Humalog shortage March 2024

[emerson.marini]

I went to my local pharmacy this morning and they had just one out of my usual 4 vials. This prescription was signed off last week and still today they had nothing coming into stock.
The cartridges production looks to be unaffected and as I have them for the pen (backup), I checked with the diabetic clinic team whether I could just use them instead of the vials to fill up the pump.
They didn't really answer that, but immediately changed my prescription to Admelog. Apparently my pump (Tandem t:slim x2) is compatible with it, so fingers crossed!

 

[In Response]

Confused as to why the pumpers can't use cartridges? I've just started with a pump and humalog and am working through my stock of cartridges. Was considering moving to vials but don't think I'll bother as I have to have a couple of spare cartridges in case the pump fails.

Is there a shortage of cartridges too?

Yes, pump users can use cartridges to fill their pumps.
However, I have read anecdotally there is starting to become a shortage of cartridges in some areas.
And, you need to get your GP to change your prescription if you do not already have them on there as pump back up.

I have done this a couple of times (due to my own mistake when away from home) and realised I had to adapt my syringe filling technique when using cartridges. Usually, I pull the syringe back to the required level before inserting into the vial and then depressing the syringe to add air to the vial. This usually makes the syringe easier to fill (the air will "force" the insulin into the syringe). DO NOT do this with a cartridge: there is no space for extra air so it will cause the bung on the end of the cartridge to fly across the room with insulin following.

 

[EllieM]

Yes, pump users can use cartridges to fill their pumps.
However, I have read anecdotally there is starting to become a shortage of cartridges in some areas.
And, you need to get your GP to change your prescription if you do not already have them on there as pump back up.

I have done this a couple of times (due to my own mistake when away from home) and realised I had to adapt my syringe filling technique when using cartridges. Usually, I pull the syringe back to the required level before inserting into the vial and then depressing the syringe to add air to the vial. This usually makes the syringe easier to fill (the air will "force" the insulin into the syringe). DO NOT do this with a cartridge: there is no space for extra air so it will cause the bung on the end of the cartridge to fly across the room with insulin following.

I've been contemplating whether to ask for vials or cartridges when I see my GP for a medication review. And was going to ask on here for the technique if I were to change to vials, because the last time I used vials was 40 years ago (pre pens) and I remember having to fill the vial with air before pulling out the insulin. As you say, with cartridges there is no need for that because you just pull the insulin out and the bung follows it down the cartridge.

New Zealand is at the end of a very long supply chain for insulin (mine is made in Europe) so I think I'm best off getting the format that is least likely to have a shortage. Worst case, I can move to novorapid, which I suspect won't be that different.

An issue in the UK appears to be that it takes so long to get a GP appointment so you can't easily change your script...

I went to my local pharmacy this morning and they had just one out of my usual 4 vials. This prescription was signed off last week and still today they had nothing coming into stock.
The cartridges production looks to be unaffected and as I have them for the pen (backup), I checked with the diabetic clinic team whether I could just use them instead of the vials to fill up the pump.
They didn't really answer that, but immediately changed my prescription to Admelog. Apparently my pump (Tandem t:slim x2) is compatible with it, so fingers crossed!

I use humalog cartridges with my tandem tslim x2 . No problem, though I find that two cartridges does me 3 set changes at 2ml per change,

 

[In Response]

Worst case, I can move to novorapid, which I suspect won't be that different.

My first ever bolus insulin was NovoRapid and happily used it for over 15 years.
Along came CGMs and I realised what people meant about NovoSluggish.
Then I trial Fiasp and Humalog.
For me (and I realised we are all different), Humalog was more limacine* than NovoSluggish.
Fiasp took time to get used to and I am not sure whether it is available in NZ but I have been used it ever since (apart from a short soujourn into pens where I have never changed my prescription of NovoSluggish).

(Apologies for the Smart Alec use of the word "limacine". I was overly pleased with myself when I found out there was a word that meant "like a slug" )

 

[Ljm84]

Do you think it would be possible, but messy, to get the humalog out of the pens to fill a pump?

 

[In Response]

Do you think it would be possible, but messy, to get the humalog out of the pens to fill a pump?

Yes.
When using it as a pen, you screw on a needle which temporarily pierces the membrane.
This is exactly the same with a cartridge.

When extracting insulin out of a cartridge for a pump, the syringe pierces the membrane.
If you want to get it out of a pen, you do the same thing.
Not sure why it would be messy. Although it might be a bit awkward to hold the pen and syringe.

Do you have single use pens as your pump back up?
If so, it might be worth seeing if you can swap to reusable pens as the cartridges take up far less space in your fridge.

 

[Ljm84]

Yes.
When using it as a pen, you screw on a needle which temporarily pierces the membrane.
This is exactly the same with a cartridge.

When extracting insulin out of a cartridge for a pump, the syringe pierces the membrane.
If you want to get it out of a pen, you do the same thing.
Not sure why it would be messy. Although it might be a bit awkward to hold the pen and syringe.

Do you have single use pens as your pump back up?
If so, it might be worth seeing if you can swap to reusable pens as the cartridges take up far less space in your fridge.

Yes, I have single use pens in the fridge as my back up. I wasn’t sure if the suction (?) and connection would make it a bit messy.
I have used a reusable pen before having a pump but that was years ago so no longer have them on repeat. At the surgery here it’s incredibly difficult to get through the phone queue, getting an appointment with a GP is near impossible.

