Changing from ProZinc to Levemir advice....

Tomorrow Silverado will have his blood drawn for the Acro/IAA tests. I think that regardless of the outcome of the tests, a change to Levemir is worth a shot. His dose of the ProZinc is 10.0 units, BID. When I change him to the Levemir, at what dose should I start? I already have the U100 syringes, but will need to get the Levemir. In terms of cost effectiveness, should I get the 5 x 3ml pen cartridges? or the 10ml vial?

Jane & Silverado

 

Hi Jane,

Not sure what to tell you, but I asked some Acrobeans on Facebook to come over here.

When I changed Tiggy from PZI to Levemir -- we started over at 1u BUT --- Tiggy is NOT an acrocat, and his PZI dose was only 2.5u BID, so starting over was not a big jump.

When I changed acrocat Norton from Humulin N to PZI -- we kept the same dose except we also changed to TID -- so 8u BID changed to 5u TID ---- so 16u per day N went to 15u per day PZI.

Levemir is a good insulin - you won't regret it.

We have only used the 3ml cartridges (having 2 "traditional" diabetics -- now 1, since Rusty has moved to NY with Ella and Edward)

When Gayle was looking at vials versus cartridges, the cost was nearly the same. So -- it came down to convenience for her -- while 10ml vial would be more practical -- she cannot buy them in Ontario -- only cartridges. With the cost being the same -- easier for her to drive down the street and buy cartridges even though with two acrocats -- she goes through a 3ml cartridge in days (less than two weeks)

phoebe

 

Hi Jane,
Silverado is gorgeous!
I looked at your SS, and I wanted to let you know that Nancy has done this. For ease and in case she doesn't see this post til later, if you have not seen it, here is her spreadsheet for Cody: http://spreadsheets.google.com/pub?key=t6GhIbRJVamDhn5VezPrsdw&output=html We were unsure of the carryover effect of Prozinc so she started with half her dose. General rule of thumb is 2/3 the dose of what they're already on, but it's always ultimately your choice. You can always move up the scale a little faster to catch up.

Insulin:
I currently buy mine at RiteAid for $88 vial with a drug card for him, however I am about to switch to a canadian pharmacy and get flexpens (not the cartridges) instead. The per unit price is pretty much the same, and since Leo's dose is coming down, I'll save money in the long run. If you look on supply closet, you'll see a thread all about the canadian pharmacies. You will need to fax in a script from your vet and it takes about 10 days in shipping, so you might choose to go vial shopping to get you started. Best advice in getting a good price would be to call everyone. Walmart, Kmart, Target, CVS, RiteAid, BJs, Costco, Sams, all the grocery stores... etc etc etc. Insulin costs can vary widely location to location.

Hope this gets you started, and congrats! We'll look forward to seeing how he does!
..C

 

Hi Jane,
I just saw this so, and its late, so more later, but

If you have a Costco nearby, that was by far the best deal I found here- but you have to be a member ( $50) and sign up for their "uninsured price" It is $85/10ml vial. Their price for the cartridges was like ... hummm $165 I think, for 15ml, so its cheaper for me to use the vial. Canada may be cheaper....
If his dose ends up at 10u BID you will drain a vial in 50 days.

You will know your test results by friday late PM (if you call) or early next week, so I might hold off starting lev until you know if that's possible.

I will have to look at your ss tomorrow.

Lev has worked much better, and saved me a lot of money. Is your vet willing to prescribe it- many don't know about it.

Did yo read the info about testing in the stickies- sending it to MSU and all, via Fed ex?

 

Our current doses are 23u and 13u BID, so our carts last one week. I can't get vials of Lev here, but I can get vials of Lantus I think - how weird.
That's OK; mine get fresh juice every week!
I paid $129.99 Cdn for a box of 5-carts on the weekend at Shoppers Drugmart

 

Thanks for all of the replies.

Carolyn... Silverado thanks you for the compliment.

Nancy... At this point my vet knows nothing about this process, but I have everything printed and ready to take to them to make sure this gets done correctly. I will make sure that they know to ship via UPS - Overnight. I will also make sure that they know to ship directly to the lab address.

Costco is 25 miles from me. I'll call around for prices and see what my local options are. I still have about 2 weeks worth of ProZinc.... I do plan to use that before making the switch. I don't expect that my vet will give me any resistance to the change. I care for 20 cats and spend lots of money with them; so, they don't usually give me a hard time about anything.

Well... we are off to the vet right now. Wish us luck. I can't wait till Friday gets here. I really need to know what's going on with him. Hopefully this will give me some answers.

Jane & Silverado

 

Many counties around the country have joined a prescription savings plan from Caremark.com
I read about it in our water bill, and picked up the free card at our library. It saved me more money than the card Walgreens offered for like $25 (their own discount card plan). With that I paid $101 at Walgreens, and at the time it was the best I could find. There does seem to be a lot of price variation, depending on where you live.

Costco doesnt sound convenient for you, and it really isn't great for me either, but they did tell me they can mail order/ ship drugs. Last time I went (because its not convenient) I bought 2 vials. I'm leery of the extra handling of mailed drugs, but its probably fine. Lev does not HAVE to be refrigerated after opening (of course I'm sure humans use it up pretty quickly so thats why its not an issue)

To check on the Caremark thing, go to their website and enter your county. The bad thing about that is you have to go in to present the card, for each store to tell you the new price... Anyway, I'm thinking many stores have their own non-insured deals, so just be sure to ask.

 

BTW they didn't finish the IAA results on Friday, but I called about 4:30p EST and was lucky enough to get someone who told me the acro test number over the phone. They probably notify the vet Mon or Tues. I think I heard the IAA on about wed thru the vet ...???

 

Your ss looks a lot like Cody's Prozinc ss. A 60 point drop regardless if you inject 3u or 10u. Maybe I was injecting water :lol:

Well, I skipped a cycle and started him at half my current dose, because we weren't sure about any shed or interaction. We increased very rapidly, I think every 2-4 cycles, by 1/2 units. It took awhile, but it was worth it.
The ss is pretty clear what we did. You may be able to start a bit higher than I did, lets see what others think.

The onset, duration and drop speed is quite different from PZIR. Spend some time in Lantus ISG reading the stickies, which apply to Lantus and Lev.

 

Hi Nancy. I agree with you that Silverado's and Cody's spreadsheets are very much alike.

Silverado's vet was thrilled that I showed up with forms, specimen protocols, and mailing instructions for the Acro/IAA tests. She did everything I asked her do and this time next week I should know the results.

I also talked to her about making the change to Levemir and she is more than willing to do that, but she admits that she knows nothing about Lev. I gave her a boatload of info that I had printed from here and other sites to bring her up to speed. I'll also let her know about how you transitioned Cody.

Thanks so much for all of the info.

Jane & Silverado

 

Good luck with the insulin switch. I plan to get a price from Costco tomorrow (I currently purchase Lantus there but the prescription expired about a week ago so it may be a good time to switch). Not certain, but I think I've heard that you don't need to be a member in order to use the pharmacy at Costco.

 

you don't need to be a member to use the pharmacy, but you only get their uninsured program price ($85 vial) if you are a member.

Jane, since Cody was the first to switch over from prozinc we were very conservative with the 14u to 7u drop back. I think we learned from me that that was too conservative and it took us a couple months to get him seeing blue, even with increases every 2-4 cycles.

Before My vet would prescribe lev, she researched it on VIN (veterinary information network?) and was reassured by a well known feline internal med consultant named Alice Wolf DVM. you should pass that name along-