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What States Sell Insulin Over The Counter

You Can Buy Otc Insulin, But Should You?

You Can Buy Otc Insulin, But Should You?

Few patients with diabetes are aware that some forms of insulin can be purchased without a prescription. Many doctors are also not aware of this. The two types of OTC human insulin are made by Eli Lilly and Novo Nordisk. They are older versions and take longer to metabolize than prescription versions. Few patients with diabetes are aware that some forms of insulin can be purchased without a prescription. Many doctors are also not aware of this. The two types of OTC human insulin are made by Eli Lilly and Novo Nordisk. They are older versions and take longer to metabolize than prescription versions. FDA says the availability lets patients gain access to the drug "quickly in urgent situations, without delays." IMS Health reports that about 15% of people with diabetes who buy insulin make OTC purchases. The availability of OTC insulin presents a difficult issue, however. It could save the lives of patients who lack insurance or regular access to a doctor, or who otherwise do not have insulin when they need it. But use of insulin can carry major risks if patients do not get the dose or timing right. Taking the wrong dose consistently can lead to high blood pressure, kidney disease, nerve damage, loss of eyesight, or stroke. Continue reading >>

Ny Laws Create Confusion At The Pharmacy Counter Over Syringe Prescriptions

Ny Laws Create Confusion At The Pharmacy Counter Over Syringe Prescriptions

Syracuse, N.Y. – Pharmacists in New York cannot fill prescriptions for needles or syringes phoned in by doctors. But they can legally sell up to 10 syringes or needles a day to anyone who walks in without a prescription. Linda Foster of Liverpool discovered those contradictory rules when she went to Kinney Drugs in Liverpool last month to pick up a prescription for insulin pen needles that had been phoned in by her doctor. The pharmacist told her he could not fill the order because she did not have a written prescription, but he’d be glad to sell her 10 needles for $1 without a prescription. “This law is really stupid and messed up,” Foster said. “A druggie can come in off the street and buy needles, but a valid patient who needs them for insulin can’t get them.” Former Gov. David Paterson signed a law in 2010 that was supposed to fix this regulatory quirk, said Selig Corman of the Pharmacists Society of the State of New York. A written script is required when a doctor prescribes needles or syringes because the law treats those items the same as controlled substances like narcotic drugs. “It really does not do anything to control drug abuse, which is what the intention was,” Corman said. Under the 2010 law, needles and syringes would no longer be considered controlled substances, allowing pharmacists to fill prescriptions that are phoned in. But the state Health Department has still not written the regulations to implement the 2010 law, Corman said. Jeffrey Hammond, a state Health Department spokesman, said his department is working to finalize regulations. In 2000 the state passed a law allowing pharmacists to sell up to 10 needles a day without a prescription. The intent of that law was to curb transmission of diseases such as HIV and hepatitis among Continue reading >>

What Diabetics Should Know About Over-the-counter Insulin

What Diabetics Should Know About Over-the-counter Insulin

Insulin is a must-have medicine for people who have type 1 diabetes and for some folks with type 2 diabetes. No matter what the reason—a broken or lost bottle or a missed prescription—not having insulin can quickly become a life-threatening situation if you have diabetes. Insulin is more easily accessible than you may think. While most insulin medications require a prescription, older formulations may be available over the counter without a prescription. “There is nothing wrong with these insulins,” Amber L. Champion, MD, director of the Diabetes Center at Mercy Medical Center in Baltimore explained. “They are not harmful, expired, or tainted. They’re just older insulin that was designed in the 1950s.” According to Champion, these standard insulins—Humulin R, Humulin N, and Humulin 50/50—used to be commonly prescribed, but newer, better insulins have been developed since. These older insulins are never her first choice when treating patients, “but in some cases, they’re justified,” she said. Financial Benefits of OTC Insulin Overall, over-the-counter (OTC) medicines are generally cheaper than their prescription counterparts, often significantly. This is no different with insulin. The high price of medicines can cause hardship for people who don’t have insurance or who are underinsured, according to Desmond Schatz, MD, president of the American Diabetes Association and a professor at the University of Florida. “Some of the over-the-counter insulins are only $25 for a vial, compared to over $200 or $300,” he said.” This less expensive option allows people to follow their diabetes treatment plan, reducing the risks of the complications—including death—that can result from untreated or under-treated diabetes. Supervision Still Needed Use Continue reading >>

Fda To Ok Insulin Without A Prescription? Or...?

