Relion Insulin: Everything You Need To Know
For my patients who have no insurance, ReliOn products at Walmart are a lifesaver. In North Carolina, we never funded Medicaid expansion. Some people could receive Obamacare through the federal marketplace, but others were left in the gap where it was too costly for them. The tax penalty was less, so they took the penalty instead of buying coverage. For those with Type 1 and Type 2 Diabetes in the no insurance gap, for those in the “Medicare donut hole,” and for those in disaster situations, ReliOn insulin is available at a very affordable cost. If you want insulin at a cheaper cost, it is important to be aware of some of the differences between ReliOn insulin and name brand insulins. Renee’s story Renee had Type 1 Diabetes, and couldn’t afford her insurance coverage here in North Carolina. After running her insurance cost numbers on the Federal Marketplace, she would have to pay $300 per month for catastrophic coverage that wouldn’t even cover her diabetes medications. Her husband had lost his job, and she worked at a grocery store, where she didn’t make a living wage, or have any insurance benefits. She came in crying. She needed help, because she had lost her insurance coverage, and she was about to run out of her insulin. She was afraid of what might happen to her, and what might happen to her little boy, if she ran out of her insulin. We referred her to a social worker who could help her with needed resources, and see if she could qualify for Medicaid, or start social security disability determination so she could get insurance when determined disabled. In the meantime, we spoke with her doctor, and he gave us conversion doses for Renee to switch to the ReliOn brand of insulins at Walmart. She had to take a combination of ReliOn Humulin N injections twi Continue reading >>
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 >>
How Long Is An Open Vial Of Insulin Good For?
Once an insulin vial is punctured and open there is a limited amount of time that the vial can be stored before it becomes unsafe to use. Many people who use insulin will have left over medication in the vial because of the size of their daily dosages. Different insulin products have different time limits on being able to store it safely and it can be hard to track and remember. Not all types of glucose will have the same expiration time on open vials. They not only vary by type but also by the drug used. Here’s a help list to refer to for the proper length of time to store open (punctured) vials: Long-Acting Insulin Intermediate-Acting Insulin Humulin N: 1 month (31 days) after opening Short-Acting Insulin Novolin R: 42 days after opening Humulin R: 31 days after opening Humulin R U-500 concentrated: 31 days after opening Rapid-Acting Insulin Aspart (novolog): 28 days after opening Glulisine (apidra): 28 days after opening Lispro (humalog): 28 days after opening Other Non-Insulin Injected Medication Bydureon: use immediately once punctured and mixed. Do not store any unused portions. Helpful Tips Do not keep insulin in a hot space or overly warm room. Heat will break down the insulin and make it ineffective. Open vials can be stored at room temperature or in the refrigerator. Do not store insulin in sunlight. Direct light will also break down the insulin. Look at your insulin vial before using it after storage. Insulin should always be clear, never cloudy in appearance. There should not be any white particles or solid crystals. Insulin that is not clear or that has a smell or odor should not be used and must be thrown away. It may feel wasteful to throw away unused insulin when the recommended use time is reached. However, the medication loses its effectiveness past Continue reading >>
How Long Does The Insulin Last? Do The Math!
In assessing an in-patient’s diabetic educational needs, I was reviewing with him his in-home regimen for his insulin therapy. Per his report, he stated that he took Levemir 50 units twice a day. I asked if it was by needle, syringe and vial preparation, which it was. I instructed him re: the shelf life of Levemir of 42 days once opened. He stated, “I throw it out after a month, but there is always insulin in the vial.” He also said he has more than an adequate supply. He was receiving his insulin by mail-order, receiving as he should, but not using it in a timely fashion. In other words, he was stockpiling his insulin. I asked him to review with me again the dosing that he takes as I reviewed the math with him. If he is taking 100 units per day and a vial contains 1000 units, his Levemir should be gone in 10 days. Both he and his wife had quite a perplexed look on their face after they did the math in their head. She stated she always left his medication management to him. I reviewed his dosing again with him and reviewed how many vials he should go through in a month. I taught them how to properly draw up and administer the insulin. He performed a return demonstration. I requested that they work together as a team and to have his wife review with him his drawing up technique for accuracy. I encouraged them to follow up with me at discharge to discuss further questions/concerns. Lessons Learned: Inform patient about how long an insulin vial or pen should last. Inform the patient how long an insulin vial or pen should last once opened. This stresses the importance of proper expiration once opened versus shelf life. Explore with the patient not only what he or she is verbally telling you, but ask how often they use a new vial or pen, and if they have extras at home Continue reading >>
