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Insulin Expiration Date Chart

Insulin Pens: How To Give A Shot

Insulin Pens: How To Give A Shot

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful as people imagine because the needles are short and thin. Insulin shots are given into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. The following instructions are for using most disposable insulin pens. If you are using a refillable pen, check with your doctor, diabetes educator or pharmacist on how to use. If you prefer to use a vial and syringe, refer to UPMC patient education page Insulin: How to Give a Shot. ADVANTAGES of insulin pens: Easy to use and carry Looks like a pen for writing (discreet/not easily noticed) No need to draw the insulin dose from a vial/bottle Can be used for most insulin types Doses can be easily dialed Less waste of expired insulin if not much insulin is used within time period designated (300 units in each pen)…see table end of this document To some people it may be less scary than a syringe DISADVANTAGES: Cannot mix different kinds of insulin together in a prescribed dose. Before you give the shot, you will need the following: Insulin pen Alcohol swab, or cotton ball moistened with alcohol Pen needle (be sure your doctor writes your prescription for the pen needles as well as the specific type of insulin pen) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of an Insulin Pen Wash your hands. Check the drug label to be sure it is what your doctor prescribed. Check the expiration date on the pen. Do not use a drug that is past the expiration date. Also do not use if beyond number of days listed in table at end of this document once opened and in use. Remove pen cap Continue reading >>

How Long Should You Keep Insulin Pens?

How Long Should You Keep Insulin Pens?

Did you read our blog on insulin vials and think to yourself, does this apply to my insulin pens too? If so, this post is for you! With so many different insulin and insulin-like products out there these days it can be hard keep track of how long each of these pens stays good. Depending on your dose, you may still have insulin left in your pen at the manufacturer-recommended time to throw it away. If this sounds like a familiar situation, know that it is important to throw away your pen regardless of whether you have any leftover. You might think it’s wasteful, but using the medication past the recommended time can actually do you more harm than good. You may notice if you continue to use insulin from a pen that’s past the manufacturers discard date, your blood glucose may 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 they don’t all have the same recommendations. As a quick reminder, the different categories of insulin are: Rapid-acting. Short-acting (regular). There are no short-acting insulin pens available Intermediate-acting. Long-acting. So how long can you hold on to your insulin pen after you start to use it? Rapid-acting insulin Novolog FlexPen: use within 28 days after first use Novolog cartridge (for use in a re-useable pen): use within 28 days after first use Humalog KwikPen: use within 28 days after first use Humalog cartridge (for use in a re-useable pen): use within 28 days after in-use Apidra SoloStar: use within 28 days after first use Intermediate-acting insulin Long-acting insulin Lantus SoloStar: use within 28 days after first use Toujeo SoloStar: use within 28 days after first use Levemir FlexTouch: use 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 >>

How To Mix Insulin Clear To Cloudy

How To Mix Insulin Clear To Cloudy

Learn how to mix insulin clear to cloudy. Drawing up and mixing insulin is a skill that nurses will utilize on the job. Insulin is administered to patients who have diabetes. These type of patients depend on insulin so their body can use glucose. Therefore, nurses must be familiar with how to mix insulin. The goal of this article is to teach you how to mix insulin. Below are a video demonstration and step-by-step instructions on how to do this. How to Mix Insulin Purpose of mixing insulin: To prevent having to give the patient two separate injections (hence better for the patient). Most commonly ordered insulin that are mixed: NPH (intermediate-acting) and Regular insulin (short-acting). Important Points to Keep in Mind: Never mix Insulin Glargine “Lantus” with any other type of insulin. Administer the dose within 5 to 10 minutes after drawing up because the regular insulin binds to the NPH and this decreases its action. Check the patient’s blood sugar and for signs and symptoms of hypoglycemia to ensure they aren’t hypoglycemic …if patient is hypoglycemic hold the dose and notify md for further orders. Key Concept for Mixing Insulin: Draw up CLEAR TO CLOUDY Remember the mnemonic: RN (Regular to Nph) Why? It prevents contaminating the vial of clear insulin with the cloudy insulin because if contaminated it can affect the action of the insulin. Why does this matter because they will be mixed in the syringe? You have 5 to 10 minutes to give the insulin mixed in the syringe before the action of the insulins are affected Demonstration on Drawing Up Clear to Cloudy Insulin Steps on How to Mix Insulin 1. Check the doctor’s order and that you have the correct medication: Doctor’s order says: “10 units of Humulin R and 12 units of Humulin N subcutaneous before b Continue reading >>