Fda To Ok Insulin Without A Prescription? Or...?

A new regulatory debate about whether certain medications should require prescriptions makes me reflect on how good things used to be when it comes to obtaining my own diabetes meds over-the-counter. Insulin, in particular. Two decades ago when I was on second-generation insulin like Regular and Lente, I could walk into a pharmacy and pick up a bottle of insulin without needing a prescription. That was helpful during those times when I forgot my insulin vial at home. Or dropped the last bottle in just the right way for it to shatter, just when it was needed the most. Yes, back before I was constantly connected to a continuous drip of insulin via my pump, and before the days of rapid-acting insulin or the many pens that are now available with a doc's Rx, I could just buy insulin at the drugstore; no doctor's orders were needed to just pick up an extra bottle. I thought that was a good thing. So it made me happy to hear not long ago that the Food and Drug Administration (FDA) announced it was exploring the idea of "expanding the availability" of certain medications, like modern insulin -- possibly opening them up to the over-the-counter (OTC) market where you wouldn't need a doc's prescription to get this stuff. You probably know that there are two types of drugs at the moment: those that require a doctor's prescription and those that don't. The latter are assumed to be safe enough for patients to treat themselves without a doctor's guidance. What the FDA is proposing now is that a third class be created, allowing those drugs that would normally require an Rx to be sold OTC under the condition of "safe use." That term could mean a pharmacist assessing whether a patient might need or can use a particular medication, and in certain cases the FDA might require a doctor's vis Continue reading >>

Behind-the-counter Products: A Third Class Of Drugs

Behind-the-counter Products: A Third Class Of Drugs

US Pharm. 2011;36(9):11-15. The issue of a third class of drugs has been controversial since the 1980s. The inciting event for the debate was the proposed switch of ibuprofen to OTC status in 1984.1 Opponents derided the switch as being liable to cause patient harm. Many of those commenting on the 1984 situation offered an alternative to full OTC status, suggesting the drug be placed in a third class of medications to be sold only in pharmacies, often referred to as behind-the-counter (BTC) products. At the time, the concept of a third class of drugs was widely hailed as a novel idea. Proponents of the BTC class offered the explanation that pharmacist counseling would add another layer of safety to the transaction. Opponents (e.g., the pharmaceutical industry) were quick to assert that pharmacist counseling would not benefit the consumer in any way if a third class was adopted.1 Physicians also voiced opposition to a third class. An editorial in a dermatology journal stated: “If pharmacists wish to practice clinical medicine, they should be required to go to medical school.”2 The issue of a third class of medications has always had its supporters and detractors. During the 1980s, both sides overlooked the fact that pharmacists had clearly demonstrated their value in controlling a third class of drugs for over half a century. The classic illustration that proved this case was that of nonprescription insulin products, and Schedule V products add credence to this point as well. Insulin A U.S. government report discussing insulin’s status stated that it is a prescription product in Australia, Italy, the Netherlands, and the United Kingdom.3 Why is it available on a nonprescription basis in the United States? When the prescription legend was codified by the 1951 Durham Continue reading >>

Buying Insulin Without A Prescription: What To Know

Buying Insulin Without A Prescription: What To Know

What would you do if you found yourself in desperate need of life-saving insulin but you were uninsured or didn’t have a prescription? It’s a scary thought and a worst-case scenario—but it could happen. If you do find yourself in this situation you should know that all hope is not lost; you can purchase certain types of insulin over the counter and without a prescription, but there are many factors you should consider carefully before doing so. Things to know Before you head out the door there are a few things you should know upfront: -There are currently only two types of human insulin available over the counter and they are older versions of the medicine, which means they take longer to metabolize than the newer, prescription versions you likely are accustomed to using. -You should NOT self-administer insulin unless you have consulted with a doctor. Incorrectly administering insulin could be fatal. -No long-acting over-the-counter insulin is available at this time. So you have to find another solution if you require basal insulin. -There may be a safer or cheaper options, such as a local clinic or pharmaceutical assistance program. The versions of insulin that are available over the counter were approved for sale that way because they are based on a less concentrated, older formulation "that did not require a licensed medical practitioner's supervision for safe use," an FDA representative told NPR. The assumption is that the person buying and administering the insulin knows what to do—but this is not always the case. Today, most prescriptions cover the most up-to-date types of insulin—basal insulins such as Lantus and Levemir, as well as rapid-acting insulins like Novolog, Humalog, and Apidra. But when you buy insulin over the counter, these brand-name insul Continue reading >>

