Forgot to put insulin cartridges in the fridge.

mountaintom

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Hi all,

I moved onto a half unit Novopen Echo pen about a fortnight ago and I forgot to put my cartridges in the fridge. I left them in the bathroom cupboard where I keep my needles etc. Have just remembered (2 weeks later!) and put them in the fridge. Do you think they’ll be ok to use? Or should I go back to my pharmacist?
Our house is essentially a shack on a mountainside so it’s pretty cold all year round. It’s probably around 15 degrees upstairs in the day time.

Thanks for your forthcoming advice!
 

Juicyj

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Hey @mountaintom Insulin out of the fridge is generally good for a month, if you haven't opened the pens then you can put them back in the fridge, however I cannot say for certain that your pens will be as effective say in a month or 2 time when you come to use a new pen - how much was left out ?
 
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bangkokdiabetic

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If you live in the UK I would think your bathroom and fridge may have had similar temperatures lately here is the general advise about storage.


Unopened, you can store your disposable pen at room temperature (not above 30°C) for a maximum of 4 weeks, or in a fridge (2°C to 8°C) until the expiry date, but keep it away from the freezing element •

Once open, your disposable pen will last for a maximum of 4 weeks, whether at room temperature (not above 30°C) or in a fridge (2°C to 8°C)-

Don’t leave the pen in a car or any other place where it could get too hot or too cold•

Always keep the cap on the pen to protect the medicine inside it from light (opened or unopened)

I would check with your Medical team to be sure.
 

mountaintom

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Thanks guys. I live in County Kerry, Ireland and we had quite a bit of snow but generally milder (but wetter) here than uk.
Jeremy, what a great mistake to make!
 

Lynne C J

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How about keeping your insulin pens in Grip packs once you've opened them. This works well at very hot temperatures (42C at Uluru) as well as at minus temperatures, I swear by my packs for both insulin pens and no problems at all. Good luck!
 

Lynne C J

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My response should have read Frio packs that you soak in cold water. That will keep your opened insulin pens at the right temperature whether you're somewhere hot or very cold
 

badmedisin

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Once they've been out of the fridge, they're OK for 4 weeks. You shouldn't put them back in the fridge, as temperature fluctuations can mess up the mechanism. If it's already gone out of temperature range, putting it back in the fridge won't solve the problem anyway, it's all about proteins being denatured - the same as an egg turning white when you boil it, and have you ever tried to un-boil an egg? ;)
It might be ok for longer than that but don't expect any sympathy from manufacturers if you have problems - if you haven't followed storage instructions to the letter, that frees them of any responsibility... ;)
 

mountaintom

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Once they've been out of the fridge, they're OK for 4 weeks. You shouldn't put them back in the fridge, as temperature fluctuations can mess up the mechanism. If it's already gone out of temperature range, putting it back in the fridge won't solve the problem anyway, it's all about proteins being denatured - the same as an egg turning white when you boil it, and have you ever tried to un-boil an egg? ;)
It might be ok for longer than that but don't expect any sympathy from manufacturers if you have problems - if you haven't followed storage instructions to the letter, that frees them of any responsibility... ;)

Oh shoot! I put them back in the fridge but they were probably only at room temperature. I think I’ll probably go back to the pharmacist and get another set of cartridges just to be on the safe side. Thanks.
 

Jeremy_Wood

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How about keeping your insulin pens in Grip packs once you've opened them. This works well at very hot temperatures (42C at Uluru) as well as at minus temperatures, I swear by my packs for both insulin pens and no problems at all. Good luck!
Great idea! Thanks @Lynne C J
 

mountaintom

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Just been to the pharmacy to get some more cartridges no problem (my pharmacist is awesome) HOWEVER I have to now drive to Tralee which is an hour or so each way and won’t get back to my fridge til later this afternoon.
SHOULD I BUY SOME FROZEN PEAS?
 

