General Question on Lantus

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Tonya and Tiki

Tonya and Tiki

Member Since 2011
How long can it be left out of the fridge before it's toast....I figure at some point I will inevitably forget to return it to the fridge but wondered if there is a length of time it can be left out without destroying its efficacy.

I also started to wonder if the COLD liquid as I inject into the cat is causing some of his wiggle butt antics at shot time - so if I let it get closer to room temperature would that be detrimental in any way to its effects?
 
From the Lantus prescribing info sheet

16.2 Storage

LANTUS should not be stored in the freezer and should not be allowed to freeze. Discard LANTUS if it has been frozen.

Unopened Vial/Cartridge system/SoloStar disposable insulin device:

Unopened LANTUS vials, cartridge systems and SoloStar device should be stored in a refrigerator, 36°F – 46°F (2°C – 8°C). Discard after the expiration date.

Open (In-Use) Vial:

Vials must be discarded 28 days after being opened. If refrigeration is not possible, the open vial can be kept unrefrigerated for up to 28 days away from direct heat and light, as long as the temperature is not greater than 86°F (30°C).

Open (In-Use) Cartridge system:

The opened (in-use) cartridge system in OptiClik should NOT be refrigerated but should be kept at room temperature (below 86°F [30°C]) away from direct heat and light. The opened (in-use) cartridge system in OptiClik must be discarded 28 days after being opened. Do not store OptiClik , with or without cartridge system, in a refrigerator at any time.

Open (In-Use) SoloStar disposable insulin device:

The opened (in-use) SoloStar should NOT be refrigerated but should be kept at room temperature (below 86°F [30°C]) away from direct heat and light. The opened (in-use) SoloStar device must be discarded 28 days after being opened.

As long as Lantus isn't exposed to temps abot 86F or frozen, it's good to use :smile: You don't really need to refrigerate in-use Lantus. Human diabetics don't but they also use larger amounts of insulin in a day so their pen or bottle doesn't last too long.

Some people briefly hold the prepared syringe in their hand to warm up the insulin before injecting.
 
So what do most people here on the boards do - do you keep it refrigerated or not? And do people here keep it longer than the 28 days? My vet said it was good way past the 28 days protocol states.
 
We keep it refrigerated so it lasts longer. I do not allow mine to get to room temp. I know some folks accidentally have left theirs out longer than they meant to. It may make it go toasty sooner.

Jill says in the stickys that proper use and storage and you should be able to use the entire pen before it goes bad. Some folks just automatically change pens at around 28-30 days just to keep numbers from
potentially getting wonky.
 
I always stored mine in the fridge....drew the insulin and put the pen back before I finished getting air out, etc. so I wouldn't forget to put it back in. My strategy was to avoid setting it down on the counter....once you do, you may forget it. ;-)

Some of the wiggles at shot time may be from the insulin itself....it's acidic, so it may sting when you inject it. You can warm the insulin in the syringe after you draw the dose...just roll it between your fingers for a few seconds.

We never got more than 33 good days from a pen. I stopped trying and just replaced it after 28 days....it wasn't worth the risk of losing regulation. YMMV
 
I am only on my first filling of the prescription and was given a vial of insulin...is there any benefit in asking for pens? What is the difference between the two?
 
if you want to get the most out of it and possibly have it go past 28 days, keep it in the fridge. we put ours in a little mug (did you watch the video on the sticky "care of lantus?") and it is a little easier to not lose track of the larger mug than just the tiny vial.

we also warm the syringe between our fingers before injecting. just a few seconds will help.
 
I have mine in a tiny left over container and then I keep it in the back behind the eggs and informed my roommate if she drops and breaks it I am free to kill her at will. Yes I watched the video - great tips. I've been leaving the syringe out for a few mins before injecting it but nothing really seems to help. He is fully aware he is getting stuck and hates it. :sad:
 
I have heard that Lantus is acidic and can "sting". Levemir allegedly does not. The two insulins are otherwise very similar, so switching should not change your current course of action much. Something to consider.

MJ&Donovan
 
i think that's true - lantus is slightly acidic and levemir is slightly base, but punkin's been on a dose of up to 15.5u of lantus and he doesn't even flinch. when he was getting tiny shots, he always reacted. i think he just got used to it. if it were really acidic enough to be a problem, he wouldn't have stopped flinching.

i think cold insulin bothers him more than anything. we just warm it between our fingers before shooting.
 
kismetttt said:
I am only on my first filling of the prescription and was given a vial of insulin...is there any benefit in asking for pens? What is the difference between the two?
Click to expand...


10 ml Lantus bottle:
Lantus.jpg


Lantus SoloStar pen:
chart3.0.gif


Other than the container, the SoloStar pens are more cost effective to use than the 10 ml bottl. A 10 ml bottle contains 1000 units of insulin. No cat will ever use up that much insulin before the manufacturer recommendation of throwing the bottle away after 28 days. Who wants to buy a $115+ insulin bottle every single month and throw a barely used one 28 days later?

A SoloStar pen contains 3 ml (300 units) of insulin. It comes in a box of five pens which is at least a 5 month supply you will have on hand. Most people won't ever use up the entire 3 ml of insulin before it starts pooping out around 28-30 days, maybe a little longer, but it's still a lot less insulin being thrown away vs the 10 ml bottle. A box of pens does cost more than a 10 ml bottle (around $225 or so. Cost varies across the US) but it comes out to about $45 per pen.

