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Can Expired Insulin Hurt You

Death By Expired Insulin Prescription

Death By Expired Insulin Prescription

A family’s grief leads to a bill that would allow pharmacists to dispense insulin without a current prescription to save lives. It’s been 16 months since Dan and Judy Houdeshell lost their son, Kevin, and they are trying to accept that they may never know exactly what happened. Kevin, who was on insulin therapy, was found dead in his home in Sheffield Lake, Ohio on January 8th, 2014. He had been without insulin for nine days at the time of his death. Dan and his family have tried to reconstruct those last days the best they can, talking with Kevin’s co-workers and examining text messages Kevin sent. “The last four days, he was by himself,” Dan says. “I can only imagine…no, I can’t even imagine what it was like.” sponsor There were many steps that led to Kevin’s death. The path may have included some less-than-perfect choices in his self-care, and bad luck; there is still so much that isn’t known. Dan is certain, however, of the first action that set off the chain of events that led to Kevin’s death: he was denied insulin at a local pharmacy on New Year’s Eve. Since then, Dan and his family have been calling for a change to Ohio state law to expand the prescribing authority of state pharmacists so people on insulin therapy, and those who need other life-saving medications, need not walk away empty-handed. The Ohio legislature is taking up a bill that would incorporate these changes into law. Dan hopes Kevin’s death might lead to a change that can help others. “It doesn’t really help us with the grieving process, it’s just something we have to do,” he says. “We don’t want this to happen to anyone ever again.” The DKA spiral Here’s what happened: On December 31st, 2013, Kevin was out of insulin and tried to get some at the pharma 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 Long Does Insulin Last Once It's Been Opened?

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 >>

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 >>

Common Insulin Pen Errors: Diabetes Questions & Answers

Common Insulin Pen Errors: Diabetes Questions & Answers

Q. I recently switched from using syringes to inject insulin to using an insulin pen, and it seems like I need to inject more insulin with the pen to counter the same blood glucose level. The length of the needle seems to be the same, the pen is primed, and yet the pen injection has less of a blood-glucose-lowering effect. What could be going on here? A. The insulin contained in vials and pens is identical. So if you’re using your pen correctly, there should be no change in the effectiveness of the insulin on your blood glucose levels. It’s not unusual for people to be educated on how to use an insulin pen and to believe they are injecting with proper technique but to make one or more minor mistakes that affect the amount of insulin being injected. I recommend that you make an appointment with your diabetes educator or health-care provider and have that person observe you injecting a dose of insulin to see what, if anything, might be going wrong. Here are a few examples of common errors that can occur when administering insulin with a pen: A person may dial in the correct dose, put the needle into the skin correctly, but instead of pushing the button at the end of the pen to inject the insulin, dial the dose back to zero. This would result in no insulin being injected. Once the dose is dialed, the button has to be pushed in all the way — you should hear a series of clicks as you push — and then the pen must be held against the skin, needle inserted, for 6–10 seconds. Some people know that they need to push the button to deliver the insulin, but they don’t push it hard enough to inject the entire dose. Another common mistake is to fail to leave the needle in place for at least 6 seconds after pushing the button on the pen. If the needle is removed too soon, t 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 >>

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 >>

Insulin Basics | Diabetesnet.com

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 >>

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 >>

Using Expired Medicine

Using Expired Medicine

When we act like responsible adults, we always look at the expiration dates on the containers of prescription medicine and over-the-counter drugs that we use. Just to give one example, I can’t count the number of times that I have tossed old aspirin tablets. Now, it turns out, I was throwing away my money. From now on I will be saving money after reading an article in the current issue of my favorite health newsletter, which I subscribe to the old-fashioned way, on paper. The article, “Out on a date” in the October issue of the “UC Berkeley Wellness Letter,” explains that expiration dates are guarantees that prescription and over-the-counter drugs will be both potent and safe until then. But they don’t mean that after the expiration date, they won’t be effective or safe. It all comes down to money. Ours and that of the drug companies. “In many cases, drugs are stable for longer,” the article concludes, “but there’s little incentive for manufacturers to test them to see how long they will really last. Longer expiration dates would cut down on sales.” At least in this respect (and in probably many other ways), my friend Gretchen Becker is wiser than me. She tells me that she was already taking the expiration dates with a grain of salt. “It’s not as if the medication is fine until midnight Sunday and then suddenly, starting Monday at 1 a.m., it’s no good,” she says. How long since the drug companies stamped out their pills is just one of many factors determining when the drugs begin to break down. Heat, humidity, light, and temperature fluctuations all count. Those are good reasons for us to store our pills in cool, dry, and dark places. Keeping them in our cars and bathrooms would be the worst places. Insulin is one huge exception to the ex Continue reading >>