Celsus

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Oh shoot! I put them back in the fridge but they were probably only at room temperature. I think I’ll probably go back to the pharmacist and get another set of cartridges just to be on the safe side. Thanks.
Don't worry too much about this now.
The pharma companies have of course to quote strict guidelines on their products for regulatory reasons. And then they also push those to the limit at times, just to drive as much sales (profits) back to themselves also. Take as example the thing about you always have to change your needle on your insulin pen after every single shot you take!
Most (if any) diabetics don't do that.
I typically keep mine on till the pen is empty. Only changes in-between in case I dropped it into some dirt while the cap was off, etc...
For the insulin pens themselves, the insulin is actually fairly more robust than most really think they are. But true, extreme high or extreme low temperatures are no good to them, as the insulin protein can get damaged. But its not like you shouldn't put them back into the fridge again. Yes you should, as to assure they don't turn any worse. So you merely halt any aging they may already have been exposed to suffer.

I have personally lived and worked in quite extreme weather zones. E.g. Moscow and also in Egypt. At all times I simply kept my daily pen in my pant front pockets at all times. Done that since they came on the market years back now. And even in 30+ degrees in Egypt they did just fine until the pen was empty weeks later (I don't use many units). It is only rarely I have 'problems' with them, and if so, its typically loosing some of its effectiveness. So e.g. the fast acting not able to lower the bg level as much per unit as normal. If observing that during a day (e.g. for lunch and then for dinner), well then just dump that pen out and start a new one.

So to summarize, your insulin doesn't turn all bad by having stood outside the fridge for a few days.
Especially not with the very modest temperatures that you quoted you had in your house.
Just mark the specific boxes so you can track them going forward, so as to distinguish them from newer ones you might get from your pharmacy in case you start to suspect the old ones lost their punch.
 
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Celsus

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Just been to the pharmacy to get some more cartridges no problem (my pharmacist is awesome) HOWEVER I have to now drive to Tralee which is an hour or so each way and won’t get back to my fridge til later this afternoon.
SHOULD I BUY SOME FROZEN PEAS?
Peas are great - I love them!
But only buy them if you like them. Your insulin wont really need them. :)
 
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mountaintom

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Don't worry too much about this now.
The pharma companies have of course to quote strict guidelines on their products for regulatory reasons. And then they also push those to the limit at times, just to drive as much sales (profits) back to themselves also. Take as example the thing about you always have to change your needle on your insulin pen after every single shot you take!
Most (if any) diabetics don't do that.
I typically keep mine on till the pen is empty. Only changes in-between in case I dropped it into some dirt while the cap was off, etc...
For the insulin pens themselves, the insulin is actually fairly more robust than most really think they are. But true, extreme high or extreme low temperatures are no good to them, as the insulin protein can get damaged. But its not like you shouldn't put them back into the fridge again. Yes you should, as to assure they don't turn any worse. So you merely halt any aging they may already have been exposed to suffer.

I have personally lived and worked in quite extreme weather zones. E.g. Moscow and also in Egypt. At all times I simply kept my daily pen in my pant front pockets at all times. Done that since they came on the market years back now. And even in 30+ degrees in Egypt they did just fine until the pen was empty weeks later (I don't use many units). It is only rarely I have 'problems' with them, and if so, its typically loosing some of its effectiveness. So e.g. the fast acting not able to lower the bg level as much per unit as normal. If observing that during a day (e.g. for lunch and then for dinner), well then just dump that pen out and start a new one.

So to summarize, your insulin doesn't turn all bad by having stood outside the fridge for a few days.
Especially not with the very modest temperatures that you quoted you had in your house.
Just mark the specific boxes so you can track them going forward, so as to distinguish them from newer ones you might get from your pharmacy in case you start to suspect the old ones lost their punch.

Thanks for the advice. I’ve kept the “old” lot as you suggested and will keep as back up. Appreciated!
 

EllieM

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When I was a student, many many years ago, there was a student canteen and student accommodation didn't have fridges. I don't remember ever having issues with gone off insulin. I always thought it was a bit like instructions to keep eggs in the fridge - they used to be good for weeks when kept outside a fridge but now they have use by dates and have to be kept refrigerated...
 
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