Need to switch to Levemir eventually

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I am on a tight budget and the $120/bottle ProZinc my vet has my newly-diagnosed cat on just isn't going to cut it. A friend managed to get me two free samples of Levemir insulin 10ml bottles that don't expire until 2012. My question is this: one of the boxes of Levemir accidentally got put in the fridge upside down so the bottle sat upside down for a few hours... will this create any issues? Also, I am very inexperienced with handling insulin (which I am currently trying to educate myself!) and accidentally opened the cap of the bottle just "checking it out"... I have NOT punctured the rubber at all yet, so is this bottle still considered "unopened" with a full shelf-life? Or do I need to consider it open now?

Thanks in advance for the help! :)

-M

P.S.
Is handling Levemir same as other insulin? Just lightly agitate it prior to filling syringe? Rolling lightly between hands and gently tipping vial up and down?
 
First: never roll levemir. It and lantus do not get rolled or inverted (gently shaken).

I think that the box that was put in upside down should be ok. I have kept a box of cartridges on their side and they are ok. Now for the cap thing, I am not sure what cap you mean? Oh! I just Googled it - you mean the green plastic cap? It should be ok and "unopened" as long as the rubber seal was not punctured with a syringe.

Wow, you are a lucky person to have a friend that can give you TWO vials of levemir! I am jealous :roll:

Before you switch, please read the Stickys at the top of this ISG forum for info on using levemir - and ask questions.

What dose are you using with PZI now? And how is your kitties blood glucose? Are you home testing? What is kitty's name?

and Welcome to the Lev ISG!
 
Hello and thank you. :) Yes I am fortunate. My girlfriend's sister is a nurse, so she has access to some free samples of insulin at times. I really wanted to try the Lantus, but she said all that was available at the time was Levemir. I'm starting to think that it's going to be a better option anyway after reading how fragile and short-lived Lantus is (and I prefer vials for some reason... makes me feel more, "doctor"ish... LOL!... I love the show House, M.D. :) )

My vet really messed me up when he sent me home with my Pixie puff with a prescribed dose of FOUR UNITS of the new feline ProZinc insulin...

I got corrected in short-order by the caring folks over on the regular Diabetes FDMB.

Sorry I did not give more background information before asking a question, but I am pretty wore out from typing so much information over the last couple days. You can see Pixie's full story here:

viewtopic.php?f=3&t=15470

Thanks for the tip on not agitating the Levemir... not AT ALL, right?

And yes, I meant the green cap. So it's still considered unopened... good, good! What's the 'opened' shelf-life of Levemir, though? Since I'm still a couple months away from the switch, I've only briefly skimmed the stickies so far.

Thanks again!

-=][V][=-
 
Out the door on my way to work (darn work always getting in the way of my fun!) but i wanted to say Hi and Welcome quickly.

No prob about the Lev vial being stored upside down - it's not that temperamental luckily.

I think you're really going to like Lev - we all do :smile:

More later, have a great day and hey, Pixie is one lucky kitty to have you looking out for her. Be proud of all that you've learned so far!
 

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Hi there and welcome. Have seen your posts on Health section, so quick question - why wait 2 months to begin the Levemir? If you have it now, start it now. The reason I say this is the sooner a newly diagnosed diabetic kitty is put on either Lantus or Lev, the better chance they have of remission.

Yes, PZI types have allowed some cats to achieve remission, but not as high of percentage as the L insulins. For Lantus it's over 60% and although the clinical data is not out there on Levemir, I'm sure the percentage is similar.

Although remission should not be the goal of insulin treatment, you want to have the best chance at it. It breaks my heart that I could not give Gandalf that chance in the beginning because I just did not know.

Either way, we're here to help. And if you decide to continue the PZI for now, be sure to check in with the PZI ISG folks as they are very knowledgeable too.
 
Mike, glad folks got you straightened out on the dosing over in the Health forum. I think your vet has some education to get on feline diabetes - sigh. And testing by cutting his nails to the quick is horrible - and totally unnecessary. Besides that, testing with a lancet is so much easier. Geeze.

As for the meter difference with the Relion and their Alpha Track - their meter can be set to measure either venous or arterial blood, the Relion is designed to only test venous blood - as all home meters are. I am not sure if the blood from the quick in arterial or not, but the real test of meters would be from an ear stick using the same drop of blood.

Anyway, you are getting the right info here.

I see he is an orange boy! Gotta love those orange fellows. They are special. Of course all our kitties are special. I see you have five cats. So do I. I feed all of mine canned food. I mix Friskies with Fancy Feast or Wellness. It's all I can afford - the Wellness was a gift from Vicky, but it is a high quality, grain free, high protein food that I "stretch" with the Friskies. All my cats have soft silky fur and are energetic. When I fed dry food mostly my cats were more lethargic at times and their fur was dry and coarse.
 
Thanks for the replies. After realizing that I was YET AGAIN dependent on the vet for something (U40 syringes), I got fed up and I think I'm going to go ahead and switch to Levemir. I'll probably just keep the ProZinc as backup... how long is it good after it's opened? Anyway...

I hope I didn't make a mistake in refrigerating the Levemir... I have two 10ml vials unopened in the refrigerator... was that the correct thing to do with it?

Thanks!

-M
 
Plugbait said:
Thanks for the replies. After realizing that I was YET AGAIN dependent on the vet for something (U40 syringes), I got fed up and I think I'm going to go ahead and switch to Levemir. I'll probably just keep the ProZinc as backup... how long is it good after it's opened? Anyway...

I hope I didn't make a mistake in refrigerating the Levemir... I have two 10ml vials unopened in the refrigerator... was that the correct thing to do with it?

Thanks!

-M

Yes, always keep it refrigerated, put it in a location where it cannot get jostled (the door is not a good place to store it) and each vial will last you probably a very long time. We don't have too much experience with vials, most of us use the flexpens or cartridges which are only 3ml, not 10ml.
 
It has been in the door for a couple days. I did not think about that... moved it to top shelf now, hopefully it's fine.
 
Yeah, a couple days is fine. It's the continuous jostling over time which might disrupt it. Also, keep them inside the boxes they came in. It's also not supposed to be exposed to much light.
 
I see some bubbles around the top of the liquid along the outer edge in both of the vials... is this normal? Anyone experienced with Levemir vials know? I only ask because my bottle of ProZinc did not do this.

Thanks.

-M
 
Yes. I used a vial to start with and mine did that. They should diminish over time. Do not shake or roll the vial. I believe that since it's a vial you want to inject the same amount of air as you plan to draw up insulin. Inject 1U of air if you're pulling out 1U of insulin to equalize the pressure. The cartridges and flexpens are not made the same way so equalizing the pressure is not necessary with them. They have a stopper which comes down as the insulin becomes less in the cartridge.
 
I wondered that. I think I injected too much air the first time (around 5-10 units as my vet taught me it wasn't that important :? this is a vet I would never trust to treat diabetes again though). I flushed $750 down the drain (minus the first few days that I used my $120 bottle of ProZinc :roll: ) on vet bills.

Hope injecting too much air the first time won't cause too much of a problem. Will do it properly next time. Thank you!!!!!!

-M
 
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