Bad insulin

[lgvincent]

I've just had my second vial of NPH to ruin, as least as far as I can remember. The first one spoiled in August 2002 during a heat wave. I've kept it in the refrigerator ever since. I don't know why this one went bad. Has this happened to anyone else?

[HeatherP]

I've been told that Humalog and especially Lantus can become unstable after they've been opened for 28-30 days. I've experienced what I think is unstable Lantus, but I'm not sure. I would assume that NPH is similar. Or maybe you just got a bad batch. How long has it been open? And are you sure it's the insulin and not other factors? Can you return it to the pharmacy?

[lgvincent]

It had been opend about two weeks when I noticed that it looked strange. Little particles are sticking to the side of the vial and there is some gray matter around the top of the vial which won't come loose.

[Shalyndria]

lg,
well, I used NPH for 12 years before my pump days, and I must say, I never had a vial go bad on me. And I'd leave them out at room temp in my Innovo pen for weeks without it ever being affected. If I were you, I'd maybe start questioning your supplier as to how they store or transport it. And like Heather said, return it!!
Hmmm, I even have 3 vials left in my fridge that've been in there for 4 months now and still look good. Should I send 'em to you maybe lol?! ;)

Shy

[lgvincent]

Sure, if I can afford them!

[notme]

Hi Vincent,
I was on NPH for 14 years before starting the pump. In those 14 years I had about 4-5 bottles of NPH go bad on me. Most of the time I would know why it spoiled, but I did have about two bottles where I had no clue what happened. Unfortunately, you will be told that you did something wrong to cause it to spoil (even if you didn't). It is your word against theirs. It totally sucks, but how can you prove that you didn't leave the insulin out. Sorry this happened to you. Have you thought about switching to Lantus and Humalog? It was a much better regieme for me before I started the pump. I know you are not me, just a thought.

Nancy

[lgvincent]

Sure, I've been using Humalog since the fall of 1996. I'm interested in Lantus but I'm not sure if I can afford it. This stuff is just so darned expensive any more. When I first developed diabetes, I think insulin cost $0.99 per vial. Now, I'm looking at $60.00 plus for a vial of Humalog.

[lgvincent]

I've just had another vial of NPH to go bad. This is the third out of four vials I purchased together that has done this. If anyone is interested, I'll try to get the control number off the vial a little later and post it in case anyone else may have bought some of this batch. I wonder, am I doing something wrong or is it the insulin? Until recently, I've only had one vial to go bad. Now I've had 3 of 4 vials to do this. I keep the stuff in the fridge and it's been fairly cool in recent weeks so I don't believe it is heat that is causing the problem.

[HeatherP]

Wow, I'm so sorry LG. It seems entirely possible they just produced a bad batch. Do you have any idea if they're all from the same batch?

I'd be interested in the number, although the vial I just bought seems to be working just fine.

Is it possible you've got a counterfeit product? I just ck'd the Lilly website and it is talking about how the are trying to counteract fakes. Here's the link if you're interested:

http://newsroom.lilly.com/news/Corporate/2004-02-05_counterfeitdrugs_effort.html

[lgvincent]

No, I kept the first vial for a while but after the second one seemed okay I threw it away. It then went bad too. I threw the second one away too so I only have the control number off the one I still have.

[WiseWords]

I would suggest contacting both the manufacturer and
the place from which you bought it.
It is doubtful that the problem originated from the
manufacturer because insulin is made under very
exacting standards. Never-the-less, they may offer to
replace it, or be interested in tracing the shipping
methods from their point of origin to the wholesaler,
to the pharmacy, to you.

Most likely, somewhere along the way, the insulin was
subject to extreme high temperatures, perhaps in a truck
with a bad cooling unit, or if shipped through the mail,
in a truck with the sun beating down on it, even if there
was a cold-pak.

It would be nice to check the lot numbers if you could
get the pharmacy to look up their records.

As you are in Alabama, and said that there was a heat wave
when this first happened, I would guess that the problem is
from improper storage during a summer shipment.

You might also want to be sure that your refrigerator,
is not too cold. Freezing of insulin is also bad for it.
If you don't have a good thermometer to check the
temp in the 'fridge, just put a small glass of water next
to the place where you store the insulin. Results in the
summer may be different.

A little bit of complaining should get that insulin replaced.
;)

[daveq]

I have been on NPH for over a year. My dosage is so low that it spoils before I finish a bottle. It lasts me 60-90 days unrefrigerated. It begins to get particles in suspension and sticking to the glass after that time. Expiration dates on these bottles is over a year if kept refrigerated.:D

[gugarci]

I keep my son's insulin refrigerated. He uses Novolog and NPH. I usually throw them out once a month. Since he uses very insulin, can i used that insulin longer than a month?

[Teresa]

erm, as far as i know ivenever had bad insulin - altho my fridge broke once and it all froze!

erm.. what i wanna know is... what would happen if u injected bad insulin? would it make u sick!???

[WiseWords]

Originally posted by Teresa
erm, as far as i know ivenever had bad insulin - altho my fridge broke once and it all froze!

erm.. what i wanna know is... what would happen if u injected bad insulin? would it make u sick!???
As long as it is not contaminated with any foreign subtance,
it should not make you sick. It is a sterile product.

I would not suggest using a partially empty vial that was
way past the expiration date, or many months old.
However, if the vial is full, or the pens are unused, and
it has been properly refrigerated, it may be good, even past
the expiration date!

If it is "bad", bad will mean weaker than normal,
which would make your dosage unreliable.
But it won't grow some kind of dangerous virus.
It just won't work, or will work poorly.

To emphasize that point, coincidently, I am just now
finishing up some Novolin R that is working properly,
even though it is outdated.
My car was broken and the weather has been too cold
and snowy to work on it. I needed to refill my Regular insulin,
but did not want to trek through the snow and wait for a
bus. I had an unused package of Novolin R in Pens that
I had gotten with a introductory giveaway. Unfortunately,
Novolin didn't give away the needles for the pens, and
I saw no point in spending more for the needles than the
insulin was worth. So, I left it in the refrigerator.
Now, when I needed the insulin, I inspected the pen
more carefully, and discovered that I could withdraw the
insulin with a syringe through the small rubber stopper.
I did, and it has worked fine.
But, the expiration date was in 1997 !
I don't recommend this as a normal procedure,
but it was 7 years past the expiration date,
and still as good as a fresh vial.
I have been making use of the free pens for the last
three weeks. Finally got out today to get a new vial,
but I still have enough for about three more days.

So, old insulin, if unopened, can be used, at least the Regular.
Long-acting that is outdated may develop white
crystals on the side of the vial, which will not dissolve by
shaking the vial. Any undissolved precipitate in the insulin
is cause to throw it out.

Lantus is in a class by itself, and does recommend that
a partially used vial be discarded after 28 days.
Most people seem to report that it is still usable past that time.

Lilly and Novo have also adopted this rule, but I believe it is
related more to sales incentive on their part, than an
actual necessity. The formula for their Human type varieties
has not changed since they were first introduced---only the
warning not to use them past 28 or 30 days !

It has also been commonly accepted that most brands of insulin
are good for 6-8 weeks past the expiration date, if unopened.
;)

[Teresa]

As long as it is not contaminated with any foreign subtance,it should not make you sick. It is a sterile product.

Thanks, the above answered my question! :)