Human diabetics use the SoloStar with pen needles, as shown in this picture. For diabetic cats, you use the pen just like an insulin bottle: stick the insulin syringe needle into the rubber stopper at the end of the uncapped pen.

How%20to%20use%20an%20%20insulin%20pen%20for%20cats2.jpg
 
I contacted Lantus customer service when I read on their website NOT to refrigerate Solostar pens once opened. I wondered why not since everyone does to prolong lifespan. Also asked about injecting air into pen (she confirmed not to do it).

She said it was more comfortable to inject room temperature insulin. Bear in mind this is for HUMANS who are taking much larger dosages. My cat never seemed to mind cold injections as the dosages are so tiny. (But since I am giving more and more insulin and I don't use full pen anyway I think with the new pen I just opened I will keep at room temperature.)

I did also run across this in my research.

From the Univerity of Queensland on their CAT , General Information Brochure:

If using an insulin pen, the manufacturer recommends that the pen and cartridge be kept at room temperature and not refrigerated. THIS IS TO REDUCE THE CHANGES IN VOLUME OF INSULIN DISPENSED ASSOCIATED WITH CHANGES IN TEMPERATURE.
Click to expand...

But even the Lantus people didn't even mention this.

Tilly's Homepage, the German group whose research makes up basis for protocol (along with Rand, etc) says people refrigerated and they found it lasted for longer than 6 months.

http://www.tillydiabetes.net/en_6_protocol2.htm

I think you just have to pay particular attention to the numbers when you are using 'old' insulin to make sure it is still viable and working. For right now I am not going to keep using mine for more than a month until I see better regulation. ( I just met someone who is still using a pen for over 6 months plus he injects air into it--I wouldn't do that but there does seem to be a alot of leeway with the viability and expiration dates.)

Elaine and PInky
 
Tonya,

There are other things that could help with the reaction to the shot as well. What size needle are you using? I used 31 gauge needles for a long time, when I bought a different brand, I got 30 gauge and it made a difference in Mr T's reaction.

Where are you shooting? You might try a different location, some kitties are more sensitive in some areas than in others. Here's a chart showing different shooting sites. http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7374
 
I have 30 gauge needles (the short stubbie kind) and have injected him in all those spots (mostly because he is jumping around and cringing as I try to do it anywhere). This morning was quite the scene and I am surprised he is still hanging out with me like he is, letting me poke his ears. He seems mopey today too... :sad:
 
Hi Tonya,

Do you think your kitty is really feeling pain duing injection?

A cat really shouldn't feel any pain whatsoever during an injection. They might try and squirm away but not jump around and cringe.

You are pulling up some skin and forming a triangle or tent. Right? You don't inject straight into cat or you may hit muscle.

Here's some pics:

IGNORE ALL THE INFO ABOUT ROLLING AND INJECTING AIR and go straight to the injecting slides.

http://bd.com/us/diabetes/page.aspx?cat=7001&id=7434

Maybe someone who is experienced can double check above pics for accuracy and can help if you feel your kitty is in any kind of pain during injection.

Best wishes, Elaine and Pinky
 
You might want to try 31g needles- I feel like my Smokey can tell the difference between the few 30g that I've used and the 31g (he doesn't even feel the 31g). Also, I've got a vial of insulin as well (first prescription before I knew about the pens) and we are on month 3 and it still works just fine. I have mine wrapped in a bubblewrap pouch in the fridge door and I put it away before I leave the counter (almost don't put it down...) I'm just going to watch Smokey's numbers and see what happens as this is my first vial...
Good luck!
 
i get allergy shots every week or so and sometimes the shots do hurt. tiny needle, but sometimes they hit a nerve. what choice do you have, though? it's not a giant owie and it's done hurting before too long.

i've called ADW and left a message about those terumo syringes to see if they do have 1/2 unit markings.
 
I switched Gracie from 30g to 31g syringes because she would make a little "meep" with the 30g. She doesn't even seem to feel the 31g. Also...if you feed him while you're shooting, that might help distract him.

Be sure you are shooting subq and not into the muscle.
 
Yes, yes, yes and yes - shooting while feeding (doesn't trick him in the least), into the subq as best I can with him wiggling all around, making a tent - again as best I can with him ducking and dodging me. I've fed him up high which he was onto after the second shot and wouldnt get back up as he usually eats on the floor. We have a great in lap, loving, purring (at least 9 outta 10 times) time while getting poked, so I was thinking of shooting him there while I was taking his BG reading. And then feeding him right away...just dont want to suddenly make him terrified of being in my lap and making him a wiggle worm while getting poked.

I just went out and bought him $20 worth of various LC treats (I hope) as he is starting to tire of his freeze dried chicken bits...found some by wellness called pure delights - chicken and lamb jerkey...ingredients include dried chicory and cultured whey....that's probably not good eh???
 
Are you inserting the needle bevel side up for easier insertion and minimized pain?

I've used 29 gauge insulin syringes on Squishy and he never felt a thing. One thing I did with Squishy was to let him know that I was about to stick the needle in by pulling his tented skin a few times. He'd pause for half a second while I injected and then continued stuffing his face.
 
So while I had him curled up in my lap for his ear poke I gave him his shot tonight - no fuss, no cringe, no wiggle butt and best of all, no sign of pain.....AND it all went in!!! So if I missed this morning, maybe we will see some movement tonight.
 
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