 

[EllieM]

Yes, I have single use pens in the fridge as my back up. I wasn’t sure if the suction (?) and connection would make it a bit messy.
I have used a reusable pen before having a pump but that was years ago so no longer have them on repeat. At the surgery here it’s incredibly difficult to get through the phone queue, getting an appointment with a GP is near impossible.

Can you just email your GP to ask for a prescription change? Do you get seen by a hospital at all ? (Am guessing you do if on a pump.) Can you get them to write to your GP to ask for the change?

 

[Tony337]

Hi
I had a shortage of novoraped at my independent chemist a few weeks ago.
My sister uses one of the big country wide chemists and experienced no such problem.
My chemist explained it was partly due to brexit (the 3 year supply has run out) partly to do with the 2 wars (where some of the insulin comes from or comes through)vand more interestingly both Boots and Rowlands (i think) have their own distribution companies and subsequently any supplies to them was given to their own chemists and the independents were left to struggle.
There was even a shortage of 4mm needles too.

I cannot corroborate this and am only repeating what i was told.

I have always kept a good supply at home and order my prescription a few days before its due so over a period of time i have stocked up.
I am not wasteful and should i snuff it my sister and neighbour can use what i've left behind and whilst this is not recommended we all trust each other and believe it or not we have 150 years of diabetes between the three of us!



I hope this is of some use to you and i wish you well.



Tony

 

[Ljm84]

Can you just email your GP to ask for a prescription change? Do you get seen by a hospital at all ? (Am guessing you do if on a pump.) Can you get them to write to your GP to ask for the change?

They don’t do emails, I tried to call but they wouldn’t talk about prescription requests on the phone. I’m going to drop off a letter today and see if they do anything. Can anyone tell me what wording they use for the cartridges on prescription sheets? Is it just humalog cartridge?
I do worry because so many mistakes are made when changing prescriptions, I don’t want them to delete any others.

 

[EllieM]

In New Zealand they call each cartridge humalog 3ml , not sure what the UK version is. The cartridges come in packs of 5 but my pharmacy splits the packs.

 

[In Response]

Can anyone tell me what wording they use for the cartridges on prescription sheets? Is it just humalog cartridge?

The wording on my prescription is "NovoRapid Penfill 100units/ml solution for injection 3ml cartridges"

I assume you could just replace NovoRapid with Humalog

 

[searley]

Or you could just ask for lymjev which is the faster acting humalog I’ve just had my prescription changed to that

 

[becca59]

They don’t do emails, I tried to call but they wouldn’t talk about prescription requests on the phone. I’m going to drop off a letter today and see if they do anything. Can anyone tell me what wording they use for the cartridges on prescription sheets? Is it just humalog cartridge?
I do worry because so many mistakes are made when changing prescriptions, I don’t want them to delete any others.

Does your Gp not run an on line system that you sign up for? I thought all Gps ran this system now. You sign up and can do anything via it. It is certainly efficient at ours and gets a same day response.

 

[Hopeful34]

We've got Systmonline @becca59 but if you ask for something not on your repeats, it's basically ignored every time.

 

[becca59]

We've got Systmonline @becca59 but if you ask for something not on your repeats, it's basically ignored every time.

Well that’s shocking. I usually write a paragraph saying why I need it and if they have questions they ring, otherwise it is prescribed.

 

[Ljm84]

We've got Systmonline @becca59 but if you ask for something not on your repeats, it's basically ignored every time.

We’re the same. We had SystmOnline and now it’s Airmid UK. I can do repeat prescription requests but they always ignore anything you add in the notes. Even if you submit a request that is only a note asking for something else or a repeat to be reissued.
It’s full of blank sections, I think because they haven’t activated them. Sadly our GP surgery is notoriously badly managed and the group covers the towns either side of mine so I can’t go elsewhere.

 

[APS1000000]

Hi everyone
Hopefully someone can help
I have just joined today because for the first time in over 30 years of being type 1 on Humalog I have been told that my pharmacy has none available to reorder, they do not know when it will be back in supply, and the diabetes team at the hospital have not heard anything about it and were completely unaware when I contacted them today. Is anyone else aware of this issue so far?
Thanks in advance for any advice or reassurance!

Yes there is an insulin shortage. I just went to the Pharmacy & they said all of their suppliers are out of Humulog Vials. It is now May 8th 2024. What is the solution. How did you get insulin that is needed for your Pump to work?

 

[searley]

Yes there is an insulin shortage. I just went to the Pharmacy & they said all of their suppliers are out of Humulog Vials. It is now May 8th 2024. What is the solution. How did you get insulin that is needed for your Pump to work?

The shortage is said to last into next year, the solution is to change insulin

My hospital sent an email last week as follows


Due to a shortage of Humalog insulin in vials can we suggest that if you are on this insulin via your pump can you ask your GP to prescribe the following insulin from your GP
Admelog 10 ml vials or
Novorapid 10 ml vials or
Trurapi 10 ml vials
Any of these will be ok or use in your pumps

 

[hboyt]

The shortage is said to last into next year, the solution is to change insulin

My hospital sent an email last week as follows


Due to a shortage of Humalog insulin in vials can we suggest that if you are on this insulin via your pump can you ask your GP to prescribe the following insulin from your GP
Admelog 10 ml vials or
Novorapid 10 ml vials or
Trurapi 10 ml vials
Any of these will be ok or use in your pumps

Good you got an email from your hospital! First I've heard of it when I went to the pharmacy and they say they were out of stock and could not fulfil it from their suppliers!!