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Insulin Kinds of insulin, action profiles, use in dogs, where to buy, etc.

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  #11  
Old 01-21-2010, 04:10 PM
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eileen eileen is offline
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Default Re: Insulin and Expiration Dates ?

I concur with your thoughts Patty. I find the need to replace Mil's NPH every month now with her Humalog lasting much longer.

Your mention of keeping a vial of Humalog for 6 months is interesting...my current vial of Humalog is at 2 1/2 months and still with good results.
With the price of Humalog I am seeing just how far it will stretch as in the past I have replaced it every 60 days.

But, as I stated previously and what you state now...I do think there's a difference in how long a vial can last based on whether it is a clear insulin or one requiring mixing.

Eileen/Mil
  #12  
Old 01-21-2010, 10:02 PM
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Default Re: Insulin and Expiration Dates ?

There have been rumors of NPH's imminent demise for years. It is an old insulin product with no patent protection so not much profit with few people using it anymore.

Do I think it will eventually go away? Yes.

But that could be next month or next year or next decade. Or longer.

Fortunately, FDA now requires insulin manufacturers to give six month's notice of a discontinuation. So when it does happen, we all will have six months advance warning.

When Humulin L, which was also a very good insulin for dogs, was discontinued, people with dogs who didn't do well on anything else stockpiled every bottle they could get their hands on. A few people literally had refrigerators full of it.

I hope... that other products will have been developed by then. And/or that the pet market or low-income markets will be large enough for someone to stay interested in producing it for a long time to come.

At the seminar I attended this last spring on pet diabetes, the presenter was tossing out the idea that NPH was going to be discontinued literally within a month or two of that date. He was discouraging someone who asked about changing from Vetsulin because it wasn't working from trying NPH because "why bother when it will be discontinued a month from now." That was in March 2009.

So I confronted him regarding his basis for that statement - he couldn't give me one. When I said that six months' warning would be given, he didn't know about it. And then he basically hinted that Vetsulin sales reps are the ones who had him convinced that it would be discontinued any day now. I think a lot of vets have been told that.

The reality is that eventually most old insulin products will be replaced by something newer. Sadly, it's almost never good news for pets.

Until the day the last bottle leaves the shelf, though, I say use what works as long as it's available. It doesn't do any good not to use it just in case it will disappear from production. About the only chance we have of saving it is creating a demand for it!

Natalie
  #13  
Old 01-22-2010, 05:54 PM
mydirls mydirls is offline
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Default Re: Insulin and Expiration Dates ?

This was an interesting topic. I wonder if the recommendation to disgard the insulin after opening after 30 days is just a marketing strategy. I have never used a vial of NPH N longer than 30 days. My girl has been just fine with her BG numbers. I just threw it away as recommended to prevent any harm. The information on the Q&A on canine diabetes was an eye opener in some points. I never heard of giving a dog only 1 injection of a NPH a day. I always was told and read it is to be 1 injection every 12 hours.
Very interesting.
  #14  
Old 01-22-2010, 06:26 PM
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Default Re: Insulin and Expiration Dates ?

I have only ever seen one dog who was said to be regulated on one injection of NPH a day.

Theoretically, because pretty much all dogs are started on NPH twice daily, there could be some dogs who get 24 hours of duration from it but they were started at low doses and the doses overlap to still create a good profile.

Natalie
  #15  
Old 03-30-2010, 07:22 AM
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O'Riley O'Riley is offline
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Default Re: Insulin and Expiration Dates ?

Eli Lilly's Humulin N package insert says nothing close to what their technical rep at Eli Lilly told me today: That unopened and unrefrigerated Humulin N is only good for 28 days from the date of manufacture. Unopened and continuously refrigerated (has never been brought down to room temperature), Humulin N is good until the expiration date stated on the vial. Once the vial is punctured, it is only good for 28 days (doesn't matter if it's been refrigerated, or kept at room temp). It CAN be kept at room temp after it is punctured, however room temperature is now defined by Lilly as 68-77 degrees F, and proper refrigeration temperature range is 36-46 degrees F (also contrary to their package insert).

The tech rep is filing a report with their safety department to report these package insert errors.

I then called CVS Pharmacy where I purchased our Humulin N 30 days ago, and the pharmacist assured me that their insulin is delivered to them refrigerated, and is kept refrigerated until the customer picks it up. I told the pharmacist that if I had relied solely on their CVS label that they stuck on the insulin box, I would have blindly thought the insulin was good for one year from the date I purchased it from CVS. In reality, according to the technical rep at Eli Lilly, the vial I used today is actually no longer any good (it was first punctured over 28-days ago).

I'm going to carry a small cooler with me next time, since refrigeration of unopened bottles is the key to potency.

Last edited by O'Riley; 03-30-2010 at 08:45 AM.
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