Hey there - I receive my insulin via mail order and sometimes my insulin arrives at room temperature. (ice pack melted) It probably is only at room temp for a day or so. I put the 3 month supply in the fridge right away - has anyone else experienced room temp insulin via the mail?
I have gotten conflicting info - some say its fine to use, others say I need it replaced. I called the manufacturer of Novolog and they said replace it but the pharmacist at Caremark said it should be fine but to call them if I seem to have trouble with it.
When I get mine from Medco, sometimes the ice in the packs is melted but still cold, and the insulin pens are cold to the touch. I don’t worry about it at all at this time of the year. If it was mid-summer that might be different. But yes, if you are having unexplained highs you might think about that as a variable.
I have previously had to use CareMark (I can now fill my order at a CVS for 90day supply!) and I use Humalog. I had the issue of it coming at room temp and immediately stuck it in the fridge. I never noticed a difference in my numbers, but I will say that I was not as actively watching my numbers during that time frame… If it does go bad, can you see if you can pick it up at a local CVS (since they are the same company)?
I have to use Caremark too. I got a mailing from them 6-8 months ago explaining that they would be checking the weather report to determine if the right temperature conditions would/should be met and if so they would send the insulin regular mail. I did not pay much attention to this. About a month later I ordered insulin and it took forever to get it. I opened my box and it didn’t even have an ice pack in it! As I started using the insulin from this shipment I noticed I was having higher blood sugars. Just to make sure I borrowed a vial from work and sure enough the insulin from this shipment had lost some of it potency. I called Caremark and asked for the persons supervisor over and over until I could be transferred no one “higher”. I have since had my insulin shipped overnight everytime I order- regardless of what the weather report says (since when are they ever right?). Make sure to monitor good until you know for sure it has not lost potency. Insulin isn’t necessarily all “good” (100% working) vs “bad” (not working at all).
I often get insulin "warm" but it never seems to make a difference. Insulin is probably ok to use as long as it remains clear ... this can be more than a month or two at room temperature. I always put it in the refrigerator as soon as it comes and use it as needed. I have never had a problem.
When Novolog is exposed to heat or brought to room temp, it generally does remain clear. There's no way to tell by looking at it that it's become totally ineffective (like injecting water) or somewhat ineffective (losing a percentage of effectiveness) just by looking at it. It's also only good for 30 days once it's come to room temp, so a three month supply is not going to last three months, unfortunately.
Another thing you have to be aware of is exposing Novolog to temps above 86 degrees. We do put insulin in our pumps, but it's only supposed to be used for three days at those temps.
Since I take so little insulin, I tried to get more than 30 days with Novolog, and I found that after about 32 days, the effectiveness drops off sharply.
I believe you’ll find that the 28 clock starts running after you break the seal on the vial, not when you bring it to room temperature. Vials you’ve started can be stored at room temperature (86 deg max) for 28 days. Unused Humalog will keep until the expiration date at temperatures from 36 to 46 deg F. (This is from the Patient Info sheet in the Humalog package).
Well, I certainly didn't find that to be the case with Novolog - once at room temp, I could use it a maximum of 32 days before effectiveness started dropping off. Note that newer insulins don't go bad immediately at room temp - they lose effectiveness gradually. The manufacturers of both Novolog and Humalog also disagree with you.
You are correct that the 30 day clock also begins when you break the seal - that's assuming the insulin's refrigerated. If the insulin's at room temp, it has already started.
I think the point is that if the vial is returned to refrigeration after let’s say, 24-36 hours, it can remain in the fridge for a long time. The clock stops ticking once the temperature is reduced again.
Wow, I started out with Caremark but then my coverage was shifted to Medco. They always send it overnight packed in ice packs, though they are sometimes cold but defrosted.
