Novolog and Lantus: how long do they last once used?

I always keep all my pens in the refrigerator until I start using them and they have quite a long life, assuming until the expiration date on the pen. Once they reach room temperature the clock starts ticking and returning them to the fridge won't stop or slow the clock. Do they offer a smaller dose pen? That would be your solution but I've never seen that. I was told by novolog that the life is 28 days.
How about this? :) Could you get a novolog vial and when it's empty, empty half your pen into it and keep in the fridge until you need the rest?

I started a discussion about this on the Type 1 forum. I got 38 replies. If you look for a discussion "do you really throw out Lantus after 28 days" or something like that you might be able to find the info there. Or you can just go to my page and open my discussions ? I don't know how to copy a discussion and paste it here sorry.

hi barbrann,

I keep them in the fridge until I use them but I had put them back in someimtes after starting one until I read your'e not supposed to do that.

I think the vial idea is a great idea, I had been thinking about something like that too but the literature says don't inject the insulin into anything else, do you think that would affect the insulin? I guess if I can get an empty vial I can try it and see what happens, it can't be any worse than throwing away nearly half a 300 ml pen. thanks :)

thanks clare, I will look for that discussion :)

I forgot to say, I'm not sure if they offer a smaller dose pen, but I think they are all 300ml maybe. I thought this would work out ok for lantus as I was on 30 units when in hospital and then reduced to 22 when I got out, but then I started honeymooning I guess and my dose was reduced a lot more due to hypos. I'm going to call the companies to see. I have thought about using pendique also, but you can't use novolog refills with that for some reason and I'm not sure if I want to switch insulin right now as I'm just getting used to all of this and to these insulins.

With my insurance, I only pay the co-pay. If I used twice as much insulin, I'd still pay the same. So I have no problem just throwing away a nearly full pen or vial. I'd rather have assurance that my insulin will work when I need it. And I often carry my humalog pen all over, with less than ideal assurance that I've kept it at "room temperature." I know I've burned my pens before. And basal insulin's like Lantus are even more fragile.

The best I can tell, the manufacturers did studies of how well the insulin stood up to worst case conditions over the time, and pretty much across the board, we have the same stated storage and in-use claims. Refrigerated, insulins are good through the expiration date, often up to 2 years. Once started, vials or pens can be kept safely at room temperature for 28 days.

So what does this mean? That the testing showed that the insulin stored at like the warmest temperature was "always" fine at 28 days. If didn't show it failed on day 29, but the manufacturer makes no claim after that. If you search, you will find of other discussions, like Clare's. A detailed discussion of what the insulin manufacturers say on the topic can be found in this editorial in Diabetes Care.

ps. And don't forget BSC's Top Ten Indications You Insulin Has Gone BAD!

thanks bsc! for all this information. I'm going to read all of it.

I still have one of the novolog pens half full, I think I may try it again, I have a feeling from something someone wrote in Clare's post that it was my lantus that may have not been working.

I pay a copay only too but it's not cheap and I guess I feel bad to waste something like this. I don't do the clearing out of 1-2 units except when I'm starting the pen/pen refill so I guess I'm using even less that way too. You're right though it's not a good idea to use half good insulin of course.

I was reading about one insulin, maybe humalog- I can't remember now, that lasts for 45 days, but I'm not sure if that one would be right for me, so I think transferring half of my 300 ml refill to an empty vial and storing that in the fridge might work for me.

I guess with syringes you don't waste as much maybe and you can get a smaller dose for corrections which I would prefer, but I really prefer pens overall- I only did the syringe once in the hospital when they were showing me how to do it and I had a hard time with it since the needle is longer and it was very awkward.

ps. I like your top ten list :)

And I was wondering why they don't make smaller pen amounts and vials for adults/children who are using smaller amounts of insulin- it would make more sense.

I worry about this too, as I don't always finish my Novolog pen in 28 days. I just started writing the date I start a new pen in my BG log, so in a few months I will be able to tell if there's a pattern in which the insulin becomes less effective at a certain point. I am also keeping my pens in a frio case at all times during the hot weather- it isn't as cold as the fridge, and it keeps the insulin at a pretty consistent temperature. I hope this is okay to do! I know you said you would prefer not to switch insulins (and if you are happy with them, I totally understand), but FYI Levemir lasts 42 days once opened.

thanks Rennie :)

great idea to keep the written log- I'm going to do that too... I have marked the finish date on the lantus pen and on my calendar for both pens- I should put it in my phone too. I'm going to look into the frio or another case- I think the reason they say not to refrigerate after starting a pen or a pen refill is that this can clog up the mechanism or something maybe, although I haven't had any problems with that as far as I know. clearing the pen or with novpen, they say to clear 19 units into a cap if something seems like it isn't working properly, could let you know if there is a problem or not. I also heard that cold insulin can be painful to inject although I didn't notice much of a difference. I think that was it- Levemir. There was an ad at my endos office on their tv/commercial thing. I'm going to read about it and see if I would consider that one because I think Pendiq can use their refills. I'm also trying to find a small fridge just for the insulin.