Expired Insulin - To Use Or Not

Expired Insulin - To Use Or Not

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. I have a vial of Humalog, new and unopened, that has an expiration date of 12/07. Am I risking by using this insulin? As far as I know the worst thing that will happen will be that it won't work. I wouldnt personally use it, but that is just because I dont want to risk a huge bg spike from lack of insulin after a meal, its not worth the risk. I would use it and test. I might not use it in a pump (infusion set, etc) without first trying one shot to confirm viability. The stuff doesn't go from 100% perfect to useless in 3 months. It loses potency over time. The only caveat is cloudiness. It has to be clear. I have a vial of Humalog, new and unopened, that has an expiration date of 12/07. Am I risking by using this insulin? Do you have an vials of humalog that are NOT expired? If so, it is unnecessary to use the expired one. The viability of expired insulin is QUESTIONABLE at best. I **ALWAYS** feel like I did something wrong when I have BG spikes that I am directly responsible for and feel like I should be sitting in the naughty chair for having done so.. Hey, if you have NO other choice, you do what you've got to do, but if you have insulin within it's shelf life range, stick with the "good stuff". While sticking a proverbial fly in the ointment is entertaining, guinea pigs are just that because they can't say NO. And just an FYI, I am GREAT at giving advice *cough* at times lousy at taking it. If the insulin has been kept in the fridge the entire time and it is within 2 or 3 months of the expiration date, I'd have no reservations about using it. Of course, I'd try to use it within 30 days of Continue reading >>

How Long Does Insulin Really Last?

How Long Does Insulin Really Last?

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. I've seen a similar thread in the past, but now I've got my own experience to go on, and I'd like to hear about yours. Your actual experience, mind - not what you've read. Now, everybody knows what the drug companies say - 28 days after first use and then get rid of it. Yet it can stay "unopened" in the fridge for 2 years. When I was researching this (will try to give references if I can find them again) the papers I found cited several factors for length of original potency: When I was using vials, I always left them in the fridge. Injecting cold doesn't bother me, but if it bothers you, let the syringe warm up instead of the whole bottle. I could routinely go 45 days with no loss of potency (Lantus). I've never had vials of Novolog, so I can't speak to that. The pens change things, because there is no added air. They have caps, so no light. Don't carry them around, so no motion. I can see no reason why they cannot be used until their expiration date. I've got a NovoPen I've been using (from the fridge) for 2 months, and it works just fine. Also, I've still got a pen (Novolog) that I started using November 4 (it has been room temp for that time). I do carry it with me (as a backup) - mostly I 'm at home for meals. I do check for cloudiness, etc, but so far so good. Used it recently, and I did shoot 5 U, instead of the 3 U I would with fresh, and worked just as expected. Yes, after 3 months it's time to change it out. So I'm asking about two things really. One is saving money - why throw it out when it is fine if kept cold? I'm sure big Pharma likes it only good 28 days - why that magic numbe Continue reading >>

