Munchie–11 yr. old MiniSchnauzer - Earned his wings

[LuvMyMunchie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

Judi - I do believe Munch is definitely going to need something besides the Novolin N and I'll do whatever is necessary. I've been talking to Natalie and think she can help me with this. Have family members who think I'm nuts and urge me to put him down but he is like my special needs child and I'll take care of him until it's his time....end of conversation with family member!

I noticed the whole syringe issue last night as I knew I had filled to the 6 unit mark but when I went to give injection it looked like the whole 6 units wasn't there. I put on my trusty visor with the magnifying lenses and sure enough it was there, had just separated.

Louise

[farrwf]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

It's that period when I'm holding syringe in my hand or under my armpit to warm insulin up that the separation is happening now - but have been using this technique every day and it didn't separate in the syringe. Hopefully, I'll get an answer from tech soon after she talks to their pharmacist. Then I'll know if I need to toss this and buy a new bottle.

That's not normal. I don't know if I'd be using it.

[LuvMyMunchie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

I have refills but is a prescription necessary for the Novolin N? Think I remember reading that it wasn't at WalMart.

Louise

[farrwf]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

I have refills but is a prescription necessary for the Novolin N? Think I remember reading that it wasn't at WalMart.

Louise

Not in most states. No script required in Tennessee.

[LuvMyMunchie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

Thanks farrwf.

Have been keeping insulin in butter compartment. Just put fridge thermometer in there and while other parts of the refrigerator are colder, butter compartment going over the 46 degrees recommended by Dr. Peterson. Maybe that's the cause.

[farrwf]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

http://allnurses.com/nursing-issues-...ut-604877.html

Aug 15, '11 by Esme12
general advice on insulins

• parenteral insulins
• regular insulin is for subcutaneous, im, or iv administration only. not for intradermal, intra-arterial, or oral administration.
• long-acting insulins are for subcutaneous administration only. not for intradermal, im, iv, intra-arterial, or oral administration.
• administer direct subcutaneous injections into abdominal wall, thigh, or deltoid. rotate injection sites within same region.
• do not use regular insulin if cloudy, thickened, discolored, or contains particulate matter.
• do not use long-acting insulin if white material (insulin) remains at bottom of bottle after mixing or if there are clumps.
• if mixing regular insulin with long-acting insulin, draw regular insulin into syringe first.
• if using insulin pen, mix contents by rolling between the palms 10 times then inverting 180° 10 times, then prime the pen before each dose. do not administer if white material (insulin) remains visibly separated from the liquid after mixing, if clumps are noted, or if solid white particles stick to walls of cartridge.

[LuvMyMunchie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

Thanks again farrwf. Insulin stays mixed in bottle once I roll but is still separating in syringe after about 5-6 minutes. I'm going to get a new bottle.

[BoJanie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

We did not keep the NPH insulin in the refrigerator. It always looked separated to me until I would roll it to mix. My hubby is also a diabetic and he told me he never refrigerated it after opening when he used it. Bo's current insulin, Levemir, is clear and needs no mixing, but I do keep it in the frig as I think it lasts longer.

[LuvMyMunchie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

In case anyone is interested....

I got a call back late this afternoon with information from the clinic pharmacist about the NPH insulin separating in the syringe and this is what I was asked/told.

(a)Wanted to know if I let the insulin sit out until it reaches room temperature before I fill syringe. (No, I haven't. I take it out, roll vial to mix, fill the syringe and then let syringe w/insulin sit).

(b)Said if I'm not letting it get to room temperature, I need to as it's possible for the cold insulin to separate in the syringe.

(c)Said if I let it sit out, fill the syringe and it still separates get a new bottle.

(d)Also said yes, refrigerate, keeping in butter section is fine and that insulin is good for up to 6 mos.

I decided to play it safe and purchase a new vial.

