Supply? How Many Lantus Solostar Pens & Length of use?

Discussion in 'Lantus / Levemir / Biosimilars' started by Tomlin, Jun 12, 2019.

  1. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    How long are you using the 3ML pen? It's 300 units so if my cat was to get 1U a day (hypothetically) thats approx 10 months, obviously give or take depending on more or less units used/needed. Does it last that long or what have you found as far as shelf life if refrigerated?

    Fortunately, I have the option to buy 1 or a pack & theres no price difference. 5 Pens seemed like overkill & the expiration date on the box the pharmacy has is 2021.
     
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I'd suggest looking at people's spreadsheets. Most of us make a note when we start a new pen. I could get between 2 - 3 months of use from a pen.

    On a practical note, if you don't get a box of pens, I'd get at least 2. While it's rare, it's possible that the vacuum in the pen doesn't work properly and you can't draw up a dose or you get bad insulin (e.g., I bought a box and the "person" at the pharmacy counter was bouncing the box on the counter while trying to get it into a bag), or the glass cartridge gets broken if you drop the pen. Having a spare in the refrigerator prevents a good deal of anxiety if you have to have your insulin shipped.
     
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  3. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    If the pens have a 2021 date they are good until then as long as kept in refrigerator on a shelf.
     
  4. Darwin H.

    Darwin H. Member

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    Nov 27, 2018
    Agree... Have brought Simba to (hopefully) recent remission with using a Glargine pen for 2-3 months without issue that I keep in the refer @ 37 degrees.
     
  5. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    Did you stop using the pen at 2-3 months because you used it all or because you didn't trust it was still good?
     
  6. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    @ Olive & Paula....Yes, but I'm thinking theres no way Im going to use 5 pens within that time period if the dose doesn't go up.
     
  7. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    Thats awesome! Happy for you guys!
     
  8. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    LOL..."person"! One of "those people". Good to know! Will definitely get at least 2 to be safe!
     
  9. Darwin H.

    Darwin H. Member

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    Nov 27, 2018
    When it ran out. YALE gov't sponsored study proved med's last up to 15 years without losing potency and it's a marketing $$ campaign for drug companies to keep people buying. Insulin may be different animal but the 28 days and throw away comes from "They don't test it past 28 days".... Potency is fine I have found out personally and with reading other posts.
     
  10. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    I'm just not sure if people will have marked that they started a new pen because it ran out or because it didn't look like it was good anymore?
     
  11. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    I worked for a couple, so you are right about its based on the study period. I'm just curious if people were able to use it until it ran out---beyond the 2-3 months thats been mentioned. I'm also going to email a vet contact to see what they say.
     
  12. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I stopped at 2 - 3 months because there wasn't any more insulin in the pen! In the vast majority of the cases, it's because the pen was empty. The instances of "bad" insulin have been few and far between since I've been here -- and that's 10 years. The most common issue is someone left a pen out of the refrigerator and was concerned about the insulin (usually it's fine) or they dropped the pen and the glass broke.

    Don't be surprised if the vet says it's good for 28 days.

    @Darwin H. - do you have the citation for the study?
     
  13. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    @Sienne & Gabby- Thank you. Its good to know its because people ran out vs noticing a change if efficacy or the insulin looking funky!
    Fortunately, my vet will not say that. I also had a U pharmacist from a vet school acknowledge its use beyond the 28 days but that obviously for legal reasons, especially as a pharmacist, they have to quote the PI from the drug.
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I used the pens to the last drop. Five lasted me more than a year. I can’t remember how long. I do remember that the vials stopped working around 6 months.
     
  15. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    I bought a pack of 5 and went through it using every pen to the last drop. My second pack I only made it through 1 and a half pens. I donated the remaining insulin, but I would of kept it on hand if he stayed with me, just in case. When I switched thinking it was the pen...it wasn't that it went stale. I never had an issue with the effectiveness even when I got a bubble in it.

    I liked having the 5 pack, it was easy to get, stayed in the fridge and I knew I had another pen in hand if needed.
     
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  16. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    Thank you!
     
  17. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    Helpful :). Excited to move on to this insulin & see how things improve.
     
