Still Confused On How Long To Use Lantus Pen

[Louellen]

I know this has been covered over and over again somewhere but, cannot find the answer again on a search so, please excuse the repeated question.

I'm using the Lantus SoloStar pens (with injector instead of syringe). I'm noticing Morrigan's numbers going back at times, up to the purple/pink levels after being solidly into the yellows for awhile. Her appetite has been really good lately so, it might be more food than usual/she is gaining weight (I don't have a scale at home for cats/babies yet...money tight) and, I've noticed her dipping into the m/d kibble more (can't get her completely off of it in spite of taking up her bowls of it early on in this journey...ran into trouble with her NOT eating for 2 days because of it so, on vet's recommendation, went back to putting down the m/d and continuing to try with her canned foods).

So, I am thinking that it may be a few things causing the upped numbers.

1) Eating more kibble/too close to test time.
2) Possible weight gain as her appetite has picked up lately.
3) Lantus Pen is at the 47 day opened mark and may be losing some strength.

I'm going to toss this Lantus pen tonight and start a new one, as well as trying to take up the kibble except when we're out or overnight AND keep canned food available overnight though she hasn't and won't touch it even when there's NO kibble down.

I've kept the pen (opened/used) in the fridge this entire 47 days and it looks clear with no changes but, I'm wondering if perhaps, the Lantus might be losing strength?

What are your thoughts on how long the Lantus pen can/should be used before it loses strength? Vet says, discard it after 30 days max. The pharmacist insists that it's ok, as long as it's refrigerated....even used/opened to continue using it up until it's finished. At 1U/day thus far, it's only less than half done. Expensive to throw away but, I can't find info on it for cats...only human consumption/use...which all say....only 28 days. That's a huge waste!

Any thoughts on what might be going on? I hope to get a mid-cycle reading today (hard to do on her for sure) to see where she's at then as well.

 

[BJM]

Refrigerated, on a stationary shelf, Lantus may last up to 6 months. The refrigeration is to prevent/retard any bacteria/mold growth.

 

[Louellen]

Thank you, BJM!
Then, the pharmacist is correct and not the vet and I need to pay more attention to her diet then, watching her carefully before she gets tested and figure out other ways to deal with her eating patterns. It may be that she's over eating just before tests...even though her food is measured for the day in both canned and kibble.

How are you doing BJ? I'm sure you're having a rough time emotionally right now.

 

[Meya14]

If you are using the pen needles and the auto-injector on the pen then you should not be putting the pen in the fridge, per the manufacturer. The temperature changes damage the injecting mechanism in the pen. Of course, you will have to use the insulin a lot sooner, or toss it sooner.

 

[BJM]

There are always regrets and hindsight is 20/20 ...

 

[Louellen]

If you are using the pen needles and the auto-injector on the pen then you should not be putting the pen in the fridge, per the manufacturer. The temperature changes damage the injecting mechanism in the pen. Of course, you will have to use the insulin a lot sooner, or toss it sooner.

That's what I was talking to the pharmacist about Meya but he insisted that it doesn't change the mechanism nor, the measuring portion...it is only about the pain factor in higher dosages in humans??? Now what do I believe? This is where I am stuck.

 

[Louellen]

There are always regrets and hindsight is 20/20 ...

@BJM I don't know of a passing where I haven't had regrets of one kind or another. That includes my entire human family as well. Of course, hindsight is 20/20 but while in the throes of grief, those hindsights can be somewhat skewed.

I have had over 22 pets in my life thus far who have passed on and with every one of them, I looked at what I thought could have, should have, might have been done differently. In spite of tens of thousands of dollars and every ounce of energy in me having been spent, I could always find a regret of some sort. But when the grief eased and thinking cleared, that hindsight I thought was so clear at that time really was skewed towards blame on myself or a vet or something. In actual fact, I had done far more than really was needed and none of it would have resulted in a different outcome or changed it in any appreciable way for any of them or myself.

I am sure time to heal and come to grips with such a loss will soften those regrets and the hindsight will shift somewhat again.


Just hugs BJ.

 

[Larry and Kitties]

From what I have read refrigerating/unrefrigerating an in-use pen can result in air being drawn into the pen chamber and that will reduce the does of the insulin injected using the pen needles. This is due to contacting and expansion of the insulin and chamber holding the insulin.

