? Particles in Lantus

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katiesmom

katiesmom

Member Since 2013
What would cause the tiny particles in a vial of Lantus?

This is the 2nd vial I have gotten that is getting particles after a couple weeks of opening. I returned the first vial, got this new 10 days ago (different lot number, I checked) and now the same thing is happening.
I have been checking closely for particles each time I invert to draw up a shot and this morning saw some swirling around. Also the glass on the inside of the bottle (at the top, where there is no insulin and you can only see glass) does not look "clean", it looks spotted on the inside, like a dirty window.

I am extremely careful with the insulin vial. It's refrigerated, I have a thermometer sitting next to the lantus in the fridge to assure it doesnt get too cold. I never shot insulin back into the bottle, do not shake or roll it, am storing it on the top shelf in it's box.
I called the company and am waiting to hear back from them, but wondered if anyone had any ideas what would cause this or what is going on.....
 
Is this second vial from a box of 5 or did you buy the vials separately? If it is one from a box of 5 there is a chance that the whole box was not properly handled before it came to you.
 
Tuxedo Mom said:
Is this second vial from a box of 5 or did you buy the vials separately? If it is one from a box of 5 there is a chance that the whole box was not properly handled before it came to you.
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These are the 10 ml vials that are sold separately, not the pens. The two vials have different lot numbers.
 
OK Thanks for that information. With the small dosing you are using you would be better off buying a box of 5 3 ml pens which each hold 300 units. You will be able to use these much more efficiently before they expire. Many US people buy their Lantus from Marks' Marine Pharmacy at a much lower price than you pay in the US
 
If you got the vials from the same place I wonder if there is an issue with their treatment of the lantus before you get it?
 
Vyktors Mum said:
If you got the vials from the same place I wonder if there is an issue with their treatment of the lantus before you get it?
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I agree, this is the first thing that came to my mind too.

Here's a long shot question: Is this original *undiluted* Lantus? Or is it possible that the vet/pharmacy is diluting it (which you are not supposed to do with Lantus). A pic of the bottle might help us figure that out if you don't know. Because dilution would certainly increase the chance of contamination methinks.

Sandi.
 
I thought the same thing----I have no idea how it is handled before I get it. I do see them pull the box out of their fridge. I am getting it from a local Walgreens. It's sealed so it's not diluted.
I just got back from there and they gave me quite the attitude, they replaced it with the another bottle, they said they would not replace again. Unfortunately the new vial is the same lot number as the previous one I returned 10 days ago.

I looked at it closely, I havent opened it, the purple seal is still on and I see a few little particles floating around in it. They are small, looks like little pieces of dust, but they are there, just like the one I just returned, although the one I returned had some bigger pieces in it too. It's not just me, my husband sees them too.

As for the thermometer, I am pretty sure it's accurate. The lantus is kinda by itself, in it's box, in a plastic cup, I dont put anything freezing up next to it.

Can you Lantus users look at your bottles for me.....wipe off any condensation on the outside of the bottle, use a flashlight and lightly move the liquid, that's when they are noticeable, when I invert the bottle to draw insulin, when the liquid is moving you can see the particles swirling about.

I dont know what to do, I have to use it for now...btw her preshot number tonight was the highest I have ever seen too. Her numbers have been so lousy the last few weeks, I've been at a loss with that and very stressed and worried about it. *tears*

I will call the vets tomorrow and ask for a prescription for the pens and go somewhere else to get them, I guess.
 
From the Lantus website:

https://www.lantus.com/using-lantus/using-a-vial-and-syringe

"Do not use if it is cloudy or if you see particle, throw it away"

The pharmacy should either replace it with another bottle from a new batch or refund your money. Since you JUST picked it up there can be no blame on you for improper use or storage. There is obviously something wrong with the batch and it is not just you that will be having problems. They should be looking into this more carefully.

