Air bubbles in Lantus pen cartridges

Hello Everyone:
I have been using the Lantus pen cartridges that come in the five packs. I had enormous problems with air bubbles in the first cartridge of the latest pack I purchased. There were huge air bubbles and I often would draw twice as much air as insulin (Floyd is on 3.5 units). I figured that my cat sitter had injected air into it, and left it at that. The second cartridge was fine, but I am experiencing the same problem with the third cartridge, and I am the only person who has used it. I am routinely drawing up 7 units or so of air.

I have always used just the cartridge (with no pen attached to the bottom end). After watching the video that a member posted on Youtube, I'm wondering if that Is the problem. Have I been doing it wrong all these months and just been lucky? Or do I have defective cartridges. Finally, can I still use the insulin?

Thanks,
Jen

 

Hi Jen;

I had the same problem where I went 5 weeks without issues, then a new Pen and lots of air...........thought it may be the syringes and maybe the lube inside was too sticky so caught the air...........who knows, but it is frustrating when I'm at .75u and can hardly see the stuff any how...........this second pen is almost done so if I end up using the next pen I hope it will be good. Yes - you can use the same pen, I keep putting the needle back in and drawing out insulin and as long as the color is still clear you are good.............

Shawna

 

You could try withdrawing the air using a clean syringe.

Also look at your technique. First get the syringe and expel the small amount of air that is in them when new. Then press firmly on the plunger and insert into the pen while still holding the plunger firmly and withdraw the insulin. The syringe plunger is flexible so if you don't press it then you may inject some air into the pen.

Wendy

 

Hi Shawna and Wendy:
Thanks for your responses but…

I don't use a pen, I just draw the insulin out of the cartridge - that's what I'm wondering… do I need a pen?

Cheers,
Jen

 

No pen - it only measures in full units so you can't tweak the dose as needed.
Use the syringe to withdraw the insulin.

Push the plunger in and out a few times before pushing in firmly and drawing up the dose.

 

pen = cartridge. Same thing.

 

The five pack includes the cartridges in pens so they are the same thing

I found that the type of syringe makes a difference. I am using Terumo syringes and get very few bubbles compared to the Relion syringes. Also, let the insulin draw slowly into the syringe. You will know if the insulin is not working by your sugar's numbers.

Did you remove the cartridge from the pen? I don't get this. Lantus is only sold in a vial or a cartridge/pen. The pen makes it easier for human diabetics to carry it around with them during the day. It is just a vessel. As long as you have access to the purple tip where you insert the syringe, it should be fine.

Holding the plunger in tight when inserting into the cartridge/pen is imperative to alleviating bubbles.

 

Perhaps what I'm using is only available in Canada - it is a cartridge that is about 2.5 inches long that has a stopper on one end. I draw the insulin from the other end but do NOT push air into the cartridge. However, every time I draw the insulin, the air bubble in the cartridge gets larger.

Today, I noticed that if I push a pencil against the stopper, it travels up the cartridge. In the past, the stopper would move up without being pushed. So I wondered if these cartridges are defective, or have I been missing a piece of equipment all this time - something that goes at the end of the cartridge and pushes the stopper.

Sorry about any confusion - it's hard to desscribe. And, I appreciate everyone's help.

Thanks again,
Jen

 

you can try holding the cartridge vertical and giving it a few good hard taps. Try to get all the air to combine into one big bubble, get that bubble to the end of the cartridge, then use a syringe to draw out the air. That has worked for me in the past, though if new air is somehow getting in it may not help enough.

Do you have one of the cartridges shown in the Lantus & Levemir Handling sticky? There is a refill cartridge pictured there and a picture of how to use it. That is what I used when Lucy was on insulin, though I don't think they are available in the US anymore.