 

[Meya14]

http://www.novo-pi.com/levemir.pdf

"LEVEMIR®FlexTouch®:
After initial use, the LEVEMIR ®FlexTouch® must NOT be stored in a refrigerator and must NOT be stored with the needle in place. Keep the opened (in use) LEVEMIR ®FlexTouch® away from direct heat and light at room temperature, below 30°C (86°F). Unrefrigerated LEVEMIR ®FlexTouch® should be discarded 42 days after they are first kept out of the refrigerator"


It doesn't say why not to store the opened pens cold, however, I've heard one of 2 things: 1. Frequent temperature changes damage the mechanism causing it to administer the wrong dose. 2. The dosing device is calibrated for a specific temperature range. As most liquids will contract when cold this might lead to giving an inaccurate dose.

How much this really affects things, I do not know. I believe the solostar directions are similar with 42 days. I think the lantus was similar with 30 day shelf life when opened.

 

[BJM]

My understanding is that refrigeration retards the growth of mold and/or bacteria that may grow in the solution.

 

[Louellen]

From what I have read refrigerating/unrefrigerating an in-use pen can result in air being drawn into the pen chamber and that will reduce the does of the insulin injected using the pen needles. This is due to contacting and expansion of the insulin and chamber holding the insulin.

Thanks Larry and Kitties.
I did a little experiment today after I posted.
I use the pen with the needle tips that screw onto the pen as the injector for now as I'm shooting a whole unit (would have to use syringes if I have to change to a half unit though).

I had asked the pharmacist whether there was expansion/contraction in the pen vials with cold and warm or whether it would affect the mechanism. He responded that it doesn't do that as vets use the insulin directly from the fridge. I tried to say that the vets use bottles and syringes...I am using the pen and the needles that attach as the injector. He responded "yes, that is what humans do too with these systems". Ok, no further ahead on this one thus far so, I asked him again..."yes, but HUMANS usually keep their pens OUT of the fridge." He responded with "yes, because HUMANS use MORE units than you're using and that can be painful" (I think he was getting the idea that I was somehow "slow"
So, I tried one last time and asked..."Ok, I understand that part but, what I want to know is...DOES THE PEN INJECTION SYSTEM WORK THE SAME WAY, COLD FROM THE FRIDGE AND WARM ON THE COUNTER OR WHATEVER...WILL IT CHANGE THE INSULIN DOSING?" (I said that slowly, respectfully and as clearly as I could muster, figuring this was my last stab at this question before he walked away from me totally, figuring I was stupid....and frankly...I was beginning to wonder myself at this point! ) He simply responded, "No!" and that was that.

Ok, I came home with a single package of the U-100 BD insulin needles (31 G, 6 mm) and I set out to figure this out.

I loaded a syringe with 1U and the injector unit set to 1U (injector needle inserted).
I squirted 1U from the injector and 1U from the syringe onto a non-porous surface and looked at the 2 of them.
There was virtually NO difference in size between the 2 of them.
*I was careful to load the syringe to exactly 1U as the injector pen dialled to 1U is supposed to be very accurate in dosing and, I knocked out a bubble from the syringe so, both should have had equal amounts, give or take a slight variation in the measuring in the syringe by eyeing the line and stopper on the plunger as it and bubbles are always the margin of error in a syringe load from previous experience with them.*

So, give or take a drop or less with loading errors/a bubble not gotten rid of or seen and on the plus or minus side IN syringe loading...I'd say that both were about equal.
The syringe was no different in size or amount than the injector system amount.

In essence, I guess that I have decided that *IF* there is an error in the amount, it's just as likely for there to be an error in amount from a syringe load due to eyeing it or a bubble that gets trapped at the top. Give or take a very tiny amount, I'd say that both are as accurate as the other. (I tried this 3 times with both to be sure and each time..got the same results).

So, if anyone else is wondering...that's what I've found thus far from the questions and the answers I've gotten as well as the experiment that I did today too.

I think I'm more concerned about the insulin losing its effectiveness due to time opened in any sort of vial/bottle/pen situation.

