# Insulin - How Long To Be Out Of Fridge?



## mum2westiesGill (Jun 17, 2015)

Hi,
I've got some insulin (Lantus/BI) which has been left out on the table from 29/5/2015 until now 17/06/2015 due to me being away on holiday etc. Will this insulin be ok to put into the fridge now and to use?


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## Northerner (Jun 17, 2015)

It's OK to use, but no point in putting it back in the fridge now it's been out Gill. Insulin is OK for up to 28 days out of the fridge  Throw it away if not used before 27th June.


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## Copepod (Jun 17, 2015)

Personally, I'd put it in fridge now, mark it with dates that it was out of fridge, so you can differentiate from any other insulin that has been stored differently, then phone either a pharmacist or the insulin manufacturer for advice. 

It's perfectly OK to put insulin back into fridge. You don't transport insulin in a refridgerated truck between pharmacy and home, after all.


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## Northerner (Jun 17, 2015)

Copepod said:


> It's perfectly OK to put insulin back into fridge. You don't transport insulin in a refridgerated truck between pharmacy and home, after all.



But is there any point if it's already been out for a fortnight? It wouldn't extend its useful life.


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## Copepod (Jun 17, 2015)

It won't do any harm to put it back in fridge. Depending on what manufacturer tells Gill when she phones manufacturer or pharmacist, the clock effectively stop, so that insulin will be OK to use until it's been out of fridge for 28 days in total (or 30 days or 6 weeks for some insulins). If I'd done that, I'd phone the pharmacist who dispensed the insulin, using phone number on label or manufacturer. 
A bit off topic, but long time ago, I asked manufacturer for advice about taking insulin to Costa Rica for a month, and, off the record, they were very reassuring about how to keep it functioning, with no need for Frio pouches. 
So, that's why I suggested a phone call for professional advice.


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## NoSugarBabe (Feb 1, 2018)

I too have been told by diabetic dr that insulin (I'm on Humulin M3) is OK for up to 28 days out of the fridge. I was told NOT to leave it out longer that that.

My question is: what will actually happen if I DO leave it out of the fridge longer that 28 days? The dr implied, when they were giving me guidelines when I first started on insulin, that some awful horror would happen if I DID do so. (As in: "You DON'T want to do that!" And I quote the GP.) I'd like to know what to expect.

BTW: Not that I _intend_ to leave it out longer, just that sometimes I get close to the 28-day deadline as have recently been reducing insulin (as am now on Canagliflozin 300mg tablets, due to too-high BMs ) so the epipens last longer for me than previously. Until I get _used_ to the change in routine, I am at a bit of a risk of going over the 28 days. Oops!  It's only ever up to 5 days or so over the deadline, not _weeks_ beyod the 28 days, and it's kept away from radiators & sunlight, but as the change in my routine is going to take a bit of getting used to I am aware it might happen a bit too often. Anyway, I'd like to know WHAT I should be looking out for! 

Does it perhaps have the effect of not changing your BMs the way it would if it were a 'fresh' (so to speak) epipen? Does this older insulin not work effectively at all (e.g. unexpectedly hike up your BMs or send them crashing down)? Or will it have another effect all together?

Any experience out there of going over the 28 days?


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## Robin (Feb 1, 2018)

NoSugarBabe said:


> My question is: what will actually happen if I DO leave it out of the fridge longer that 28 days?


Nothing dramatic will happen, I don't use a whole cartridge of my basal in 28 days, and it's easier to remember to change it on the first of the month, so end of February is the only month I change it on time! I have noticed though, that if I'm using a cartridge that I've taken on holiday as a spare ( whether basal or bolus) and then shoved back in the fridge when I've got home, that sometimes it seems to be.a bit less effective towards the end, and I've changed it early.


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## everydayupsanddowns (Feb 1, 2018)

In my experience a bit like a pint of milk I suppose. You can carry on using it after the date, but the insulin degrades, sometimes quite suddenly during one day, and doesn’t work any more. 

It might be that you see doses creeping up gradually, but sometimes the insulin seems to stop working altogether and your BG can skyrocket.


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## C&E Guy (Feb 1, 2018)

I got told that modern insulins are more robust and can even stand to be out of a fridge, in a pocket, when on holiday in a hot country.

The advice was "keep them in the fridge until you start using them. Then they're ok out of the fridge".


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## NoSugarBabe (Feb 6, 2018)

Thanks for the help, everyone. That's great!

So I wonder why the GP just _confused_ the whole issue by making it sound like the matter was of crisis/disaster proportions - ?! As by doing so he potentially caused panic!

I mean, the GP knows me & that I'm not stupid. So he could have explained better. Thinking about it, I think that if the NHS appointments were longer - but don't start me on THAT issue!  - he might have explained better/more fully what he possibly meant to indicate i.e. that epipens shouldn't be used _weeks or months_ after they are taken out of the fridge, & that if I did they would like as not just not 'work' rather than - err - _kill_ me! 

Hey-ho! That's the NHS for you! No time & no money!