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® (insulin aspart injection) 100 U/mL is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus. NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is re Continue reading >>

Update On Insulin Treatment For Dogs And Cats: Insulin Dosing Pens And More

Update On Insulin Treatment For Dogs And Cats: Insulin Dosing Pens And More

Authors Thompson A, Lathan P, Fleeman L Accepted for publication 19 February 2015 Checked for plagiarism Yes Peer reviewer comments 3 1School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia; 2College of Veterinary Medicine Mississippi State University, Starkville, MS, USA; 3Animal Diabetes Australia, Melbourne, VIC, Australia Abstract: Insulin therapy is still the primary therapy for all diabetic dogs and cats. Several insulin options are available for each species, including veterinary registered products and human insulin preparations. The insulin chosen depends on the individual patient's requirements. Intermediate-acting insulin is usually the first choice for dogs, and longer-acting insulin is the first choice for cats. Once the insulin type is chosen, the best method of insulin administration should be considered. Traditionally, insulin vials and syringes have been used, but insulin pen devices have recently entered the veterinary market. Pens have different handling requirements when compared with standard insulin vials including: storage out of the refrigerator for some insulin preparations once pen cartridges are in use; priming of the pen to ensure a full dose of insulin is administered; and holding the pen device in place for several seconds during the injection. Many different types of pen devices are available, with features such as half-unit dosing, large dials for visually impaired people, and memory that can display the last time and dose of insulin administered. Insulin pens come in both reusable and disposable options. Pens have several benefits over syringes, including improved dose accuracy, especially for low insulin doses. Keywords: diabetes, mellitus, canine, feline, NPH, glargine, porcine lente Introduction Insulin the 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. 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 56F and 80F.) 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 36F and 46F). 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 56F and 80F.) 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 started to use them. Lispro (Humalog): Discard opened bott Continue reading >>

Novolog Mix 70-30

Novolog Mix 70-30

NovoLog® Mix 70/30 (70% insulin aspart protamine suspension and 30% insulin aspart) Injection, [rDNA origin]) Suspension for Subcutaneous Injection DESCRIPTION NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) (70% insulin aspart protamine suspension and 30% insulin aspart injection, [rDNA origin]) is a human insulin analog suspension containing 70% insulin aspart protamine crystals and 30% soluble insulin aspart. NovoLog Mix 70/30 is a blood glucoselowering agent with an earlier onset and an intermediate duration of action. Insulin aspart is homologous with regular human insulin with the exception of a single substitution of the amino acid proline by aspartic acid in position B28, and is produced by recombinant DNA technology utilizing Saccharomyces cerevisiae (baker's part (NovoLog) has the empirical formula C256H381N65O79S6 and a molecular weight of 5825.8 Da. Figure 1: Structural formula of insulin aspart NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) is a uniform, white, sterile suspension that contains insulin aspart 100 Units/mL. Inactive ingredients for the 10 mL vial are mannitol 36.4 mg/mL, phenol 1.50 mg/mL, metacresol 1.72 mg/mL, zinc 19.6 μg/mL, disodium hydrogen phosphate dihydrate 1.25 mg/mL, sodium chloride 0.58 mg/mL, and protamine sulfate 0.32 mg/mL. Inactive ingredients for the NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) FlexPen are glycerol 16.0 mg/mL, phenol 1.50 mg/mL, metacresol 1.72 mg/mL, zinc 19.6 μg/mL, disodium hydrogen phosphate dihydrate 1.25 mg/mL, sodium chloride 0.877 mg/mL, and protamine sulfate 0.32 mg/mL. NovoLog Mix 70/30 (insulin aspart protamine and insulin aspart rdna origin) has a pH of 7.20 - 7.44. Hydrochloric acid or sodium hydroxide may Continue reading >>

Levemir Flextouch And Vial | Levemir (insulin Detemir [rdna Origin] Injection)

Levemir Flextouch And Vial | Levemir (insulin Detemir [rdna Origin] Injection)

