Inject air into Lantus vial or not?

[MelanieP and Ninja]

In searching the forum archives, I keep finding conflicting advice about whether or not to inject air into the Lantus vial when drawing up the insulin dose (I use the vial not the pens). The official Lantus manufacturer's website says, yes, inject air equivalent to the dose you will be removing. Question: If the official Lantus site says to do this, why do some of you disagree? Is there a source of info you can cite on which you are basing your opinions? I anticipate getting conflicting opinions here too -- and that is fine. Just trying to find out what folks are doing and why. Biggest concern is making sure the effectiveness of the Lantus lasts as long as possible and wondering if, despite what the manufacturer says, injected air degrades the contents faster in your experience; and also, if there is any downside to NOT injecting the air. Thanks!! PS: Here's a link to the video instruction from the Lantus manufacturer's website as well as the transcript.
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From Lantus.com: http://www.lantus.com/starting/how-to-u ... antus.aspx
(Note: bottom video is for the vial)

Lantus Injection Instructions Video:

"First get a new vial of Lantus Take of the cap and leave the stopper in place. Wipe off the top of the vial with a clean swab dipped in rubbing alcohol. Now take the syringe and draw air into it equal to the dose of Lantus you will be giving yourself. Then push the syringe through the stopper and inject the air into the vial. That makes it easier to pull out the full amount of Lantus. Keep the syringe in the vial and burn both upside down, making sure the tip of the needle is well within the Lantus. Then pull the plunger until you have the right dose. Take a look inside the syringe, if you see any air bubbles pull the syringe straight up and tap it gently until they rise to the top. Then gently push the air bubbles and insulin all the way out with the plunger, then draw the correct dose back into the syringe."

 

[Larry and Kitties]

Injecting air makes it easier to withdraw the insulin form the vial. You are using a vial and not a pen, right?
I would not inject air since it can slowly react with the insulin and make it go bad faster. For humans it is not much of a concern since they use the vial up a lot faster. However, air is going to get into the vial any but just to not inject any.
Most users here use the disposable pen and just use a syringe to withdraw the insulin. No air needs to be injected since the rubber stopper at the other end will mode as insulin is withdrawn. Although the cost per ml for the pens is more expensive most users never have to through any insulin out.

 

[squeem3]

Keep in mind that the information on the Lantus web site is for Human diabetics, not pets, so some of the info does not apply to anyone here.

Honestly, I have never injected air into the 10 ml bottle. I just pushed the plunger all the way down to the zero line, stuck the needle into the bottle, drew up a little more insulin than I needed, remove needle from bottle, and squirted out the extra insulin I don't need along with the bubbles. I have never had a problem with getting the insulin out or pooped out insulin.

The inside of the syringe barrel is coated with a lubricant. If the lubricant gets inside the insulin bottle it may negatively affect the insulin.

I suggest just following the Lantus handling and storing sticky here on FDMB.

 

[Melanie and Smokey]

If you are trying to make your insulin last as long as possible, then you don't want to be injecting back into the vial. If you are a high dose and use it up quickly, it won't make much of a difference. I think the only drawback to not injecting the air is that you have to fight with getting the air bubbles out a little more.