, if any cloudiness or discoloration is noted. This issue with bacterial contamination seems to be extremely rare. Pet owners are much more likely to accidentally drop and break the vial, than to have to throw it away because it develops discoloration. Continue reading >>

Can Insulin Go Back In The Fridge?

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 >>

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