Morrigan's numbers have been up a bit a couple of times in the past 2 days in spite of what I think is measured doses etc.. However, I *think* (I may be wrong though and thus, my question) that the Lantus insulin when refrigerated and not left out or jarred as BJM has mentioned, will remain stable for more time than I've been using this particular pen. I am looking back at my notes and I think that perhaps, it's more to do with food related numbers on testings as she is a "free feeder" and eats m/d kibble more through the night while we sleep or while we are out and refuses to eat canned food left out. She actually doesn't like canned food so, that's an ongoing battle to get her switched over...though, since last month, I'd say she's about 50/50 now between the 2 so, some progress there!

Thank you, Larry and Kitties. I really appreciate your response very much.

 

[Louellen]

http://www.novo-pi.com/levemir.pdf

"LEVEMIR®FlexTouch®:
After initial use, the LEVEMIR ®FlexTouch® must NOT be stored in a refrigerator and must NOT be stored with the needle in place. Keep the opened (in use) LEVEMIR ®FlexTouch® away from direct heat and light at room temperature, below 30°C (86°F). Unrefrigerated LEVEMIR ®FlexTouch® should be discarded 42 days after they are first kept out of the refrigerator"


It doesn't say why not to store the opened pens cold, however, I've heard one of 2 things: 1. Frequent temperature changes damage the mechanism causing it to administer the wrong dose. 2. The dosing device is calibrated for a specific temperature range. As most liquids will contract when cold this might lead to giving an inaccurate dose.

How much this really affects things, I do not know. I believe the solostar directions are similar with 42 days. I think the lantus was similar with 30 day shelf life when opened.

Thank you, Meya...I do keep the pen in the fridge (opened and the unopened ones) so, there's little temperature change for those 10 minutes or so that it's out. However, the pharmacist said that the 28 days in the literature, assumes that it's for "human use" and therefore, more units used (sometimes huge amounts) so, being cold from the fridge, it's 1) more painful so most people keep it out but...2) most people use up most of that pen within the 28 or 40 days or whatever they are using so, not much goes to waste. In the case of Lantus, if it's kept cold, he said, "it should be good for as long as the pen's expiration date, unopened because it's been refrigerated". Not sure I would go for that one but, I think using it for only 28 days with 1 or 2 U is really a waste no matter what we do. That would mean that a bottle of Lantus would mostly be tossed away??? Doesn't make sense to me to do that??? Our vet uses bottles, keeps them in the fridge....so, if that were true...that would mean him throwing out a bottle every 28 days if he isn't using it on a a lot of patients????

Interesting about the temp range though. I'm wondering, given what I've experimented with today and wrote above in response to Larry and Kitties, whether that would also be true (expansion and contraction of the insulin) in both an injector system and the syringe method??? If that were to be true (the insulin expands and contracts with cold and warmer temps) then, that would mean that even using the syringe from the bottle/pen would *possibly* be an "inaccurate dose" too??? By that, I mean that if the insulin is contracted at a lower temp then, even in a syringe loading, it would also mean that the dosing there would be different were the insulin to expand with warmer temps. That would mean that all of us are giving our cats a slightly higher dosage from the fridge than were we to syringe load from a warm vial/bottle/pen. Does that make sense? Not sure that I'm explaining that correctly or whether I'm confusing us both now.

But, as for the mechanism working better under certain temps...that's a GOOD question. Given what I tried today (as mentioned above), it doesn't seem to be the case BUT...I suppose it is possible. The pharmacist (allegedly, who also does diabetes counselling and is familiar with the different insulins and injection methods), doesn't seem to think it's an issue??? Is HE right? I have NO clue right now and my confusion continues. YIKES! I think I'm driving myself insane over this as I've tried both methods and I've found margins of error in even loading a syringe. Those lines are so tricky to get "exact" with so, there's even a difference there and, forget about bubbles! They are a real headache!

Thanks so much Meya. You've given me more to ponder and think about.

 

[Meya14]

Yeah it's hard to say how much of a difference it really makes. I think the people that might be able to give you the best information is novo-nordisk, the manufacturer. They probably have a consumer help line where this issue can be asked about.