They don't do that because they make more money by selling larger quantities than is necessary and then telling the patients they have to throw it out after 28 days. They have billions of colonies of ecoli bacteria manufacturing our insulin and really all they have to do is collect it purify and package. I don't know if you realize the billions of dollars at play here. Of course it would make a lot of sense to make smaller pen amounts for people using less, but that would cost the big pharma companies money. And they're not big fans of missing out on their piece of the diabetic pie. JMHO

How do you get your top 10 list to post in your reply ? I was looking for my discussion about How long does Lantus last and found it but I could not figure out how to copy and paste ?

Go to the web page that you want to like to and copy the URL. Then go back to the page where you are posting and select the tab with "link." Then simply paste in the URL. Send me a msg if it is not clear and I will talk you through it.

https://forum.tudiabetes.org/topics/do-you-really-throw-out-lantus-or-humalog-after-28-days Meee, this is the discussion I was talking about. Thanks bsc for the information on copying/pasting.

You are a fast learner and now are extemely dangerous.

Hi Clare, I was just recently diagnosed and I didn't know all that much about diabetes or all of the politics involved, no one in my family has been diabetic that I know of yet. Yes I realize the money at play with medications and medical care in general, but I thought it might also be because most people are on much higher doses, but then I guess there are probably many at lower doses too.

And I have noticed insulin has not gone generic yet and it's way too expensive. Would it really cost them that much in profits though if people weren't throwing half used vials/pens etc. away? I wonder how much more money they're making by doing that, it would be interesting to see the actual cost breakdown.

It's sad if you're hunch is correct. If I could switch to a smaller amount for now I would.

That is interesting that it's manufactured by ecoli bacteria, I had no idea about that.

thanks!

I noticed a lot of people don't throw out their insulin.. wonder what types they're using- I will have to back and re-read.

All the new insulins out today are are called insulin analogs. They are derived from some hi tech maneuvers with rDna and ecoli. But they are not exactly the same as the insulin you would produce if in fact you still did. That's how they can engineer insulins like Lantus or Levemir that lasts longer and insulins like humalog and novolog that are rapid, short acting insulin. They just change a few amino acids in the insulin sequence and it changes the action. Back in the "olden days" I started in 1975 using insulin that was basically ground up pig pancreases. The good thing about it was it was still very similar to what my own body would have made if my islet cells weren't destroyed. The old insulin still contained C-peptide which is thought to be a neuro protective component in insulin. The insulin analogs do not contain any C-peptide.
And yes there is a lot of politics involved in D and pharma. If you look at some of the other discussions here, one was "will there be a cure in my lifetime ?" It was a bit disheartening, but all too true, we are a money machine to companies like Abbott, BD, MiniMed, Omnipod, Eli Lily, Novo=Nordisk, Sanofi Aventis. They all want their piece of the pie so there is no profit in a cure. And yes it would really cost them too much if they let us use insulin until it was well past the 28 day time period.
I too have no one in my family with diabetes, so it has been a learning experience from day 1. I recently called my Mom to thank her for not being soft on me when I was first diagnosed at 14 years old. It has made a big difference in my life, she did offer up, "Clare I did give an orange an injection" to which I replied, yes, but you never gave me one did you ?

Wow, this is interesting! The idea of animal-derived insulin is pretty weird to think about, but it sounds like there were advantages to it. I wonder if there's a difference in how the synthetic stuff will affect us in the long run.

Richard is a 50+ year veteran of D and he posted a little while ago about the benefits of C-Peptide and how he felt that the complications he has have come about as a result of the lack of C-peptide in the insulin analogs. There is a pharma company
www.cebix.com/ in California doing a clinical trial in patients with neuropathy and using C-peptide along with their insulin therapies. "Recent results indicate that proinsulin C-peptide, contrary to previous views, exerts important physiological effects and shows the characteristics of a bioactive peptide. Studies in type 1 diabetes, involving animal models as well as patients, demonstrate that C-peptide in replacement doses has the ability to improve peripheral nerve function and prevent or reverse the development of nerve structural abnormalities. Peripheral nerve function, as evaluated by determination of sensory nerve conduction velocity and quantitative sensory testing, is improved by C-peptide replacement in diabetes type 1 patients with early stage neuropathy. Similarly, autonomic nerve dysfunction is ameliorated following administration of C peptide for up to 3 months. As evaluated in animal models of type 1 diabetes, the improved nerve function is accompanied by reversal or prevention of nerve structural changes, and the mechanisms of action are related to the ability of C-peptide to correct diabetes-induced reductions in endoneurial blood flow and in N a + , K + -ATPase activity and modulation of neurotrophic factors. Combining the results demonstrates that C-peptide may be a possible new treatment of neuropathy in type 1 diabetes." This is a copy of the abstract from a recent paper.