  18. Sybil and Zoe

    Sybil and Zoe Member

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    Oct 16, 2018
    I have been very curious about this because after I switched to Lantus in May, I purchased 2 pens from a member while waiting for my vial to arrive from Canada. In the mean time I went to see an aunt in SC and she had been on Lantus but was using Basaglar and had 5 vials of unopened Lantus in her refrigerator they had been holding on to. They gave me the insulin and I felt like I hit the lottery but sadly the vials expired in March. I have not used them yet but wonder if they have been kept the whole time in the refrigerator and transported in ice, would they still be usable. I know if I asked a pharmacisit what they would say because it is insulin and in a human they would have repercussions for saying use after exp date. Any thoughts? Since I have yet to crack Zoe's BS ceiling, I would have no way of knowing if it was bad or good since she stays pretty much the same no matter what. ( I am currently on the second pen and have not opened my purchased vial from Canada.
     
  19. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    @ Sybil & Zoe-I'm trying to look into whats out there. I'm attaching links for what I have found so far.

    1) The first link is from Harvard & has some great info into how/why expiration dates came about for medications & clearly states there are exclusions with insulin being one of them mentioned:

    https://www.health.harvard.edu/staying-healthy/drug-expiration-dates-do-they-mean-anything)

    2) The second link is the 2003 article by Dr. Grajower that was published in the journal Diabetes Care in September 2003 "How long can a vial of insulin be used after it's started":

    http://care.diabetesjournals.org/co...57539997ed5c569582612613&keytype2=tf_ipsecsha)

    3) The 3rd link is then the follow up abstract from Dr Grajower's initial 2003 article titled "How long can a vial of insulin be used after it's started: where are we 10 years later?". It was published in the Journal of Endocrine Practice in February 2014: * will try to access full article vs just abstract-working on it!

    https://www.ncbi.nlm.nih.gov/pubmed/24246357

    4) The 4th link is a Response written by Dr. Mark E. Molitch (Northwestern University, Chicago, IL) titled "How Long Should Insulin Be Used Once a Vial Is Started?". it was published in Diabetes Care in May 2004 & is in response to Dr. Grajower's original article published in 2003:

    http://care.diabetesjournals.org/content/27/5/1240.2.full
     
  20. Sybil and Zoe

    Sybil and Zoe Member

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    Oct 16, 2018
    Thank you so much for that information. These vials are unopened and I hate to throw them out. THey just have the exp date March 2019. ugh its so expensive otherwise. I may try one next. I am still using a pen I got from another member. I had a terrible experience at vet today. I may post it in another post. I took my spreadsheet and my papers on TR dosing. He reacted as most md's do to internet information. Not kindly. Not interested. His excuse was because he was not familiar with the information and it didnt come from a vet, but a bunch of "pet parents". I showed him my spread sheet and all my info. He said he didnt even know what her BS was because I was using a human meter and it invalidated all the result. He didnt bother to check on himself. And he made a point of telling me a vial expires 28 days after it has been punctured. And he says some pharmacisit may give you insulin if it is for a pet. I would like to know which ones! Most around here wont even honor Good Rx coupon if they find out it is for a pet. I left there feeling so dismissed.:arghh::mad: I took her in for a suspected UTI which they couldn't get urine from her and gave me antibitoic prophalactically. $132 later I am not sure why I went.:eek: She seems fine and I think I jumped the shark by going.:(
     
  21. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    You are welcome. I want to say that I'm so sorry that happened to you at your vets office. You 100% did the RIGHT thing by taking her to the vet. Based on what you've described, the vet was out of line, unprofessional & inappropriate! Trust your instincts AND trust your knowledge about diabetes & your cat. Is there another option for a vet? Move on & don't look back! Whether its my vet or the MDs that work with me or a family member, I absolutely MUST be able to have a place at the table with regard to discussing symptoms & treatments in a respectful way. Its the best way for medicine to be practiced & provides the best chance for good outcomes. Did pharmacists suddenly become Oprah?? "You get a free medication & you get a free medication...."...SERIOUSLY?! How clueless :banghead:! Please stay focused on your goal & know that you are doing all the RIGHT things for your Zoe's health. Take the emotional energy from today & use it to make some calls tomorrow & find a new vet. Medical issues are hard enough without having to deal with physicians who are disrespectful, dismissive & unwilling to communicate appropriately with another adult. Its not 1960....the days of "yes Doctor" are OVER.
     
  22. Sybil and Zoe

    Sybil and Zoe Member

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    Oct 16, 2018
    yes I definitely agree!
     

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