In the literature regarding vials, it says to refrigerate them. For the pens is states Do Not refrigerate after opening. Cold insulin hurts whether coming out of a vial or pen, so I'm sure that's not the reason that the manufacturer has this in the literature. It would be interesting to find out exactly what the issue is.

 

[Louellen]

Can anyone tell me if this makes any sense really?

I was reading a study done by a doctor for his patients. He wrote to different insulin manufacturers about the stability of insulins used by his patients. Aventis, the Lantus manufacturer, wrote back with this letter (cutting and pasting the portions that are confusing...to say the least).

***In-use stability (open vial).
The in-use stability of Lantus was assessed over a 4-week period with or without refrigerated storage (Aventis, data on file). During the study, 2 units of Lantus were removed each day and discarded. The samples were stored at either 41 or 77°F (5 or 25°C) for a period of 28 days. The remaining product after 4 weeks met all stability criteria. It is recommended that Lantus be discarded after 28 days following the first use, regardless of refrigeration.
***Open (in-use) vial.
Opened vials, whether or not refrigerated, must be used within 28 days. They must be discarded if not used within 28 days. If refrigeration is not possible, the open vial in use can be kept unrefrigerated for up to 28 days in a place away from direct heat and light, as long as the temperature is not >86°F (30°C).

Now, I'm not sure but, this all sounds like a puzzle/double talk.

They are seemingly saying that opened....at 28 days, whether the Lantus has been refrigerated or not, it should be discarded after 28 days. Yet, the product after 4 weeks, still met it's stability criteria and are saying to still "discard after 28 days", regardless of refrigeration. Why bother to refrigerate any open vials/pens/bottles then???

But, here's the kicker/double talk it seems...."If refrigeration is not possible, the open vial in use can be kept unrefrigerated for up to 28 days...." WAIT...WHAT? What's the difference then? "if refrigeration is not possible"???? No matter whether it is refrigerated or not, according to the above....once opened, the insulin must be discarded after 28 days. Why mention refrigeration at all then? Either way, they are saying...dump it after 28 days no matter what???

So, that would mean that anyone using the 10ml bottles, using only 1 to 2U or even 4u twice a day...would essentially then, refrigerated or not....be throwing out pretty much most of that bottle every 28 days once opened.

This makes very little sense to me and is sounding like it's double talk. Anyone else understand it differently? (I know it's 2 a.m. here and I'm wonky but, I'm not getting this to make much sense to me right now).

 

[Meya14]

The 28 day thing is a marketing gimmick and due to FDA regulations. They -chose- to only study and offer evidence to the FDA regarding shelf life for the 28 day period, so the FDA approved for only this use. Therefore, the literature reflects that the insulin was only studied to be safe and effective in this period. This makes them much more $ then say, studying to see if it has a 3 month or 6 month shelf life (it most likely does).

The refrigeration thing is confusing for sure. I work with diabetics at my job, and the recommendation in the past for vials was to refrigerate. In the past 2 years, the guidelines from the pharmacies have changed due to the new labeling/literature. At my job, we no longer had to keep them cold, just room temp. Most hospitals are the same. I think this reflects recent studies as you mentioned above. This is a relatively new finding, which is probably why the literature is worded so strangely for vials. People's habits are hard to break, so they don't want the literature to back pedal and make people think that the old way of keeping it cold was unsafe. The state considered it a med error to administer past the date for the opened shelf life, they used to check temps, but no more.

 

[Louellen]

The 28 day thing is a marketing gimmick and due to FDA regulations. They -chose- to only study and offer evidence to the FDA regarding shelf life for the 28 day period, so the FDA approved for only this use. Therefore, the literature reflects that the insulin was only studied to be safe and effective in this period. This makes them much more $ then say, studying to see if it has a 3 month or 6 month shelf life (it most likely does).

The refrigeration thing is confusing for sure. I work with diabetics at my job, and the recommendation in the past for vials was to refrigerate. In the past 2 years, the guidelines from the pharmacies have changed due to the new labeling/literature. At my job, we no longer had to keep them cold, just room temp. Most hospitals are the same. I think this reflects recent studies as you mentioned above. This is a relatively new finding, which is probably why the literature is worded so strangely for vials. People's habits are hard to break, so they don't want the literature to back pedal and make people think that the old way of keeping it cold was unsafe. The state considered it a med error to administer past the date for the opened shelf life, they used to check temps, but no more.

