Couple of general Lantus questions

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AlyMcF

AlyMcF

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1. Where do you dispose of your old insulin bottles?
2. I've heard there is a Lantus pen which has a small quantity of insulin, and I'm wondering if it has the little rubbery disc you push the needle into? In other words, does it function just like a regular bottle of Lantus, only it's a smaller quantity?

Thanks!
 
AlyMcF said:
1. Where do you dispose of your old insulin bottles?
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In the trash. Lantus is a hormone not a drug. Check with your municipality. Individual cities or towns may have different regulations.
AlyMcF said:
2. I've heard there is a Lantus pen which has a small quantity of insulin, and I'm wondering if it has the little rubbery disc you push the needle into? In other words, does it function just like a regular bottle of Lantus, only it's a smaller quantity?
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See the LANTUS & LEVEMIR - INFO, PROPER HANDLING, & STORAGE sticky.
The info you're looking for is there... complete with pictures. :)
 
We have drop offs for old medicine at some pharmacies and police stations. I've tossed empty or mostly empty Lantus containers in the garbage. Check with your local pharmacy, they should be able to tell you.

Yes, there is a little stopper area at the end of the pen that you draw from just like a vial. One the Solarpen it is purple.
lantus pen.jpg
 
Jill & Alex (GA) said:
In the trash. Lantus is a hormone not a drug. Check with your municipality. Individual cities or towns may have different regulations.

See the LANTUS & LEVEMIR - INFO, PROPER HANDLING, & STORAGE sticky.
The info you're looking for is there... complete with pictures. :)
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Hmm. Now I have additional questions after reading this:
  • Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
  • If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon (this is probably what makes "floaties", it forms a white precipitate). Better to waste a drop than ruin whole vial, cartridge, or pen.
I have a vial, not a cartridge or pen. My friend who is a nurse told me to remove air bubbles, you draw out more than you need and push the excess back into the bottle and the air bubble will tend to disappear from the syringe. So that is what I have been doing for months. But this info makes me think that is dead wrong for insulin. If I need 2 units, I should just draw out 2 units carefully, no more? And if I have too much, I can't put it back in the bottle, I have to squirt it out?

Also I watched the YouTube video on that page. Why is the instruction different for vial vs pen? I have been doing something similar to the pen instruction, only with the vial. I've never drawn air into the syringe and then then stuck it in the vial. It's not how my vet showed me to do it. Is that really what I'm supposed to do?
 
I always draw about a half a unit more than I need, flick the syringe and push it up to my dose over the sink. I never push back into the pen.
 
The instructions in Julie's video are correct.

Ideally, you don't want to push insulin back into a vial or pen because there's a greater risk of contamination. Most of us take extra precautions when it comes to handling insulin for our cats or two reasons: we use a vial or pen of insulin far longer than a human does (humans have much larger doses) and the insulin is so darn expensive! We want the insulin to last as long as possible.
 
In addition to what Jill noted, with the pens, because they operate with a negative pressure system (there's a stopper that moves down the cylinder as you draw off insulin), you don't want to inject anything back into the pen.
 
You don't want to have any air in the syringe before you stick it in the pen or the vial. I always push the plunger in and hold it until I insert it in the pen to keep any air from getting in.
 
carfurby said:
You don't want to have any air in the syringe before you stick it in the pen or the vial. I always push the plunger in and hold it until I insert it in the pen to keep any air from getting in.
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In the YouTube video that's linked on the LANTUS Storage Sticky, it shows at minute 3:40 that she's drawing air into the syringe and then injecting it into the air of the insulin vial before flipping it over and drawing insulin out. This is the part that is confusing me. That's not how my vet originally showed me to do it. The first thing I do when I uncap the needle is push the excess air out of the syringe, because there always seems to be some. Then I tilt the the vial upside down and sticking the needle in, then draw out the dose. My vial has never been less than half full so maybe I've just been getting lucky with that technique.

There's a lot of talk about negative vacuums that I don't understand perhaps 'cause I'm an art person not a physics person. I'm guessing (without having tried it yet) that once you'd drawn air into the syringe and injected it in to the vial, then once you flip the vial, the syringe will automatically draw back the exact amount you need. I had a weird batch of syringes last week that were trying to suck insulin in to them automatically. I never figured out why that was happening but it isn't happening with my usual syringes.
 
I'm not sure what's in the video, but I never pushed anything back into the vial or the pen. The negative vacuum is for the pens. From what I understand, it just means the pens are pressurized and it helps keep the insulin from going bad. I started with the vial and I just held the plunger in and drew insulin out. My first vial lasted almost a year.
AlyMcF said:
I had a weird batch of syringes last week that were trying to suck insulin in to them automatically. I never figured out why that was happening but it isn't happening with my usual syringes.
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It sounds like you just had a bad batch of sryinges. They don't help you draw insulin out normally.
 
The big difference is between the vial and the pens....In the vials, you DO add air to help equalize the pressure. Sounds like your vet didn't show you that you should inject air into the vial. It's not 100% necessary, but it does help

In the pens, there's a vacuum "built in" so you shouldn't inject air first
 
I made the video you're asking about, Alyssa. The reason for injecting air into the air of the vial is because you're replacing the volume of insulin that you're going to draw out with air. It just helps the process work smoother. If you don't inject air into the air of the vial, and you continually withdraw insulin, you'll create a bit of a vacuum.

This might not be the best visual, but it's all I can think of . . . when we use freezer bags, we put a straw in and suck out the excess air before sealing the bag. The bag is then sucked up against the food that's in the bag. That's a vacuum.

With the insulin, if you keep removing insulin without adding air, you're also going to create a vacuum. Look at the part in the video where I drew up the dose from the pen and it sucked the insulin back out of my syringe and into the pen. That was a vacuum. Think about your vacuum cleaner that sucks air in - it would be like trying to withdraw a dose against that vacuum effect that is trying to suck the dose back in.

Nothing dire will happen to the insulin in your vial if there is a vacuum in the bottle, but it will make it harder to draw up your dose and the risk increases that the dose might get sucked back into the vial. There's nothing wrong with the insulin going back into the vial except that with our modern syringes, there is a lubricant inside the syringe. It's the lubricant that's the problem. The lubricant can contaminate the Lantus. As expensive as it is, most people want it to last as long as possible.

Your vet likely learned how to draw insulin on earlier insulins. I don't know much about them, except the one called "Regular" insulin (Humulin or Novolin R). That's a fast-acting insulin. It's one that I used with Punkin, in addition to Lantus, because he was a high dose kitty. The only point of me telling you this is that R seems to be practically indestructible. I had one vial for punkin that i used for more than a year, maybe even 2 years. It didn't need to be refrigerated and it seemed "tough." It was far cheaper than Lantus too. I just wonder if the technique your vet demonstrated for drawing the dose is perhaps because he learned on insulins that weren't like Lantus.

In any case, I'd assume you want your expensive Lantus to last as long as possible, so I'd treat it carefully.
 
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