Crossing The Line — Insulin

Crossing The Line — Insulin

Crossing the line separating Indiana and Illinois sometimes means dealing with different laws and customs. Readers are asked to share ideas for this weekly feature. This week: Insulin. Hoosiers with diabetes who don't have regular access to a doctor, or prefer not to visit one, often cross into Illinois to purchase the insulin needed to manage their blood sugar levels. That's because the Indiana General Assembly unanimously voted in 2014 to make Indiana the first (and still the only) state in the country where diabetics must have a prescription for all insulin purchases. The requirement was strongly supported by the Indiana State Medical Association, whose doctors told lawmakers that diabetics who try to manage their condition without proper medical advice often choose the wrong insulin or administer an improper amount. Most newer insulin formulations already are prescription-only. But older versions of the drug, which can be less efficient and effective, are available over-the-counter in Illinois. IMS Health, a national medical consulting firm, estimates that about 15 percent of U.S. insulin purchasers do so without a prescription. Continue reading >>

Otc Status

Otc Status

US: OTC Over the counter/no Rx required: No Rx Needed-Insulin-US Humulin 50/50 Humulin 70/30 Humulin N Humulin R Novolin 70/30 Novolin N Novolin R ReliOn/Novolin 70/30 ReliOn/Novolin NPH ReliOn/Novolin R The insulins listed above need no prescription to be purchased in the US. Rule of thumb is that if it is an analog insulin, it will require a prescription. The beef and pork insulins of CP Pharma require Rx because they are not US-FDA-approved, and the veterinary insulins available in the US (Vetsulin, PZIVet), were FDA-approved as prescription-only medications. Though not required by law, the policy of the pharmacy you deal with may be to require a prescription. Canada: OTC Over the counter/no Rx required: If the insulin is not sold in Canada, special paperwork will be needed to obtain it, however. In honor of the discovery of insulin in Canada by Banting and Best, Canadian law mandates that ALL insulins sold in the country must be able to be purchased without need of a prescription. UK/EU: In the UK and most other countries, ALL insulin is by prescription only. Insulins you see listed here would require a prescription outside of the US and Canada. No Rx Needed-Insulin-Countries[1] Bulgaria Canada Costa Rica France Italy Mexico Philippines Puerto Rico New Zealand Some report having been asked for a prescription Switzerland Turkey Some countries also require a prescription for insulin syringes and/or pen needles. No Rx Needed-Syringes-Countries[2] Austria Bulgaria Canada Costa Rica France Germany Italy Mexico Philippines New Zealand May need to show proof of diabetes Slovenia Switzerland Turkey UK May need to show proof of diabetes In the US, whether or not you need a prescription for syringes/pen needles is determined by state, not US, law. The laws of your state[3] wi Continue reading >>

Rules And Regulations

Rules And Regulations

STATE BOARD OF PHARMACY [49 PA. CODE CH. 27] Sales of Hypodermic Needles and Syringes [39 Pa.B. 5312] The State Board of Pharmacy (Board) adopts amendments to § 27.18 (relating to standards of practice) to read as set forth in Annex A. The rulemaking alters the requirements regarding the sale of hypodermic needles and syringes in pharmacies. Notice of proposed rulemaking was published at 37 Pa.B. 4652 (August 25, 2007). Publication was followed by a 30-day public comment period. The Board received comments from the National Association of Social Workers, the Pennsylvanians for the Deregulation of Syringe Sales, the Pennsylvania Medical Society (PMS), Allegheny General Hospital, Pittsburgh AIDS Task Force (PATF), Prevention Point Pittsburgh, Southwestern Pennsylvania AIDS Planning Coalition (SWPAPC), Montefiore Medical Center, the AIDS Law Project of Pennsylvania, Representative Babette Josephs, Valley Forge Medical Center & Hospital, the University of Pittsburgh Program for Health Care to Underserved Populations, the Student Global AIDS Project of the University of Pittsburgh, the American Civil Liberties Union of Pennsylvania, Reading Risk Reduction, the American Liver Foundation, the Pennsylvania Pharmacists Association and many individual commentators. The House Professional Licensure Committee (HPLC) submitted four comments to the proposed rulemaking on October 3, 2007. The Senate Consumer Protection and Professional Licensure Committee (SCP/PLC) made no comments. The Independent Regulatory Review Commission (IRRC) submitted two comments to the proposed rulemaking on October 24, 2007. Summary of Comments and Responses to Proposed Rulemaking Age Requirement IRRC and several other commentators questioned the need for the provision in the proposed amendment that prohi Continue reading >>