Louise

[Abby's Mom]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

Louise...
Thanks for the information. I find that very interesting, because I have had the humulin nph separate while in the syringe as well. But more recently it has not, but I have taken the approach of rolling it about 10 times, and by that time, I think the bottle has gotten to room temperature, with the warmth of my hands.

Strange how the smallest little thing can make a difference. So Novolin is saying that the insulin will last 6 months in the refrigerator, AND bring to room temperature prior to rolling/mixing.

We will be converting to Novolin soon... hopefully my Walmart has restocked their shelves, as the last time I was there, the did not have any Relion brand whatsoever.

Barb

[CraigM]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

So Novolin is saying that the insulin will last 6 months in the refrigerator, AND bring to room temperature prior to rolling/mixing.

Just to be clear, I believe Louise said it was a pharmacist and not directly from the Novolin people. Really doubt an in-use vial of Novolin-N would last 6 months, but???

I would be concerned with possible condensation forming on the inside of the vial if brought all the way to room temperature before every use. Especially if we inject room temperature air into the syringe.

It would be interesting how your new vial behaves.

[Abby's Mom]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

Louise..

After some research on the internet... guess where it lead me back to ... a posting on this forum, when Walmart was switching from Novolin to Humulin for their Relion brand.

http://www.k9diabetes.com/forum/showthread.php?t=1849

So, I have my answer, it appears that the Novolin, whether refrigerated or not will last up to 42 days, and perhaps refrigerated up to 6 months...

But, on this posting is was also mentioned that because we are mixing and injecting air into the vial, this can be shorten the life of the insulin, once it has been opened. I have been very careful in the amount of air that I am injecting into the bottle, and it seems to me that it is lasting longer. I believe I may have been injecting too much air, and now I inject a little less than what I am drawing out.

I suppose after 30 days we will know how long it truly lasts.

Barb

[Abby's Mom]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

ooops, Craig. Just saw your posting. I think our posts had crossed.

[BoJanie]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

The insulin will start breaking down after it's opened and after the needles and air are inserted, so six weeks is probably all you'll get. Room temperature is fine, actually recommended, as long as it's kept in cool place, see bold below:

Patient Information for Novolin® N

NOVOLIN® N (NO-voe-lin)

NPH,

Human Insulin Isophane Suspension Injection

(recombinant DNA origin) 100 units/mL



All Unopened Novolin N:

Keep all unopened Novolin N in the refrigerator between 36° to 46°F (2° to 8°C).
Do not freeze. Do not use Novolin N if it has been frozen.
If refrigeration is not possible, the unopened vial may be kept at room temperature for up to 6 weeks (42 days), as long as it is kept at or below 77°F (25°C).
If refrigeration is not possible, the unopened PenFill cartridge or InnoLet prefilled syringe may be kept at room temperature for up to 14 days, as long as it is kept at or below 86°F (30°C).
Keep unopened Novolin N in the carton to protect from light.


Novolin N in use:

Vials

Keep at room temperature below 77°F (25°C) for up to 6 weeks (42 days).
Keep vials away from direct heat or light.
Throw away an opened vial after 6 weeks (42 days) of use, even if there is insulin left in the vial.
Unopened vials can be used until the expiration date on the Novolin N label, if the medicine has been stored in a refrigerator

[jesse girl]

Re: Munchie–11 yr. old MiniSchnauzer–Just Diagnosed

the question that we all would like to know is it better to refrigerate or not an open vial of insulin

i have refrigerated an open vial from the beginning i dont warm it up her doses are so small and it doesn't bother her we only use it for a month at the most

now would that insulin be better at room temperature and work better than taking it from a cold state to a warm state every time you remove it from the refrigerator common sense may say at least for me that that constant abrupt changes in temperature may affect the quality of the insulin .

it is convenient to keep in the fridge but could it easily be kept in a medicine cabinet

well you got me thinking and that can be dangerous

i may rethink what i am doing and may go without refrigeration when we make the change next month change for me is a bit of a reset

many thoughts on this no specific answers i guess it is so individual just like this disease is for our pups