Cost for Glargine

[Kerflumper]

What should I expect the monthly cost to be for Glargine? My vet gave me a price of $70 for a 25 day supply. Evidently the shelf life is very short so I'd need to buy every month.

 

[Dyana]

You might want to post this over in the Main Health Forum.

I usually get my insulin in the packages of 5 pens which last a lot longer than the 1 vial. My pens usually last about 2 months or close to.

 

[Michelle & Scrabble (GA)]

We use the package of pens too, I bought them last month and the cost was around $230 but it was for 5 pens.

 

[Ann & Maggie11 (GA)]

I bought a vial of Lantus insulin September 12 for $143.99 at Walgreens, and it will last me five to six months.

 

[Kerflumper]

Ann & Maggie11: Does your vet give you a prescription that you can use at Walgreens? What's the specific name of the product you're getting, size? What syringes do you use?

Michelle & Scrabble & Dyana: Are those pens the Solostar? Aren't those for once daily dosing? Do you use syringes with those too? Which ones?

Is Lantus the same as is used for humans?

 

[Sienne and Gabby (GA)]

The human Lantus is the same insulin we use for cats. There's no difference.

The Solostar pens do come with separate needle tips. You do not want to use the needle tips. We insert a syringe into the rubber gasket at the top of the pen the same way you would with a vial of insulin. The pens do not dispense insulin in smaller amounts than one unit and you will need smaller doses -- hence the use of a syringe. You use the same syringe for the pens as a vial. We use U100 syringes, usually in 30 or 31 gauge. I use a 5/16 inch. length needle; some here use a 1/2 inch needle. In all likelihood, you will need a prescription for syringes although this varies from state to state.

This is from the New to the Group sticky:

U100 3/10cc syringes with half unit markings are the best to use for fine dosing. BD, Monoject, GNP, and ReliOn are some of the brands available with half unit markings. Needle gauge and length is your preference They come in ½ inch or 5/16 inch needle lengths. Needle gauges 29, 30 or 31 (31 being the thinnest).

You can get Lantus at any pharmacy. I'd call around to see where you get the best price. You don't need a membership at Sam's Club or Costco to use the pharmacy. If you vet does not specify, you will get a vial of Lantus. If you vet writes the prescription for the Solostar pens, you'll get the pens.

You may want to take a look at the starred sticky note on Info, Handling and Storage of Lantus. Many of your questions are reviewed there along with a good deal of additional information.

 

[Ann & Maggie11 (GA)]

Hi, it looks like Sienne covered everything in the above post. Yes, my Vet gives me a prescription for it. He calls it in for me, as he asks where I want to buy it. It's the Lantus U-100 Insulin 10ML vial, the same as for humans. As for syringes, I use the Monojects, and I see Sienne has it posted, too.

 

[Ann & Tess GA]

You can buy the syringes from ADW, there is a link on the top of the page. They have a great price and FDMB gets a commission to help keep the board running. Most brick and mortar pharmacies (except Walmart) dont carry the half unit marked syringes. ADW is a good source for lancets and testing strips too.

 

[squeem3]

Here's a $25 coupon for the SoloStar pens: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=36964 It expires Dec. 31, 2012 so you should use it soon.

To save some money on Lantus, you can use a free prescription drug card. Here's one for pets that you can use at any pharmacy: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=53397 Also in that thread are links to other free prescription drug cards you can use.

Some people buy their Lantus from online Canadian pharmacies. Here is a thread with info: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=11530

My vet gave me a price of $70 for a 25 day supply. Evidently the shelf life is very short so I'd need to buy every month.

Are vets allowed to directly sell Human medicines such as Lantus? confused_cat

Watch out if you buy Lantus from the vet - some vets repackage the insulin from the original sterile 10 ml bottle or 3 ml pen into another container that may or may not sterile and then they stick a vague label on the container. I would not risk using potentially contaiminated/expired/etc insulin. Ask to see the package of insulin before you buy it from the vet. If it doesn't look like this or this do not buy it.

 

[Kerflumper]

The vet says it's compounded by some third party (witchdoctor if you ask me).

 

[Sienne and Gabby (GA)]

Lantus is not a compounded type of insulin. It is straight from the manufacturer -- Sanofi Adventis. If he's telling you it's compounded, ask for a prescription and let him know you can get it filled at any pharmacy. FWIW, Lantus does not have a veterinary "indication" -- that's FDA-speak for the manufacturer not having jumped through all of the expensive hoops for it to be used with animals. It's use in animals is "off label." There are lots of medications for humans and animals that are used off label. That doesn't mean that you have to go through a third party to get the drug. I've bought my Lantus at both a hospital pharmacy and Walgreens.

 

[Marje and Gracie]

To reinforce what Sienne said, please do not use any insulin labelled "lantus" or "glargine" that has been compounded neither should this insulin be diluted in any way.

 

[Kerflumper]

I'm confused. The vet says that the glargine for cats that she gets is compounded and that she can't prescribe the stuff I'd get at the pharmacy. Further she insists that it will not safely last more than a month.