Diabetic Denied Syringes At Walmart Pharmacy Calls 12

Diabetic Denied Syringes At Walmart Pharmacy Calls 12

RICHMOND, VA (WWBT) - A diabetic trying to buy syringes says a trip to the Brook Road Walmart turned into a nightmare that nearly jeopardized his life. Jacob Fleming says the pharmacist made assumptions about him and refused to sell him syringes he needed for insulin. NBC 12 On Your Side talked with both sides of the complaint. Fleming believes Walmart discriminated against him. Walmart corporate says its pharmacist could not verify the needles were for a legitimate purpose. You don't need a prescription to purchase syringes over-the-counter in Virginia, but you do have to show a history of your insulin dependency. "I showed him all of my vials," said Fleming. "I showed him my other prescriptions, my lisinopril. Did he ask for them? No, I just showed him to let him know, because all those things are associated with diabetes." Fleming says he was led to believe he was being taken care of, only to be denied after waiting twenty minutes. "I could have went into a coma or died. Really. It's that serious. I knew how my body was reacting, and I said all I need to do is just get some insulin," said Fleming. "Basically my legs, my thighs, my muscles were starting to tighten up. I was beginning to have acid reflux, which is a sign of ketoacidosis." Virginia law gives pharmacists leeway to make a professional call and deny over-the-counter sale of syringes, but Jacob thinks this particular pharmacist overstepped his authority and misjudged him based on persistent problems in the neighborhood. "He's saying, 'is this another guy in my area just trying to get needles to do drugs?' Yes, I had everything. I have a list of papers showing that I'm diabetic, and it's like the good people being punished for the bad people." After a week of reaching out to Walmart for its assessment of wha Continue reading >>

Over The Counter Insulin: A Safety Net With Sizable Risk

Over The Counter Insulin: A Safety Net With Sizable Risk

Though many physicians consider it a bad idea, it's possible to buy insulin over the counter (OTC), or without a prescription, in all states except Indiana. This less expensive option exists for people caught between a diabetes diagnosis and the difficulty of having inadequate, or no health insurance. The assumption is that individuals exercising the non-prescription option know how to administer the insulin safely. While that does not always turn out to be true, some who purchase OTC insulin consider it a matter of survival. What’s Available The insulins available without a prescription are not generics of up-to-date brand name insulins. They are older, less concentrated formulations: R, or Regular insulin which is short-acting, and N insulin, an intermediate-acting version that is taken twice daily. No long-acting OTC insulin is available for people requiring basal doses. The FDA points out that these older insulin formulas were approved for OTC sale since they “did not require a licensed medical practitioner’s supervision for safe use.” Their availability is intended to increase patient safety by making insulin obtainable “quickly in urgent situations, without delays.” Risks However, professionals caution that no one should self-administer any type of insulin unless they have consulted with a physician, for two reasons: An incorrect administration (e.g., wrong dosing, poor timing) may lead to erratic glucose levels, and potentially fatal high or low blood sugar episodes. The level of daily glucose control people obtain using OTC insulin is questionable. Though the drug quality is high, it takes longer to metabolize in the body than newer versions. This means users of R and N insulins need to maintain stability in their diet and daily activities—somethin Continue reading >>

Non-prescription Access

Non-prescription Access

State Pharmacy Only Prescription Required Information on Purpose Required Record Keeping by Pharmacists Required Purchasers Required to Show ID Display limits CA S S (except for use with insulin or adrenaline, but local govt may authorize sale of <11 without prescription) S CT S S (for > than 10 only) S (prescriptions must be retained on file for not less than 3 years) S DE S S (date of sale, description of instrument sold and prescription on file) S (name, age and address of purchaser) S FL S (sale to minors only) GA R R (no sale if seller has reasonable cause to believe syringe will be used for an “unlawful purpose”) R IL S S (sale to minors, or for > 20 only) S IN R R ( name and quantity of device, purchase date. and the name or initials of the pharmacist) R (unknown purchasers must show ID) KY S (pharmacists must determine purchaser’s planned use of the syringes) S (purchaser name and address. quantity of syringes purchased, date, purpose) S ( ID) S LA R R ME S S (purchaser must be >17 years old) MD R R (sales shall be made in good faith by the pharmacists to purchasers showing indication of need) R (patients must show proper identification) MA S S (nonprescription purchaser must show proof > 18 years old) MN S S (for >10 only) S NV S S (exceptions: needles to treat diabetes or asthma, or for injecting prescribed medication, or for injecting animals or other commercial/indu strial use) S (if prescribing without a prescription, only specific purposes are permitted) S (records of refills must be kept) R NH S S (for > than 10 and minors only) S (date of sale and number of instruments sold shall be recorded on the prescription) NJ S S NY S S (for > than 10 only) S & R (date of sale and pharmacist’s signature for prescription sales) OH S (and authorized dealers) Continue reading >>

Why Is Some Insulin Available Over The Counter?