Humulin N Vials: Indications, Side Effects, Warnings - Drugs.com
The originating document has been archived. We cannot confirm the completeness, accuracy and currency of the content. Generic Name: insulin isophane (IN-su-lin EYE-soe-fane) Brand Name: Examples include Humulin N and Novolin N Humulin N vials are an intermediate-acting form of the hormone insulin. It works by helping your body to use sugar properly. This lowers the amount of glucose in the blood, which helps to treat diabetes. you are allergic to any ingredient in Humulin N vials you are having an episode of low blood sugar Contact your doctor or health care provider right away if any of these apply to you. Some medical conditions may interact with Humulin N vials. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you drink alcoholic beverages or smoke if you have heart problems (eg, heart failure); kidney or liver problems; nerve problems; adrenal, pituitary, or thyroid problems; or diabetic ketoacidosis if you use 3 or more insulin injections per day if you are fasting, have high blood sodium levels, or are on a low-salt (sodium) diet Some MEDICINES MAY INTERACT with Humulin N vials. Tell your health care provider if you are taking any other medicines, especially any of the following: Beta-blockers (eg, propranolol), clonidine, guanethidine, lithium, or reserpine because they may increase the risk of high or low blood sugar or may hide the signs and symptoms of low blood sugar, if it occurs Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), disopyram Continue reading >>
Q & A: How Long Can Nph Insulin Be Used Once A Vial Is Started?
How long can human, recombinant NPH insulin be used once the vial is opened? Our local pharmacist told one of my diabetic dog owners that the human NPH insulin she is using for her dog would only be effective for 30 days. After that time, the pharmacist claims the vial should be discarded and replaced with a fresh vial of insulin. The pharmacy also told the owner that the insulin should not be refrigerated. I'm confused. I always thought that NPH insulin should be refrigerated and is good 'till the last drop!" My Response The pharmacist is right and wrong in his advise — it just "depends." In general, open NPH insulin vials in human diabetic patients are kept unrefrigerated to minimize local injection site irritation, which may occur after injection of cold insulin solutions. Human patients are also told to replace the insulin with a new vial every 4 to 6 weeks. Why? Because the insulin my lose some of its potency after the vial has been in use for >30 days when stored at room temperature. In both humans and animals, we can recommend general guidelines for the storage and handling of NPH insulin preparations, which include Humulin N, Novolin N, or Humulin/ReliOn NPH (1). All opened insulin vials should be inspected daily for physical changes, such as clumping, frosting, precipitation, or discoloration, that may be accompanied by a loss of potency. Insulin vials should be optimally stored at refrigerated temperatures (36–46°F). The insulin vial should never be allowed to freeze. Insulin vials should never be used after the expiration date printed on the label and carton. Unrefrigerated insulin vials that are in use should be kept cool and away from excess heat or sunlight. We ask our pet owners to refrigerate the insulin, which tends to extend the shelf life of the 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 >>
Diabetes Mellitus In Dogs And Cats (proceedings)
a. Should not be diluted or mixed as this will affect pH b. Should be kept refrigerated. Once open the vial has a shelf life of 4 weeks at room temperature. I would discard any remaining insulin after 8 weeks of refrigeration pending further clinical data. 2. PZI: As with dogs we only recommend the use of PZI Vet from Idexx. The initial starting dose 3. Humulin N and Novolin N: Similar to PZI with remission rates of 40-50 % when used with a low carbohydrate-high protein diet. Starting doses are generally 1-3 units/cat once a day. 4. Vetsulin: Again similar to PZI and Humulin N with remission rates of 40-50 % when used with a low carbohydrate-high protein diet. Starting doses are generally 1-3 units/cat once a day. If you have patients currently taking either Humulin L or Humulin U, I would switch them to either Vetsulin or Humulin N. The initial starting dose will remain the same with re-assessment of clinical signs and a serial blood glucose curve performed 1 week after changing insulin preparations. If you wish to transition them to glargine, I would follow the dosage recommendations as outlined above under newly diagnosed patients. It is important to note that remission rates will be much lower with glargine and a low carbohydrate-high protein diet in long standing diabetic patients (cats with diabetes for more than 6 months) than in newly diagnosed patients. With the recent introduction of the AlphaTrak Blood Glucose Monitoring System (Abbott) we have the ability to very accurately measure blood glucose concentrations in both dogs and cats using very small quantities of blood. This will allow both veterinarians and pet owners to obtain very reliable results in both the hospital and home setting. This information can then be used to make informed decisions regarding Continue reading >>
