? Oh no! I dropped the Lantus bottle on the floor. Is it destabilzed? ;(

Discussion in 'Lantus / Levemir / Biosimilars' started by lovemycat444, Oct 12, 2018.

  1. lovemycat444

    lovemycat444 Member

    Joined:
    Jul 10, 2017
    When I was preparing my cat's Lantus shot last night the bottle slipped out of my hands. The glass didn't break but it hit the floor very hard. My vet said to roll the Lantus gently to mix it before using it. I've read it should not be shaken. Hitting the floor definitely "shook" the Lantus. Is it destabalized now, do I have to buy a new bottle of Lantus now? (Oh my god, Lantus is close to $300), I'm due to buy a new bottle in December. (My vet said for cats, one bottle of Lantus can last 3 months.) Please let me know! Thank you so much.
     
  2. Carol in Chicago

    Carol in Chicago Member

    Joined:
    Apr 5, 2017
    My suggestion is don't panic. I'm so glad the glass didn't break! I would suggest you monitor this situation over the next few days to evaluate the effectiveness of your vial. First thing is always visually examine to make sure it is clear (not cloudy or has "floaties"). Next thing is review your SS and evaluate the insulin response - is it still working over the next week or so? I would make a note in my SS on the day you dropped it much like many make a note when they start a new vial.

    Next thing is going forward, you should not roll it to mix it - please review insulin handling sticky. From the sticky:
    Never shake or roll your vial, cartridge, or pen

    You will also see that many have used the same vial for six months or longer, don't worry about the 28 day a pharmacy may have indicated for expiration or the 3 months your vet told you. There is no need to discard insulin that is visually clear and continues to be effective. I myself have used my vial for several months, so please don't discard until you can see it is no longer good.

    Finally - don't pay $300 for lantus. Please use this coupon for $99!!!
     
  3. lovemycat444

    lovemycat444 Member

    Joined:
    Jul 10, 2017
    Oh wow, thank you SO much Carol. For all of this! Two vets at the same office have now told me to roll the Lantus. omg. So frustrating, I didn't know to not roll it. UGH! Also the coupon is amazing, I can't thank you enough for that. I'll keep a record and monitor as you suggested. He just went up to 5 units from 4 units (he's been on 5 u. for about a week now) and I think he's so much more regulated now, bc he barely drinks his water (he's getting 95% wet food only, so he get's water from that, I mix in a little extra water bc he loves the "gravy" and the other part, dry food (trying to ween him off the dry food completely.) I will defintiely monitor him, and awesome idea about a calendar. thank you!
     
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  4. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Hi Carol, I'd forgotten about the Lantus coupons, I'd tried to use one when Taco was first diagnosed (approx 2 years ago), the original pharmacy, they said the coupon could only be used for humans not pets. Have you run into this? Also, I just talked to my pharmacist (CVS) and he confirmed Lantus coupons could not be used for non humans. Do you know if there's a way I can use the coupon? thank you so much!
     
  5. Carol in Chicago

    Carol in Chicago Member

    Joined:
    Apr 5, 2017
    I used this coupon just a few weeks ago at Costco with no issues. They knew it was a veterinary prescription so maybe you should shop around.

    I heard from some other members that they had problems with non-human use of this coupon, so I reviewed the fine print and see no exclusion for animal use. Of course, another option is Marks Marine in Canada, but I have been worried about having this shipped. For the same reason you were worried about dropping it, I didn't think it would be good to ship. However, many members order routinely from Marks with no issue.
     
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  6. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
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  7. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Oh that’s really helpful thank you, and pls last question bc I’ve only been to Costco once I’m not familiar with it to buy the Lantus there and use the coupon did you bring a paper prescription from the vet?

    Did you buy the Lantus pens at Costco or a vial?

    Thank you so so much !
     
  8. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
  9. Carol in Chicago

    Carol in Chicago Member

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    Apr 5, 2017
    I had my vet phone in the Rx to my local Costco. I buy both insulin vials and also syringes from Costco. I printed the coupon and presented it at the pharmacy when I went to pick it up.

    My suggestion is that you get a paper Rx from your vet. Even if you use it at Costco, keep a copy so you have it if you ever need to order from Marks.

    One more thing - I have also had some good luck using goodrx at Costco - so it is worth a look if you have to purchase any other drugs available from a human pharmacy.
     
  10. lovemycat444

    lovemycat444 Member

    Joined:
    Jul 10, 2017
    Thank you for taking the time for all of this and answering my questions Carol ! Ok terrific. I will try this out. so appreciate it! ;)
     
  11. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Shaking my head...once again uninformed vets giving people inaccurate instructions. Tsk, tsk... :(
     
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  12. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Hi Sue, wow it’s so frustrating!
     
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  13. Rosie & Bailey

    Rosie & Bailey Well-Known Member

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    Sep 4, 2018
    I was told the same thing by my vet. Well, actually it was the vet tech so idk if my vet would say the same thing, to be fair.
    Was also told to draw insulin into syringe, release back into the pen, then redraw. Just learned that's a big no-no.

    On the plus side, my vet directed me to this board so I give her credit for that.
     
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  14. Carol in Chicago

    Carol in Chicago Member

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    Apr 5, 2017
    I can't blame the vets - looking at the current AAHA guidelines, they are told to tell us to roll it. :banghead:
    • When using other insulins (glargine [Lantus], PZI [Prozinc], NPH [Novolin, Humulin]), roll but do not shake vial.
    If you have a look at the guidelines, take what you read there with a large grain of salt because they don't support the use of human meters or any change to dose without vet approval either... While I was initially excited to see that the template for discharge instructions includes "home monitoring" I am very disappointed that they want you to monitor only food and water input / output...

    Having been at this a while, I'm half tempted to re-write the discharge instructions given to Rose at DX as a community service. I might discuss with my vet at some point.
     
  15. Jim Martin

    Jim Martin New Member

    Joined:
    Aug 27, 2018
    I think Rolling the vial(gently) is for ProZinc not Lantus - which is probably where vets get that advice - they don't really know human insulins like Lantus. Also, sometimes people here have extra pens to sell through the forum 'Supply Closet'. Shipping unopened fresh Lantus with an icebag is relatively safe.
     
  16. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    I just came across your post about dropping the Lantus.Lantus does not need to be mixed & can be used to the last drop. That's what i've been told since i started back in Feb. I know people that bought it from Alan at the Supply Closet & are Happy with the purchase .
    I thought i read a few weeks ago that someone here was helping you set up a SS (spread sheet) for Taco? It would make it a LOT easier for the people here to advise you if there was a SS to refer to once it's set up all you need to do is enter the readings.

    Good luck with Taco. :)
     
    Last edited: Oct 13, 2018
  17. Cindie

    Cindie Member

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    Sep 9, 2018
    I was also told to roll the Lantus vial, so that's what I've been doing. What are the implications of having done that?
     
  18. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    Your Lantus is probably OK. But it is best not to shake or roll it. Take a look at the "sticky" dealing with proper handling of Lantus, etc., at the top of the forum :
    http://www.felinediabetes.com/FDMB/threads/syringe-insulin-info-handling-drawing-fine-doses.151/
    At the very end of the "sticky" you will find a remark that Lantus is not as fragile as we used to think. But it should in any event be treated gently.
     
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  19. Cindie

    Cindie Member

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    Sep 9, 2018

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