Why Is Some Insulin Available Over The Counter?

To answer this, we walk you through the history of drug regulation in the U.S. There’s been a resurgence of interest in non-prescription insulin, no doubt a result of the high prices for the most widely dispensed-by-prescription branded analogs and a political climate that’s breeding uncertainty over the continued availability of insurance for people with diabetes. People have been turning to old-line products, such as Lilly Humulin and Novo-Nordisk Novolin, and Walmart’s store-branded ReliOn products, or at least researching whether such lower-cost brands are an option. sponsor Why is a prescription for Novo Novolin, one of the products supplied under the ReliOn brand at Wal-Mart, available just for the asking if Novo’s Novolog is not? To begin to understand why and why not, it’s useful to look at how the federal and state public health agencies have historically approached drug safety and effectiveness. Read more: Why Walmart insulin isn’t the answer. Federal Regulation The insulin varieties that are available today can trace their lineages back to the days before there was a U.S. Food and Drug Administration, and before many states had pure food and drug laws, professional pharmacists’ codes, or regulations restricting distribution of medicinal products. Pretty much all that was required in the 1930’s to lawfully manufacture insulin for sale was the right to do so under the Banting patent and a manufacturing facility meeting the U.S. Agriculture Department’s standards for cleanliness. In the beginning, there was one U.S. patent holder — Eli Lilly — and one Lilly plant in Indianapolis extracting insulin from material shipped from slaughterhouses. As long as those responsible for mixing the batches took proper steps not to let impurities in and th Continue reading >>

Novolin R: Solution For Injection (100u)

Novolin R: Solution For Injection (100u)

Brand 100% *Brand contains same active ingredient but may not represent FDA-approved generic equivalent 100U Ingredients Close All Sections Reported Side Effects for Novolin R 100units/ml Solution for Injection Close *This is an approximate aggregated range of reported side effects from clinical studies performed on this drug. Your experience with this drug may be different. Close Class B - Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate and well-controlled studies in pregnant women. OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester. Class B - Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate and well-controlled studies in pregnant women. OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester. Class B - Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate and well-controlled studies in pregnant women. OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester. Continue reading >>

You Can Buy Insulin Without A Prescription, But Should You?

You Can Buy Insulin Without A Prescription, But Should You?

As anyone with diabetes can tell you, managing the disease with insulin usually means regular checkups at the doctor's office to fine-tune the dosage, monitor blood-sugar levels and check for complications. But here's a little known fact: Some forms of insulin can be bought without a prescription. Carmen Smith did that for six years when she didn't have health insurance and didn't have a primary care doctor. She bought her insulin without a prescription at Wal-Mart. "It's not like we go in our trench coat and a top hat, saying, 'Uh I need the insulin,' " says Smith, who lives in Cleveland. "The clerks usually don't know it's a big secret. They'll just go, 'Do we sell over-the-counter insulin?' " Once the pharmacist says yes, the clerk just goes to get it, Smith says. "And you purchase it and go about your business." But it's still a pretty uncommon purchase. Smith didn't learn from a doctor that she could buy insulin that way. In fact, many doctors don't know it's possible. When she no longer had insurance to help pay for doctors' appointments or medicine, Smith happened to ask at Wal-Mart if she could get vials of the medicine without a prescription. To figure out the dose, she just used the same amount a doctor had given her years before. It was a way to survive, she says, but no way to live. It was horrible when she didn't get the size of the dose or the timing quite right. "It's a quick high and then, it's a down," Smith says. "The down part is, you feel icky. You feel lifeless. You feel pain. And the cramps are so intense — till you can't walk, you can't sit, you can't stand." Smith says her guesswork put her in the emergency room a handful of times over the years. The availability of insulin over the counter presents a real conundrum. As Smith's experience shows Continue reading >>

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