 

Just be patient and do what you have to in order to get rid of the air first.........I had 5+ weeks of perfection then all of a sudden I'm getting air. I did nothing different and know what I'm doing and I'm equating this on either bad syringes with maybe too much good inside (okay, lube) and the air is sticking to it, or a batch of insulin where the end where I stick the needle in isn't as air proof as the other..........I just keep drawing more insulin, flicking the needle about 5-10 times to get the air to the top and then ejecting the air out and sure enough with the little amount of insulin I need I have to draw more and do the same process over.......oh well, eventually I get the insulin without air bubbles.........I'm using the BD Ultra Fine II syringes and hear they have air issues at times.........good luck, and as mentioned at least you're getting the insulin in when your numbers are working for you.

Shawna

 

pen = cartridge with a nice plastic covering that makes it look like a pen.

cartridges are not available in the US. we can only buy pens.

fwiw, i've been using pens for years. i ALWAYS end up with a huge air bubble at one end. i ignore it. doing so has not seemed to bother the efficacy of the insulin at all. overall, alex is very well regulated, if not tightly regulated, most of the time.

p.s.--- with proper care, i'm one of those who uses their insulin to the last drop. :mrgreen:

 

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I've tried drawing the air out, but it can fill the entire syringe. It's like the stopper seal is broken. It has never been an issue before.

And indeed, the thing I'm describing is the 3ml Cartridge Refill for the OptiClik Pen. So I guess I'm wondering if I should be using it with the pen.

I apologize for being obtuse,
Jen

 

I am Canadian and I think I have seen those, they are just the lantus filled end of the pen right? Can you google and show us a picture

Anyway I wouldn't worry about it as long as you can still get the lantus out.

 

Here's a trick that works very well on removing the excess air out of the SoloStar pen cartridges. I'm not sure if this will work for the OptiClik, though. I also took some pictures of how to do it that might help. (Note: the last two pictures are related to this post on dosing techniques and are for experimental purposes only.)

 

Hello all. I am having the same problem with bubbles and almost impossible to draw insulin out of the pen. I am a relative newbie but after 6 months of doing twice daily injections this is the first pen I have had this problem.
My frantic question is this: Now I have 2 or 3 small bubbles in the cartridge. The online pharmacist told me to inject air into it. Have I ruined the pen?? Or can I just keep using it? I use new needle twice a day by the way.

Thank you

 

Air bubbles aren't going to hurt but don't insert air into the pens. They work on negative pressure where the vials DO need air inserted - not to work but to equalize pressure on either side of the rubber seal. Not sure what insulin but assuming it's Lantus. Don't shoot Lantus back into the vial as it's acid based - the lubrication from the syringe can possibly contaminate the insulin. As long as you're getting a good reaction, you can keep using it.

 

Hi and thank you. I never have inserted air before into the pen, was a bit confused when online "Pharmacist" suggested I do so. It is Lantus and this is the first problem pen I have received, am wondering if I need to get another. Thank you for the quick reply.
When you said as long as I am getting a good reaction, do you with the pen or the effectiveness of the insulin?

Thanks

 

The effectiveness of the insulin - as long as you're able to see a good curve while testing, the insulin is still working.

 

Online pharmacists?? Now that's a new one on me..I've seen online doctors and online vets, but never an online pharmacist (although I suppose it makes sense!)

Just a tidbit of advice....you're going to get much better advice from the people here...we've pretty much already done it all, made our mistakes and know how to deal with this crazy disease

 

I know it sounds strange. Its actually a pharmacist that works for the online company where I purchased the insulin. I do believe I will use this pen for a little while then get another soon. It still is clear and smells strong. I think those are good signs right?

 

yes, as long as it's clear and there are no "floaties" in it, it sounds like it'll be fine

And we've all had real life pharmacists give us bad advice about using the pens/cartridges, so I guess it shouldn't be a surprise that the online pharmacist gave you the same bad advice

 

thank you, glad you said that too, it does seem there is bad advice or mixed opinions on this subject, which likely makes us all quick learners. it stressful and confusing, as well as expensive, and all you want to do is help your cat! Thanks again everyone, you guys are so quick to respond and are very helpful. NOW I do know where to come with questions or advice. THANK YOU!