5 Insulin Mistakes You Need To Avoid

5 Insulin Mistakes You Need To Avoid

If you use insulin to keep your blood sugar in check, these five common mistakes could lead to dangerous lows or highs. What you need to know: 1. Wrong dose, wrong insulin. There are four basic types of insulin: Rapid- and short-acting insulins are injected before a meal to cover the rise in blood sugar from the food you’re about to eat; intermediate- and long-acting insulins control blood sugar for up to 24 hours, covering periods of time when shorter-acting types have stopped working. People with type 1 diabetes often take a combination of shorter-and longer-acting insulins – and that’s where mix-ups can happen. Among the most common: Taking a too-high dose of a rapid-acting insulin because you’ve mistaken it for a longer-acting type, according to a report in the journal Clinical Diabetes. The danger: Low blood sugar. The fix: If this happens to you, eat enough carbohydrates to cover the extra insulin, keep monitoring your blood sugar, watch for signs of hypoglycemia (such as shaking, sweating or a headache ) and call your doctor right away if you have any concerns. To prevent it from happening again, make sure you know which insulin is which and what the right dose is. In a 2014 report in the journal Prescrire International, experts note that sometimes, doctors and pharmacies abbreviate the word “units” to “U”, which can look like an extra zero, leading people to take insulin doses ten times higher than prescribed. Ask your doctor or pharmacist if you’re unsure of the right dose. 2. Sharing an insulin pen. Insulin pens are a convenient way to get a just-right dose without filling and injecting yourself with a conventional syringe. They can be used multiple times, with a new needle each time. But a fresh needle doesn’t mean sharing’s OK. The Cent Continue reading >>

The Truth About Expired Meds

The Truth About Expired Meds

En español | There's certainly controversy about expiration dates on food, but as upsetting to your stomach as it can be to eat items that are no longer fresh, taking expired medications can be more complicated and, in certain cases, have far greater consequences. "If the drug is an over-the-counter product for minor aches and pains, you may not get 100 percent of the benefits if the expiration date has passed, but it's not dangerous," explains Rabia Atayee, an associate clinical professor of pharmacy at the University of California, San Diego. However, for people taking medications for chronic or life-threatening illnesses — such as heart conditions, seizures, COPD or severe allergies — a drug that's not completely effective can be downright dangerous, she says. Here are some answers to common questions that may help you stay out of harm's way when it comes to ingesting and discarding expired medications. 1. "I have some five-year-old antibiotics I want to take on my vacation in case I get sick. Are they still good?" They won't make you sick, but they may not be strong enough to fight off infection, which can be harmful. Over time, antibiotics stored at home can lose up to 50 percent or more of their strength, meaning they may not be able to halt a potentially life-threatening bug that's invading your system. Plus, if you're taking leftover antibiotics from a past illness, you won't have a complete dose to knock out all the bacteria. As Amy Tiemeier, associate professor of pharmacy practice at St. Louis College of Pharmacy, points out, not taking a full dose allows the most drug-resistant bacteria to remain in your body. You then risk getting the same infection again and needing a stronger drug to knock it out, which could mean more side effects and pricier antibi Continue reading >>

Old Insulin Better Than No Insulin?

Old Insulin Better Than No Insulin?

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. I ran out of insulin a few weeks back while I was out of town, and couldn't get a refill on my insulin (without paying full price) because I had already refilled the week before. Anyway, I've decided to give a friend an extra bottle of insulin where I travel to on a regular basis in case I forget / run out of insulin unexpectedly, but started to think: if it's several months down the road - would the insulin still be any good? (We're dealing with an opened refrigerated bottle of Humalog.) let me think here, I THINK 3 months after its been opened refigerated, I know it's 1 month out of the fridge We get our insulin thru the mail, three month supply at a time, so it must be safe in the fridge for at least three months. But it would be better if it was unopened, I would think LocationSomewhare in the South Pacific??? but started to think: if it's several months down the road - would the insulin still be any good? (We're dealing with an opened refrigerated bottle of Humalog.) As long it's been in the fridge it should be ok I would think. For me I have disposable syringes to get the last drop as I hate waste. Which reminds me to go to the pharmacy and get some novorapid. Does anyone know if the potency just diminishes, or if it goes bad completely after 3 months or so? I am sure if the vial has not been opened it will be good for a very long time. I would also think that a partially used vial if refrigerated would have an extended life. One thing you could consider if you can get it is a box of the Humalog pen cartridges. Each vial in a box with 5 I believe is 3 ml in volume rather than 10 ml (Ith Continue reading >>

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