Humulin N Vs. Novolin N: A Side-by-side Comparison
Diabetes is a disease that causes high blood sugar levels. Not treating your high blood sugar levels can damage your heart and blood vessels. It can also lead to stroke, kidney failure, and blindness. Humulin N and Novolin N are both injectable drugs that treat diabetes by lowering your blood sugar levels. Humulin N and Novolin N are two brands of the same kind of insulin. Insulin lowers your blood sugar levels by sending messages to your muscle and fat cells to use sugar from your blood. It also tells your liver to stop making sugar. We’ll help you compare and contrast these drugs to help you decide if one is a better choice for you. Humulin N and Novolin N are both brand names for the same drug, called insulin NPH. Insulin NPH is an intermediate-acting insulin. Intermediate-acting insulin lasts longer in your body than natural insulin does. Both drugs come in a vial as a solution that you inject with a syringe. Humulin N also comes as a solution you inject with a device called a KwikPen. You do not need a prescription to buy Novolin N or Humulin N from the pharmacy. However, you do need to talk to your doctor before you start using it. Only your doctor knows whether this insulin is right for you and how much you need to use. The table below compares more drug features of Humulin N and Novolin N. Humulin N Novolin N What drug is it? Insulin NPH Insulin NPH Why is it used? To control blood sugar in people with diabetes To control blood sugar in people with diabetes Do I need a prescription to buy this drug? No* No* Is a generic version available? No No What forms does it come in? Injectable solution, available in a vial that you use with a syringe Injectable solution, available in a cartridge that you use in a device called a KwikPen Injectable solution, available in Continue reading >>
How Until My Dog's Insulin (humulin N) Expires And I Should Purchase A New Bottle?
Experience: Vet Tech for over 35+ years working w/Dogs/Rescues The majority of insulins are good for 28 days after opening. Since the time it is opened is over the 28 days, I personally would get a new bottle. You want to make sure that the insulin is at its best to do keep the balance in the blood sugar. Joan It still looks fine and my vet said three months but I don't really trust her and she is very new - ask her to give me a prescription to be on the safe side? Can it be filled at any pharmacy? I want my dog to have the best possible care but I am trying to cut costs (she has Cushing's as well). Dog Specialist: Joan , Vet Techreplied 6 years ago The shelf life if unopened is 5/2013. They say the open life of insulin can go from 28 days to 60 days for humans. I usually will go no more that 60 days once open. I am always afraid of loss of potency. Some Vets do feel that 90 days is safe since the smaller dogs get such a small amount and the shelf life is still good. Most owners feel bad throwing out the remainder of the bottle, since there is so much left. If you would feel better you could go the full 90 days, or as I would do use it until 60 days and refill it. Most Pharmacies can fill this for you. I would check prices at Walmart and Target as they may be cheaper. I hope this helps. Joan I think this is the greatest web site in the world. Thanks to all! I have referred several friends to your web site. I'm impressed with how easy it is to use your site, the Experts available and the quickness of answers. I am completely pleased with the quick response that I received in our time of need for our dog, Jasmine. I couldn't believe how quick the response was and I thank you. It's good to know you're there!! Please let everyone involved with your site know that your Expe Continue reading >>
Humulin N Nph U-100 Insulin (isophane Susp) Subcutaneous : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd
Insulin isophane is used with a proper diet and exercise program to control high blood sugar in people with diabetes . Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke . This man-made insulin product is the same as human insulin . It replaces the insulin that your body would normally make. It is an intermediate-acting insulin (isophane). It starts to work more slowly but lasts longer than regular insulin. Insulin isophane works by helping blood sugar ( glucose ) get into cells so your body can use it for energy. Insulin isophane is often used in combination with a shorter-acting insulin. It may also be used alone or with other oral diabetes drugs (such as metformin ). Read the Patient Information Leaflet provided by your pharmacist before you start using insulin isophane and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. Learn all preparation and usage instructions from your health care professional and the product package. Before using, gently roll the vial or cartridge, turning it upside down and right side up 10 times to mix the medication . Do not shake the container. Check this product visually for particles or discoloration. If either is present, do not use the insulin . Insulin isophane should look evenly cloudy/milky after mixing. Do not use if you see clumps of white material, a "frosty" appearance, or particles stuck to the sides of the vial or cartridge. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin and to avoid developing problems under the skin Continue reading >>
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 >>
23 -insulin Therapy - 5thsemesterhuy