Levemir FlexTouch, the latestin prefilled pen technology from Novo Nordisk Low-injection force push button.A built-in spring mechanism requires low force to inject all doses. When your dose is delivered, youshould hear or feel a clicka Accurate dosing.Turn the dose selector to select the number of units you need to inject, from 1-80 units. A large and clear dose display shows the units you have selected Thinnest needle available.The 32G Tip needle is the thinnest needle made by Novo Nordisk,b a leader in diabetes care for more than 90 years More insulin than a vial.One box of LevemirFlexTouch contains 5 disposable pens, each prefilled with 300 units of Levemir for a total of 1500 units of Levemirinsulin. Youll get 50% more insulin than you get from a vial (1000 units) Insurance coverage.Levemir FlexTouch is covered by most health insurance and Medicare plans nationwide aAfter dose counter has returned to 0, keep needle in skin for 6 seconds before the needle is removed. If you do not, you may not have received your full dose and you should check your blood sugar more often because you may need more insulin. You may or may not hear an audible click at end of dose. bNeedles are sold separately and may require a prescription in some states. Needles and LevemirFlexTouchmust not be shared. If you prefer to take your insulin with a vial and syringe, or if you need to receive your insulin in a vial for insurance reasons, you can still get Levemir. Unopened Levemirshould be kept in the refrigerator at a temperature range between 36 and 46F (2 and 8C) Keep unopened Levemir in the carton to protect from light Unopened Levemir can stay in the refrigerator until expiration. See the expiration date on the box Keep at room temperature, below 86F (30C), and not refrigerated for up to Continue reading >>

Long-acting Insulins

Long-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Drug UPDATES: TRESIBA ®- insulin degludec injection [Drug information / PDF] Click link for the latest monograph Dosing: Click (+) next to Dosage and Administration section (drug info link) Initial U.S. Approval: 2015 Mechanism of Action: The primary activity of insulin, including TRESIBA, is regulation of glucose metabolism. Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis. TRESIBA forms multi-hexamers when injected into the subcutaneous tissue resulting in a subcutaneous insulin degludec depot. The protracted time action profile of TRESIBA is predominantly due to delayed absorption of insulin degludec from the subcutaneous tissue to the systemic circulation and to a lesser extent due to binding of insulin-degludec to circulating albumin. INDICATIONS AND USAGE: TRESIBA is indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use TRESIBA is not recommended for the treatment of diabetic ketoacidosis. Dosing: Individualize dose based on type of diabetes, metabolic needs, blood glucose monitoring results and glycemic control goal. Rotate injection sites to reduce the risk of lipodystrophy. Do not dilute or mix with any other insulin or solution. Administer subcutaneously once daily at any time of day. Do NOT perform dose conversion when using the TRESIBA U-100 or U-200 FlexTouch pens. The TRESIBA U-100 and U-200 FlexTouch pens dose window shows the number of insulin units to be delivered and NO conversion is needed. HOW SUPPLIE Continue reading >>

Regular-insulin, Injectable Solution

Regular-insulin, Injectable Solution

Insulin regular (human) injectable solution is available as brand-name drugs. It’s not available in a generic form. Brand names: HumuLIN R, NovoLIN R. Insulin regular (human) comes in three forms: injectable solution, powder for inhalation, and an intravenous injection. Insulin regular (human) injectable solution is used along with a healthy diet and exercise to control high blood sugar caused by type 1 or type 2 diabetes. Low blood sugar warning: Insulin regular (human) can cause low blood sugar (hypoglycemia). If you have a low blood sugar reaction, you’ll need to treat it right away. Symptoms can include: hunger dizziness shakiness lightheadedness sweating irritability headache fast heart rate confusion Thiazolidinedione warning: Taking certain diabetes pills called thiazolidinediones (TZDs) with insulin regular (human) may cause heart failure in some people. This can happen even if you’ve never had heart failure or heart problems before. If you already have heart failure, it may get worse. Your healthcare provider should monitor you closely while you’re taking TZDs with insulin regular (human). Tell your doctor right away if you have new or worse symptoms of heart failure, including: shortness of breath swelling of your ankles or feet sudden weight gain Infection warning: Do not share insulin vials, syringes or prefilled pens with other people. Sharing or reusing needles or syringes with another person puts you and others at risk for various infections. Insulin regular (human) is available as an over-the-counter (OTC) and prescription drug. It comes as a solution that you inject subcutaneously (under your skin). Your healthcare provider will show you how to give yourself the injection. You can also follow this guide for self-injection. Insulin regular (human Continue reading >>

Insulin And Non-insulin Injectable Diabetes Medications: Practical Information For Pharmacists

Insulin And Non-insulin Injectable Diabetes Medications: Practical Information For Pharmacists

