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October 16, 2001

Insulin Analogs

Question from West Milford, New Jersey, USA:

My 12 year old daughter is switching to glargine soon, and I have several questions. What is the shelf life of unopened glargine? What is the shelf life of opened glargine? Does it lose its potency after a give period of time? I understand glargine is more painful at the injection site and has some mild irritation. Is this true (especially for children)? Since glargine can't be mixed, if a shot of Humalog is given in the same area, is there a problem? Since the events of September 11, 20001, what can be done to secure a supply of insulin in the event of a national emergency when your pharmacy may not have its channel of distribution?

Answer:

Lantus (insulin glargine) should be stored like all other insulins. While unopened vials are best stored at a refrigerator, opened and used vials can safely last at least 30 days. Unopened vials should last at least until their expiration dates (one to years years usually). Like batteries and film, it probably lots longer as long as there are no extremes of temperature.
Most of the kids using glargine do not complain too much of local irritation, but some have more than others, of course. It is very individual.
Lantus cannot be mixed with any other insulin in same syringe, and it is probably best to use a different site if you need a boost with Humalog or other fast acting insulins at the same time as you are usually using Lantus.
You should always have at least one extra vial of all the insulins you are using. It is more likely you would drop and break one of the glass insulin vials than there will be an insulin shortage or disruption in distribution, and there is no evidence that there is likely to be any insulin shortage. Much more than that is not likely to be helpful. It is also unlikely that your insurance company will allow you to stockpile. If you want to purchase on your own, as long as you are storing in a refrigerator (not freezer), most insulins have long expiration dates, from when they are obtained at pharmacy.

SB