I would definitely get a prescription for the pens. They come 5 pens in a box and each pen is good for 300 units. Mark's Marine Pharmacy in Canada is used by quite a few US members here and they have all been happy with the service.

https://rxcanada4less.com/search.php

Your vet can either fax the prescription to them or you can e-mail a copy of it. Even if the vet gives you a prescription for the 10 ml vial, Mark's will substitute it for the pens.
 
katiesmom said:
Can you Lantus users look at your bottles for me.....wipe off any condensation on the outside of the bottle, use a flashlight and lightly move the liquid, that's when they are noticeable, when I invert the bottle to draw insulin, when the liquid is moving you can see the particles swirling about.
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I checked a barely used pen vial of Lantus that has been sitting in the back of the fridge. Last used 28 June. It's clear.

The problem could very well be the pharmacy. Ordering from Canada is cheapest, if you can wait that long.
 
Might help to call walgreen's corporate office or call the makers of Lantus themselves. They are going to have major problems once they give that lot to a HUMAN and they get sued! It's clearly a bad batch or walgreen's refrigeration system is faulty. I wouldn't go away quietly.
 
StephG said:
Might help to call walgreen's corporate office or call the makers of Lantus themselves. They are going to have major problems once they give that lot to a HUMAN and they get sued! It's clearly a bad batch or walgreen's refrigeration system is faulty. I wouldn't go away quietly.
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I did call the makers of Lantus. She took the info, gave me a case #, said the dept that approves replacements was gone until Monday, and they may very well not approve a replacement because its used on a cat and not approved for off label use (what a bunch of bull) and nothing could be done until Monday. She told me to contact pharmacy to see if they would replace.

Like I said, pharmacy gave me a really hard time because of the previous replacement, they obviously think I am full of crap or I am doing something. The replacement bottle I got tonight the pharmacist had obviously opened the carton and eyeballed it and said was fine. I get it home, look very closely with flashlight and can see the particles.

Granted the particles are hard to see right now, without the flashlight they are not noticeable...right now. They look like little dust specks. But I know in a week they will be bigger and more obvious. That is what happened with the first vial, I did notice the little particles, I thought they were just tiny bubbles until after a another week or two and started seeing larger pieces of debris floating by with the naked eye, no flashlight, and realized they were definitely not bubbles and something was wrong.

I know if I take this back she will say she cant see anything wrong. She is not going to believe there is anything wrong, she already looked at it, said it was fine, and at a glance it does, you really have to look closely. She said "it was definitely the last time she would replace, there has been no recall, and she has sold it to other patients that use it on HUMANS! with no complaints. REAL PEOPLE are using it!" (like because its for a cat that makes any difference or not as important) ....and she was so very nasty to me. I hate being talked to that way. Hell, does she think I am making this up? That I am enjoying this? I just want to help my girl and assure she has good clean insulin. Like everyone else here, we are just trying to take care of our kitties and do our best.
I have been so upset all night.
 
Grr hopefully they look into it better... Scary that humans are using it too. Could try reporting to the FDA? I don't think I'd be able to hold it together as well as you. I hope it's resolved quickly and you get a good bottle. Could maybe have a different pharmacist check it, at a different pharmacy, to see what they think. Maybe they can talk some sense into your pharmacist or alert lantus too.
 
When Teasel was on Lantus for a few months I'd check his vial carefully against a bright light and it was always absolutely clear when new. One vial developed very tiny particles, almost like miniscule snowflakes, toward the end and I replaced it immediately.
 
Kris & Teasel said:
When Teasel was on Lantus for a few months I'd check his vial carefully against a bright light and it was always absolutely clear when new. One vial developed very tiny particles, almost like miniscule snowflakes, toward the end and I replaced it immediately.
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Exactly-that's what they look like! At first there are just a few and then they increase in quantity and size. Thanks for your reply.
 
I would take it back again. I would also notify the FDA and the makers of Lantus as it could be a batch issue or an overall QC problem that they are unaware of. As an aside, Squeaker hasn't needed insulin since June 2014 and I just threw the bottle out in Jan 2016 when I lost him, it was still clear as a bell. No I didn't use it on him, it was more like a childish good luck charm.
 
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