Insulin and Non-Insulin Injectable Diabetes Medications: Practical Information for Pharmacists At some point in your career, youve probably encountered questions from patients or health care team members about diabetes medications stability and how the products are supplied. The following tables are intended to serve as practical guides, providing information on the various insulin vials (Table 1), insulin pens (Table 2), and non-insulin injectables (Table 3) currently available on the market. Please read individual package inserts for more details and updates as they occur. Erin Pauling, PharmD, is a clinical assistant professor of ambulatory care at Binghamton University School of Pharmacy and Pharmaceutical Sciences. She received her PharmD from the Bernard J. Dunn School of Pharmacy at Shenandoah University. She completed a PGY1 community pharmacy residency with Appalachian College of Pharmacy and a PGY2 ambulatory care residency with Wingate University School of Pharmacy. Her professional interests include anticoagulation, diabetes, immunizations and travel medicine. Pharmacy Times is the #1 full-service pharmacy media resource in the industry. Founded in 1897, Pharmacy Times reaches a network of over 1.3 million retail pharmacists. Through our print, digital and live events channels, Pharmacy Times provides clinically based, practical and timely information for the practicing pharmacist. Features and specialized departments cover medication errors, drug interactions, patient education, pharmacy technology, disease state management, patient counseling, product news, pharmacy law and health-system pharmacy. Pharmacy Times Continuing Education (PTCE) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy educati 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 >>

Short-acting Insulins

Short-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Onset: 30 minutes Peak: 2.5 - 5 hours Duration: 4 - 12 hours Solution: Clear Comments: Best if administered 30 minutes before a meal. Mixing NPH: If Regular insulin is mixed with NPH human insulin, the Regular insulin should be drawn into the syringe first. Aspart - Novolog ®: Compatible - but NO support clinically for such a mixture. Draw up Novolog first before drawing up Regular Insulin. Lispro - Humalog ®: Compatible - but NO support clinically for such a mixture. Draw up Humalog first before drawing up Regular Insulin. Mixtures should not be administered intravenously. When mixing insulin in a syringe, draw up the quickest acting insulin first (e.g. draw up Humalog or Novolog before drawing up Regular Insulin, or draw up Regular insulin before Novolin N (NPH) or Lente insulin. CLINICAL PHARMACOLOGY Insulin is a polypeptide hormone that controls the storage and metabolism of carbohydrates, proteins, and fats. This activity occurs primarily in the liver, in muscle, and in adipose tissues after binding of the insulin molecules to receptor sites on cellular plasma membranes. Insulin promotes uptake of carbohydrates, proteins, and fats in most tissues. Also, insulin influences carbohydrate, protein, and fat metabolism by stimulating protein and free fatty acid synthesis, and by inhibiting release of free fatty acid from adipose cells. Insulin increases active glucose transport through muscle and adipose cellular membranes, and promotes conversion of intracellular glucose and free fatty acid to the appropriate storage forms (glycogen and triglyceride, respectively). Although the liver does not require active glucose transport, insulin increases hepatic gl Continue reading >>

Keeping An Eye On Your Insulin

Keeping An Eye On Your Insulin

For millions of people with diabetes, technology has supplied us with wonderful, helpful aids to help control blood sugar. While some of these medications come in pill form and remain stable when stored out of light and at moderate temperatures, people with diabetes who use insulin need to depend on more than technology to make sure their insulin is in top form. As associate dean and professor of pharmacy at Washington State University, a certified diabetes educator and a person with diabetes for more than 50 years, Keith Campbell knows the importance of keeping an eye on insulin. Campbell believes that establishing a routine surrounding insulin use helps ensure the product stays potent and stable. Step One: Check the Label Campbell advises that the first thing a person with diabetes should do is check the insulin’s expiration date, even before leaving the pharmacy. “Drug companies and the FDA are very conservative with the dates,” says Campbell. This means they tend set expiration date at the earliest time the insulin could possibly go bad, and sometimes even earlier. Sofia Iqbal, RPh, a drug information scientist with Novo Nordisk Pharmaceuticals, confirms this. “Expiration dates and storage guidelines are based on stability data obtained for batches of each formulation of insulin,” Iqbal says. She adds that the dates are valid as long as the insulin is kept stored under the correct conditions. “Never use insulin after the expiration date printed on the label and carton,” Iqbal warns. If you get your insulin home and discover the expiration date has passed, what should you do? Campbell advises that you return it to the pharmacy immediately for replacement. Step Two: Examine the Insulin Eli Lilly and Company’s Kara Appell, RPh, a medical information adm Continue reading >>

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