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## trophywench (Feb 6, 2018)

We aren't talking about Epipens though, are we? - we're talking about insulin whether in disposable pens , cartridges or vials.


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## Hobbit (Feb 7, 2018)

I was going to start a thread but saw this on the front page. My fridge broke down and I'm having a new one delivered today. I had a box of Novorapid and a box of Levemir in there which have now been at room temperature for well over 12 hours. Should I just keep them out of the fridge now and make sure I don't use them beyond 28 days or are they safe to put back in the fridge?


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## Robin (Feb 7, 2018)

Hobbit said:


> I was going to start a thread but saw this on the front page. My fridge broke down and I'm having a new one delivered today. I had a box of Novorapid and a box of Levemir in there which have now been at room temperature for well over 12 hours. Should I just keep them out of the fridge now and make sure I don't use them beyond 28 days or are they safe to put back in the fridge?


When I've been on holiday, and my spare insulin has travelled there and back at room temperature, ( but been in a fridge while away) I've always just stuck it back in the fridge when I've got home, but made sure I've used it next, and it's been fine.


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## everydayupsanddowns (Feb 7, 2018)

I'm the same as Robin, if I've taken stored insulin our of the fridge I try to make sure I use it next in line, but don't consider it 'spoiled' if it returns into the fridge after a short while. When taking supplies away/in transit I effectively operate as if 'time out of fridge' forms part of the 28 days, but that the clock stops when the insulin returns to the fridge. I'm not sure if it actually works like that, but I've not had/noticed sufficient insulin degrading mishaps to prove to me that it doesn't.

To be honest, the acid-test for me is essentially whether the insulin is working more or less how I expect it to. And if it isn't count the insulin itself among all the possible things that might be causing elevated BG: individual meal error, change in basal requirement, change in bolus ratio, site absorption/set change, illness brewing, and finally... 'is this insulin still OK?'


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## Lanny (Mar 12, 2018)

This is eye opening to me. I was switched from tablets to insulin 6 years ago Levemir & Novorapid 300 units flexpens. I was just told to store them in the fridge until I took them out to use & then keep them out.

2 years ago when I had to rush to my mum in Hong Kong when she was diagnosed with pancreatic cancer & given a prognosis of 3 months. I ordered 5 boxes of each to last me 5/6 months. I was told by my GP to take them in hand luggage as it can freeze in hold luggage & put them back in the fridge when I got there. Mum only lasted 6 weeks so, I was left with boxes left which I carried on using after putting them in the fridge when I got back to the UK.

My diabetes took a downturn, which I'm still dealing with now, & put it down to the effects of grief. It never crossed my mind it could be due to ineffective insulin.

I won't be doing that again! I'll have to research travelling with insulin & storage.

Thanks to all for flagging this up for me! A new member of Diabetes Uk.


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## everydayupsanddowns (Mar 12, 2018)

Welcome to the forum Lanny


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## Lanny (Mar 12, 2018)

Thanks. Just call me Lanny. I used my full name when joining & I don't know how to change it.


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## everydayupsanddowns (Mar 12, 2018)

Lan Fong Tang said:


> Thanks. Just call me Lanny. I used my full name when joining & I don't know how to change it.



I'll get @Northerner to change your username


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## Northerner (Mar 12, 2018)

Lanny said:


> Thanks. Just call me Lanny. I used my full name when joining & I don't know how to change it.





everydayupsanddowns said:


> I'll get @Northerner to change your username


All done - your User Name is now Lanny


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## Lanny (Mar 12, 2018)

Oh, thanks guys. Still soaking up info on these forums. You're all such a nice lot!


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## trophywench (Mar 12, 2018)

Research 'Frio Bags' whilst you are Googling - been using them ever since they were invented I think, for holidays.

Not needed at the moment since we have a nice fridge freezer in our motorhome with us!

Insulin very often is still OK after a month Lanny - trouble is though - equally often it isn't.  We have no idea what's really happened to it before it gets delivered to our pharmacy, without us forgetting to bung it in the fridge to store it afterwards.


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## Lanny (Mar 12, 2018)

Thanks Jenny. Saw those. But, I think I'll go with a bag with ice packs as it'll hold my testing kit too (meter, strips etc.). I'm very nervous when I travel & probably test more often than I need to, even though I delibrately let my sugars run a little high to avoid hypos.


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## trophywench (Mar 12, 2018)

You just lob your meter in your handbag Lanny - it doesn't need to be cold, neither does any of your kit other than the insulin itself - and that only needs to be 'cool' - never put an icepack right next to a cartridge or a pen - FAR too cold!  Meters stop working below a certain temperature anyway (or indeed above a higher one) - but there again - so does my body when I am! - so don't ever let them do that.

I'd usually aim for 7-ish when travelling too, for the same reasons as yourself.  The spare boxes of strips and box of pen needles, I always stuck in the hold luggage


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## Lanny (Mar 13, 2018)

Thanks Jenny for your insights. The last thing I’d want when I’m nervous anyway is for my meter not to work: send me into panic mode!


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