Wow, Meya...I didn't know that you work with diabetic patients.
That makes more sense then that they are literally, covering their rear ends legally.
I can see an entire team of lawyers, sitting, busily working out and fine tuning those terms to put into the literature so as not to get sued.

And, yes...before I went totally bleary eyed (couldn't sleep last night...good ole insomnia), I read the same thing about the insulins now, not needing refrigeration once opened.
Of course, everything came from sites meant for human use where amounts are far greater than for cats. That would assume that most human usage would be using up the pen/vial much more quickly and not as much would get tossed as we'd be doing with our kitties' insulin.
However, that would also assume that a good percentage of the dollars being tossed away through human use, is covered by an insurance plan and therefore, not such a big deal for a lot of users.
But, we, using it for our cats and not being covered by insurance (for the most part...some may have pet insurance that will pay???) have to toss away money most of us don't have after vet bills are paid especially.
I feel as though I may as well throw $100 bills out my car window on the way to the pharmacy!

But, then...really...what this is all saying is that insulin, whether refrigerated or not...once opened, has a "Discard Date" stamped onto its little rim the moment you open a vial or a pen. It doesn't matter what you do with it...refrigerate it or not...our first use of it renders that clock ticking on the count-down to "unusable", according to their legal standards.

Then, why not make 1 ml pens and 3 ml vials (for larger dose users)? That would be my question.
And, given that cats and dogs usually use very low dosages, does PET insulin (those designed for use in pets and bought through vets) come in smaller vials/pens and have the same requirements?

That's a good question, isn't it?
Anyone using pet insulin here who can tell us how yours is to be stored, vial/pen sizes etc.?

Thanks Meya..I am long winded as you can tell but, I'm really thinking out loud and I'm sure more veteran members are just scratching their heads now, watching me question this while they've long since figured it all out.

 

[JAAshwell]

Wow, Meya...I didn't know that you work with diabetic patients.


That's a good question, isn't it?
Anyone using pet insulin here who can tell us how yours is to be stored, vial/pen sizes etc.?

Hi,

When I started here reading about Lantus and refrigeration and how long it would last, etc., etc., it was very confusing and contradictory too.

I have used the pen and the vial. We refrigerate both. I have used one vial from January - April. I thought maybe it wasn't working as well and went out and bought a new one (@ $250!!) and that wasn't the problem at all. My pharmacist assures me it can last as long as six months if refrigerated.

My vial is never out of the fridge for more than five minutes and if it's cold to the cat, she hasn't complained.

Good luck!
Emmy&Judy

 

[MrWorfMen's Mom]

That literature surely needs to be re-written by someone with "technical" writing skills to make it "user" friendly. It is indeed double talk and far too wordy. It could easily all be summed up in two clear, concise sentences. But as Meya pointed out, a lot of this rhetoric is due to legal requirements. It's like those commercials for drugs on TV. They list every potential side effect to the point where you'd have to be crazy or very desperate to even want to try the drug. If 1 person is assumed to have had a particular side effect as a result of the drug, it comes into play in the literature for legal reasons.

These drugs are manufactured for humans who use larger doses and most folks don't have a lot, if any waste, so there is no reason for the drug companies to test the efficacy of the product beyond the 28 days (Lantus) or 42 days (Levemir). If the majority of their market were discarding that much, I am sure they would have been pressured into making vials smaller than the 10ml available a long time ago. The pens are a relatively new convenience that I doubt had anything to do with waste. The cat I am doing shots for is on ProZinc (pet insulin) which is a larger vial that is kept refrigerated. Now that you mentioned it, I must check the Rx date on it to see how old the insulin is and see what the insert literature says about it's shelf life.

If you asked 3 different pharmacists the same question, I'll bet at least 2 out of 3, if not all 3, would quote the 28 day limit because they don't have anything other than hear say to back up suggesting exceeding that limitation. We are a unique group of users for whom the pharmacists may risk telling us it's OK to extend the use. While no product is going to be ineffective the minute that prescribed period of use is over, there is no concrete data available to tell us exactly how much longer it can be assumed to be effective. That extended time frame might be different for each batch of the medication or be affected by how it was handled even in the pharmacy. The 28 day time frame is a "safe" time frame supported by clinical data and we unfortunately are left scratching our heads as to how long after that we can extend out the use of our pens and vials.

