questions on changing from HumulinN to Relion Novolin N

[spiritdog6]

Hi everyone,
I am getting to the time that I need a new bottle of insulin. When I called WalMart about the Relion Novolin N, she said the life of the bottle is only 28 days. Which seems awfully short. What is your experience?

Akiko said that my bottle of Humulin N is good for 3 months.

And can I use my needles that I have been using with HumulinN, with the Relion Novolin N? Or do I need to change those as well?

Thanks in advance.

[CarolW]

This information was provided to me by my vet. The life of a vial of Novolin-NPH insulin, once opened (punctured for the first time), she said, is about five weeks (35 days), and after that, the insulin may lose potency. She said I could go for a sixth week, but should watch the BGs, to make sure Kumbi isn't climbing (that the insulin is continuing to work properly), if I use the vial for a sixth week (42 days).

Factors that affect life of the insulin in a vial: contamination introduced by injecting air, number of punctures of the rubber stopper (to fill the syringe) - and also, exposure to undue heat or light. Also, being shaken-up, as that tends to break down the molecules. Once the molecules start breaking down, that pretty well ends the useful life of the contents of a vial.

So, while Kumbi was alive, I merely changed to a fresh vial (unopened one) every five weeks. Shelf life, before you open the vial, is considerably longer! - always assuming it's stored well.

I always avoided any "unnecessary" testing with Kumbi, because he was so stressed by the testing (even though he was always a very good boy, and accepted the testing).

We were using Novolin-NPH, but Humulin-N or NPH (same thing) is probably about the same.

I wouldn't have used a vial of Novolin-N nor of Humulin-N (same as NPH) for longer than six weeks at the most (42 days), and preferred changing at 5 weeks (35 days). But three months seems to me to be asking for trouble, as by then, you probably would start getting breakdown in the molecules. Big difference between 42 and 90 days!

Now, about the syringes - yes, you can (and should) use the same syringes for Novolin-N as you've been using for Humulin-N. That's because both insulins are the same concentration - they contain 100 units of insulin per milliliter of fluid.

Full explanation of this, with diagrams (and too many jokes and silly stories for some people) are here:

http://www.coherentdog.org/vek/merrymeasure.php

So, they are measured exactly the same way as each other, and all those silly stories could have been about Little Humie instead of about Little Novie.

Concerning Walmart's remark about 28 days, that would be what a pharmacy SHOULD say - the most conservative possible estimate.

Sat, 10 Jul 2010 06:18:14 (PDT)

[Patty]

I agree with Carol. I do change my bottle out a bit earlier at around 25 days just because I was noticing a trend in Ali's blood sugar creeping up on me in the past. You'll find varying answers on this, but personally I think 3 months for a suspended insulin too long.

Patty

[eileen]

Originally Posted by spiritdog6

Hi everyone,
I am getting to the time that I need a new bottle of insulin. When I called WalMart about the Relion Novolin N, she said the life of the bottle is only 28 days. Which seems awfully short. What is your experience?

Akiko said that my bottle of Humulin N is good for 3 months.

And can I use my needles that I have been using with HumulinN, with the Relion Novolin N? Or do I need to change those as well?

Thanks in advance.

Quite honestly if it were me I would not switch right now TO ReliOn Novolin N as in September it will no longer be available at this discounted price, and as some are finding it can not even be found right now.

I would stick with Humulin as it will then be the cheaper insulin being sold as ReliOn Humulin N .

[spiritdog6]

Thanks everyone. Eileen, yes I saw that they were changing it in Sept. do you think the new Relion Humulin N will be at the $25 cost then?

Right now Humulin N runs about $50 here, I found the cheapest at $48 something.

I'll talk to my vet about his thoughts on how long insulin lasts, to see if he agrees with Akiko or not. I don't think he will agree.

Sounds like we are definitely due for a new bottle then.

PS. When I did call my WalMart today 7/10, they had the Relion Novolin N in stock.

[eileen]

'They' haven't yet said what the cost will be...only that it will be comparable.

You could always stock up on the ReliOn Novolin N as unopened it is good until the expiry date.

I just 'begged, borrowed and stole' so that I could buy 4 vials with a date of 2012.
I'll continue to buy a few whenever I get the chance until it is no longer available at Walmart, just so I can put off making the switch to Humulin.

[spiritdog6]

Eileen, unfortunately I have been using the Humulin N, and to switch to something that may be gone in a few months, let alone the fact that I don't know that the switch would be good or bad, I guess I'll have to bite the bullet $$ for Humulin N as I know it works.

I have read most dogs switched just fine but I have also seen others that the switch did not go well.

[eileen]

Originally Posted by spiritdog6

Eileen, unfortunately I have been using the Humulin N, and to switch to something that may be gone in a few months, let alone the fact that I don't know that the switch would be good or bad, I guess I'll have to bite the bullet $$ for Humulin N as I know it works.

I have read most dogs switched just fine but I have also seen others that the switch did not go well.

Well, that's why I originally said that if it were me I wouldn't make the switch to ReliOn Novolin N only to turn around and switch back to Humulin when ReliOn picks that up come another month or so.

Six years ago Mildred started out with Humulin, about a year in I switched her to the ReliOn Novolin N without so much as an issue.

I'm sure she too will be fine when I must switch her to ReliOn Humulin N as the cost is a factor for me.

[k9diabetes]

How long a bottle of insulin lasts seems to depend on lots of different things - how many draws you take from it, how well the temperature it's stored at is regulated, how well it's mixed, how much you draw from it each time.

I know people who can't get past 25 days or so and others who use it for several months.

If home blood glucose testing, you can see whether, after 28 days, it's still having the same effect.

Hospitals stick strictly to a schedule but they would also potentially make dozens with draws from a bottle a day, making it far more likely that the mixture could lose it's balance of crystals and amorphous insulin and more opportunities for contamination from so many needle sticks.

Probably also depends on how sensitive your dog is to slight differences in the insulin.

I'm guessing that it's the mid-size doses that cause the most variation in the crystal/noncrystal ratio... a small dose like 2 units wouldn't make much of a difference in a bottle of 1,000 units of insulin so you could probably easily do 120 draws and still not generate much of a change. Large doses like 20 or 30 units per injection would drain the bottle in less than a month so it wouldn't be an issue.

It's too bad that this change is making Relion unavailable! If you find some, you could buy a few bottles to get you through it.

Natalie

[spiritdog6]

Thank you Natalie.

He is on 4u 2x a day. He was up to 5u for a bit, but then had a "crash", so we put him back to 4u, and so far the past 2 weeks he seems good. The vet is happy with the #'s.

I guess I'll just shell out the $$ for Humulin N, and await the new Relion Humulin N in September and hope the cost is lower, back around the $25 mark.

I've had this bottle since May 17, and it all seems fine. That is why I wanted to ask for opinions.

But I'll still talk to my vet on Monday. That is when I find out Side's LDDS results too.