 

[Sienne and Gabby (GA)]

Your vet is absolutely incorrect. Lantus is a patented insulin. Like all drugs that are still on patent, cannot be compounded or it's a patent violation and your vet can be sued by the manufacturer. It may be that because Lantus does not have a veterinary indication, that a compounding pharmacy will provide it. However, you will pay more for the insulin via a compounding pharmacy than buying it at a human pharmacy.

I get Lantus that is in the original package. I buy it at a hospital pharmacy where they are capable of compounding pretty much anything. There's absolutely no way the vet can repackage a Solostar pen. Further, I've got a prescription for Lantus written by my vet sitting in front of me at the moment. It would be the same thing as your vet saying she can't write a prescription for Clindamycin (or Baytril, Flagyl, or ondansatron, etc.) for your cat and you have to get it compounded. We all go out and get these prescriptions filled at our local pharmacy. If you don't believe me, call your local pharmacy and ask if they will fill a prescription for Lantus from your vet. Walgreens even has a discount card for veterinary prescriptions.

I use the Solostar pens. The last 2 pens I used lasted 50 and 48 days respectively. Your vet is going by the manufacturer's recommendation that any unused Lantus be discarded after 28 days. Please see the information that's from the sticky I linked. Pay attention to the section that's in bold and italics.

• The manufacturer of Lantus recommends discarding the insulin after 28 days of use (in-use, unrefrigerated, for humans).
  However, many Lantus users have been able to use a vial/cartridge/pen for as long as six months.
• Opened Lantus and Levemir vials, cartridges, and pens can last longer than many FDMB members seem to think. Some caregivers of diabetic cats have used Lantus/Levemir down to the last drop. Lantus users from the German Katzen Forum have reported using opened Lantus for up to six months and Levemir up to four months if kept refrigerated and handled properly. Lantus is NOT as fragile as we once thought.
• From two of the leading researchers in the field of lantus use with feline diabetics, Jacquie S. Rand BVS, DVS and Rhett D.Marshall BVS (University of Queensland, Brisbane, Australia):
  
  "Glargine should be refrigerated because it has a shelf life of 4 weeks once opened and kept at room temperature. We have found that opened vials kept refrigerated can be used for more than 6 months. If using an insulin pen, the manufacturer recommends that once a vial of insulin is used, the pen be kept at room temperature because temperature changes associated with refrigeration alter the volume administered by the pen."
  http://www.uq.edu.au/ccah/index.html?page=43599&pid=0
  
• We use U100 syringes to draw Lantus from cartridges and pens. We do NOT use needle tips which can be attached to the pens to administer insulin. Therefore, refrigeration will not alter the volume administered by the pen apparatus. Refrigeration combined with the use of syringes to draw insulin (versus using the needle tip made for the pen) from the opened pen has been found to extend it's life well beyond the 28 days suggested by the manufacturer.
  
• Unopened Lantus is good until the expiration date stamped on the box if refrigerated and handled properly.

 

[Barb & Checkers (GA)]

I am not using Lantus at the moment, but I did get my Lantus at Walgreen's with a discount card.
It was the least expensive available to me. Call around to local pharmacies to price.

 

[squeem3]

There's absolutely no way the vet can repackage a Solostar pen.

One can always use a syringe to remove the insulin from the SoloStar pen or 10 ml bottle and squirt the insulin into another who-knows-if-sterile-or-not container (bottle). A newbie awhile ago posted a picture of a green bottle with a rubber stopper top that the vet repackaged the Lantus into and it had a label with no information on it other than the cat's name and owner's name. No name of the liquid inside, no expiration date, etc.

I'm confused. The vet says that the glargine for cats that she gets is compounded and that she can't prescribe the stuff I'd get at the pharmacy. Further she insists that it will not safely last more than a month.

Your vet CAN write you a prescription to buy Lantus or any other Human medicine your cat may need at the Human pharmacy. Everyone here buys their Lantus from a pharmacy. I've bought it at CVS before. I've gotten other Human medicines for my cat from the Human pharmacy with a written prescription from the vet.

There is only one Lantus available anywhere for anyone. It is the one that is FDA approved for Humans and made by Sanofi-Adventis, http://www.lantus.com. Cats use the exact same Lantus, just "off label" because it is not FDA approved for use in animals.

 

[Amy&TrixieCat]

I'm confused. The vet says that the glargine for cats that she gets is compounded and that she can't prescribe the stuff I'd get at the pharmacy. Further she insists that it will not safely last more than a month.

Wow...this is very, very scary. Honestly, I'd try to find another vet....

I also use the Solostar pens. My local Target pharmacy allows me to buy them individual - about $50 each - and they last 2 months. I know, though, that not all Target pharmacies will sell the pens individual, and if I were to buy the whole box of 5 at one time, it would result in a lower "per pen" price; however, I really can't swing buying the whole box at once.

Calling around is key...I found a wide range of prices in my area before I settled on Target.