 

[Melanie and Smokey]

Then, why not make 1 ml pens and 3 ml vials (for larger dose users)? That would be my question.
And, given that cats and dogs usually use very low dosages, does PET insulin (those designed for use in pets and bought through vets) come in smaller vials/pens and have the same requirements?

Since Lantus/Lev is not not labeled for pets, they don't package it for the doses we use. Humans go through it much faster than we do. Pet insulin is U40, not U100 so there is less insulin in a vial. I believe I've seen PZI and Prozinc users say they often use their insulin until it is gone, I know when I had Vetsulin, what I found in research was that the way it is mixed users should stick to its stated shelf life (42 or 56 days ?? I quit using it long before then)

I would think that the error at the lower doses due to warming/cooling of a pen used with the pen tips wouldn't be that much more of a variance than those of us eyeballing doses on syringes.

Opened vials, whether or not refrigerated, must be used within 28 days. They must be discarded if not used within 28 days. If refrigeration is not possible, the open vial in use can be kept unrefrigerated for up to 28 days in a place away from direct heat and light, as long as the temperature is not >86°F (30°C).

Now, I'm not sure but, this all sounds like a puzzle/double talk.

I don't think it is double talk. It is saying the life is 28 days once opened. You can store it opened in the refrigerator or under those conditions to have it last 28 days. I think the reason they restate the 28 days in the second sentence is because if you do not have it refrigerated and do not meet those conditions, the life of the Lantus could be less than 28 days. They make no claims for it to be good if you leave it sitting in the sun or heat.

As with many expiration dates, the mileage is often different than what is stated such as canned goods that should be good forever if not damaged, but still much have an expiration date on them.

My hopes is that as the patent on Lantus expires, the company will co after the pet market more and work on getting labelled for use in pets. Possibly getting smaller pet sized packaging and a better pricing. A girl can dream.

 

[Louellen]

Thank you JAA and Mr.Worfmen's Mom...you're both right. I was going to change that pen last night but, it's only half way through. I will likely not go beyond the 6 week mark by much and will toss it away but, it's been kept in the fridge with the other un-opened pens.

JAA...I was about to do the same thing you have done and start a new pen but, I thought about it all first as that's a lot of money to be throwing out...money that I really don't have to toss away.

Mr. Worfmen's Mom...I agree so totally with your take on this. I think it is all about the marketing and the human tests and there being a lower number of days in use for humans. Most do use it up or most of it, before the 28 days so, they are not losing much, if any at that point. You're right. Why go the extra miles in testing when most humans use it up within that time frame?

The literature sent to this doc who wrote to all of the insulin producers for his human patients, did say that even 4 weeks after opening, all of the criteria with the insulin (including efficacy) were still stable and no contamination was found. I don't think that they went beyond those 4 weeks though as again...why would they, given that most human usage means a finished vial/pen within that time frame.

But, that means that though my call will fall on deaf ears, I think I will call/write to the manufacturer and let them know that more and more pets are being put onto their insulin and they need to have a veterinary report for lower dosages and stability during those time frames that would be in use.

I did see a few people on a forum say that they only use a tiny dose (I'm sure larger than what we're using in our cats though) and didn't have insurance covering that cost. I believe that this was a children's diabetes forum (I've read so many now). The long and the short of it was that most of them were keeping the pens/vials refrigerated after opening and using them longer than those 28 days. One guy was using his for up to 6 weeks before he found it was losing its strength.

But, here in Canada, where insulin is more inexpensive than the U.S., if I create a wave about pet usage, it's just as likely that the prices will soar *IF* they were to consider creating a smaller unit for pet usage...which I doubt would happen...and VETS would get on the bandwagon in obtaining sole rights to sell us those smaller vials/pens at much inflated costs! So, we can't win for losing.

So, I will try to hold on for another few days, then change pens and see if there is a difference. Like JAA, I think Morrigan's numbers are going up at times due to a food related rise vs the insulin losing strength. I do check for clarity, crystals etc..