More expensive than short acting insulin though Similar to dry powder inhaler (counsel on technique) Short duration --> less hypoglycemia risk Requires good lung function and technique - Will need multiple inhalations if they need more than 8U of insulin 6 units of Novolog usually used, use 8 units of Afrezza Given with meals to replace post-prandial insulin Liver is busy processing alcohol instead of making insulin Weight gain - Because insulin increases storage of TGs in adipose, remember Lipodystrophy - Lipohypertrophy: Thickening of adipose tissue More portable and discreet than vials - also more convenient, save time, easier to set doses and may be more accurate BUT they are more expensive than vials and syringes - Also not all types of insulin are available in pens, and you can't mix the insulins - Also, you have to remove the needle in the pen Humalog, Levemir, Novolog, and mixes are available in syringes Small device is worn externally that delivers insulin continuously to the pt NOT multiple types and NOT intermediate/long acting insulins Insulin pump: Constant infusion of basal insulin dose Set at different rates for better control Instead of using a long acting insulin, it will just give spurts of rapid/short acting insulin as needed Pt should write a new expiration date on the vial once it has been opened Shorter needles are used for children/thin pts Make sure the syringe is large enough to hold the dose - Inject at 90o if using a short needle, but at 450if using a long needle Wait 10 seconds before removing the needle Should you give rapid/short acting insulin if you aren't going to eat? Rotate sites to avoid abnormal fat distribution Can inject in abdomen, arms, thigh, or buttocks BUT stay within the same area of the body (because they have different abs Continue reading >>
Buy Humulin N Kwikpens Online Pack With 5 Pens X 3 Ml Each
Less common negative effects may include: Hypoglycemia or low blood sugar is the most common side effect of insulin. Because of this you should always carefully monitor your blood sugar levels. If left untreated, low blood sugar levels can lead to the loss of consciousness, coma and even death. shortness of breath and a sudden drop in blood pressure. Generalized allergy reactions are very serious and can require hospitalization. Get medical assistance immediately if you think you may be having a generalized allergic reaction to Humulin N. Diabetic ketoacidosis (DKA) may develop if your body does not have not have sufficient insulin. This can happen if you forget your insulin, take a smaller dose, eat more than you should, or if you get an infection or fever. Symptoms of DKA come on gradually and tend to get progressively worse. The symptoms may include, flushed face, feeling drowsy. Humulin N KwikPens are for subcutaneous (under the skin) injection only. Suitable injection sites include the thigh, upper arm, buttocks or abdomen. KwikPens are not to be refilled and are not designed for use with a syringe. Always read the Instructions for Use section before you start taking Humulin-N and each time you receive a new KwikPen. Never share your KwikPen with anyone, even if you have changed the needle. You may get a serious infection or disease from them or give other people a serious infection. Unused KwikPens are to be stored in the refrigerator at between 36F to 46F (2C to 8C). Do not freeze it. For KwikPens that you are currently using, store at room temperature (up to 86F 30C). Keep your KwikPen away from heat and light. Make sure to throw away your KwikPen after 14 days, even if it still has some insulin left in it. The Humulin-N KwikPen is not recommended for use if yo Continue reading >>
Changing Insulin Brands May Disrupt Diabetics
For nearly three years after a miniature pinscher named Ditty was diagnosed with diabetes, his owner successfully managed his blood-sugar levels by giving him regular shots of insulin. Then Ditty abruptly turned hypoglycemic. His owner brought the shaky, unsteady dog to his veterinary clinic in Poland, Maine. Dr. Derralyn Rennix quizzed Ditty’s owner about what might have changed in the dog’s daily routine. Different food? More exercise? That’s when the owner remembered: A week or two earlier, the Wal-Mart pharmacy where she purchased Ditty’s insulin had switched his brand of medication because of changes in pricing. “She was told by the pharmacist that they were the same,” Rennix told the VIN News Service. “...They switched — without calling us, without asking us, without telling us, they just told the owner it was the same.” The idea that different brands of the same type of insulin are readily interchangeable isn’t unusual. It’s a common understanding in the medical community. But while it may be true for most human diabetics, switching brands seems to spell trouble for some veterinary patients. On the Veterinary Information Network (VIN), an online community for the profession, numerous practitioners around the country have reported in recent months cases of dogs whose insulin brands were switched developing out-of-control blood glucose levels, a potentially life-threatening condition that can be expensive to remedy. Dr. Sherri Wilson, an internal medicine consultant at VIN, called the information “an eye-opener.” On a message board discussion in which multiple colleagues described cases of dysregulation, Wilson commented, “It has really changed how I think about this brand change ...” Asked about its policies and practices in substitut Continue reading >>