Pharmacy manager versus Customer Care Specialist

I’ve never had a problem with my pharmacy refilling my Insulin prescription when I called it in, until yesterday. My pharmacy has a new manager, and when I tried to refill it yesterday, they told me it was to soon and expected me to wait 8 more days. At that rate my I will be almost through my last insulin pen. I called the pharmacy and asked for the manager, and it was her opinion that if there is not enough insulin left in my Levemir Flexpen for my full dose of insulin plus the two units to prime it with, I’m supposed to inject what is left in that pen, then get a new pen and new needle out and inject a second time in order to get my full 22 units a day. I immediately called Novo Nordis and talked to a woman in their Customer Care dept. When I communicated to her what the pharmacy manager had just told me, she said that they do not recommend doing that, and that they recommend to get a new pen out instead. After that call ended I called the manager at my pharmacy back and told her what the Novo Nordis Customer Care said. All she could do was make rude comments to me such as “Out of thousands of people, I’m the only one that does this” and “Nobody else wastes it.” I’m almost 80 years old, and my wife gives me my injection. The directions on my prescription reads to “inject 22 units one time daily.” I’m wondering if anyone has any information or opinions about this?

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Welcome. My daughter uses the toujeo pen. She was on 20 units and doing well so the endo lowered it to 15. She had 12 units left in her pen and I would not let her use that and then use a new one. We threw the used one away. Can your endo or PCP prescribe an extra pen next time so that this doesn’t happen? I agree with the customer service person that said not to finish the old pen and use a new one.

I use Novolog and Tresiba pens. If I don’t have enough insulin left in a pen, I will inject what I have and then inject from a new pen. I didn’t realize that there was a problem with doing this. It seems to work fine for me. Am I missing something?

Thanks for posting @Willy.

I am left wondering why Novo says to discard the pen with usable insulin in it?

It certainly seems reasonable that if you had 11 units left after priming, you could use that and then start a new pen and give yourself another 11 units after priming the new pen.

I imagine they don’t want people doing basic math and screwing up the math and giving the incorrect dosage. That’s all I can think of.

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Is she not practicing medicine with out a license - telling you how to dose your insulin - far fetched I know, but still

I use humalog pens. If there aren’t enough units left, I take what is left and then take the pen needle off and use a syringe to get the remaining units out of the pen. The plunger hits the end of then pen, but there are usually ten units or so left in the pen. I used to throw the pens away at that point but why waste precious, expensive insulin?!? I use it. If after using the syringe to drain the pen I still need more units to make my dose, I open a new one.

I have been diabetic for 33 years and have never once had a problem doing this. I’m at a point in my life where I don’t want to waste even one precious drop of this life saving medication.

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Its likely that the FDA approval was based on that being documented in the dosing instructions. On a case by case basis, some people are comfortable taking the correct dose by using 2 pens. Some may not be able to do split correctly.

Kind of like the speed limit. Sometimes you follow the rules, and sometimes you think its safe to do differently.

I use vials, and think there may be a “use within 30 days once opened” rule. I choose to use every drop.

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@MM1 in looking at the dosing instructions I don’t see anything that directly supports that idea - Levemir dosing

To expand on my earlier post, What if the daily dose was 60 units and the pen only had 58 units after priming? Would the “correct” procedure be to just discard that insulin?

This is a common problem. Don’t go to the pharmacist. Don’t go to the manufacturer. That’s a road to nowhere.

You need to call your endo’s office and have them call in a new Rx to the pharmacy with a higher daily dosage on the paperwork. Unfortunately, its a holiday weekend. So, you may need to call your clinic’s urgent care and just get a Doctor to do it, not necessarily YOUR Doctor.

Like other recommend, I recommend using everything in the pen, prime only a unit, and use a syringe to get the last bits out of your current pen, and old ones that are laying around, if you need to.

Worst come to worst, you can get R and NPH over the counter, no prescription needed, for $20/bottle, at Walmart.

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