 

[Louellen]

Since Lantus/Lev is not not labeled for pets, they don't package it for the doses we use. Humans go through it much faster than we do. Pet insulin is U40, not U100 so there is less insulin in a vial. I believe I've seen PZI and Prozinc users say they often use their insulin until it is gone, I know when I had Vetsulin, what I found in research was that the way it is mixed users should stick to its stated shelf life (42 or 56 days ?? I quit using it long before then)

I would think that the error at the lower doses due to warming/cooling of a pen used with the pen tips wouldn't be that much more of a variance than those of us eyeballing doses on syringes.



I don't think it is double talk. It is saying the life is 28 days once opened. You can store it opened in the refrigerator or under those conditions to have it last 28 days. I think the reason they restate the 28 days in the second sentence is because if you do not have it refrigerated and do not meet those conditions, the life of the Lantus could be less than 28 days. They make no claims for it to be good if you leave it sitting in the sun or heat.

As with many expiration dates, the mileage is often different than what is stated such as canned goods that should be good forever if not damaged, but still much have an expiration date on them.

My hopes is that as the patent on Lantus expires, the company will co after the pet market more and work on getting labelled for use in pets. Possibly getting smaller pet sized packaging and a better pricing. A girl can dream.

I like and agree with all that you've said, Melanie

 

[Melanie and Smokey]

I have used vials for 2 months once and 3+ months twice now.
With Smokey we were so close to remission I didn't want to risk that so we switched it out right at the end when I though I was seeing floaties. When she fell out of remission she went high dose we burned through a vial in 3-4 weeks. Pens were not economical with her. I tried them for a while, but preferred the vial.
With Sly, he is around 4 months on his vial, his numbers just wandered off on me recently and on inspection it seems like I might see the same floaties. Sly's vial was definitely packing a punch at 2 months and dropping him in to the 40s repeatedly, still into the 50s into the 3rd month on that vial and a much lower dose. We will be switching to a pen on him when it gets here.
ChrisFarley took 2 months to remission, we used the same vial that whole time on him. I took the remaining vial back to the shelter for another cat to use up.
So our mileage has been that Lantus is effective well past the 28 days. We haven't gotten the 6 months some do, but a good 3.5-4 months.

 

[Meya14]

We bought a vial in January of this year when max was still at a high dose. His dose ended up going down pretty rapidly after so it took much longer than we thought to use it up. Just finished it up last week, so got about 4 months out of it. Didn't notice any decrease in BS when we got our new pen, so I think it was still pretty active after 4 months.

 

[Larry and Kitties]

I have used up an entire vial of Lantus. It took over a year and it was fine even to the end.

 

[Kity Bop]

Hi all,

been reading all kinds of info about Lantus Solostar Pens. Just got a few. I know to store unopened boxes in the fridge, but once I start to use the pen (using the syringe thru the rubber stopper method) do I then put back into the fridge? Do I keep it out? I have read both and it's making me crazy.

She gets 1 unit twice a day.

Thank you in advance for any help.

 

[MrWorfMen's Mom]

Most if not all of us are keeping our in-use pens in the fridge to keep it as fresh as possible for as long as possible. If kept in the fridge, many people report being able to continue using a pen for months as opposed to the 28 days suggested by the manufacturer.

 

[Kity Bop]

Hey thank you! That was a fast reply. Good, that makes me feel better. I will store in fridge. Your kitty looks just like mine too.

 

[MrWorfMen's Mom]

My pleasure. Just happened to be checking the board. I look forward to seeing a pic of your sugar baby!

 

[Kity Bop]

Photo added. Thank you again for the quick reply, im sure I will be back again soon.

 

[MrWorfMen's Mom]

Welcome to the board. I'm fairly new here myself (few months). You will find an extraordinary fountain of knowledge and wonderful supportive folks here who are willing and able to answer any and all questions, offer very helpful tips and tricks and help you keep your sanity when issues crop up. So ask away!
Love the pic! Our kitties could be related! SO cute!

 

[Kity Bop]

it's good to know there is help and advice out there, this can get quite tricky as I am sure you know. was just so frustrated about the refrigerate or don't issue. Thank you! I will be back.