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As a pharmacist, I was often asked whether it was safe to use expired insulin and how I would tell you if it was worsened by exposure to a fever or cold.
Drugs have expiration dates because they cannot guarantee stability based on clinical research.
Taking the opportunity to eat expired food is one thing. It may be harmful to your overall health as it may not function at its maximum capacity.
Can I use insulin after its expiration date?
Using expired insulin is absolutely not recommended and should only be done if there are no other options.
The efficacy of insulin breaks down over time, and it is impossible to predict how well an expired insulin will work, or if it will work at all!
Insulin is a bit unusual in that it had two expiration dates. One is the expiration date when insulin is unopened and stored at the appropriate temperature. The second expiration date is when the manufacturer is kept at room temperature, suggesting that insulin is suitable after opening.
Check if insulin is still safe to use and check both dates.
What happens when you use expired insulin?
It is similar to what happens in an early diabetes diagnosis when the pancreas is not producing insulin that suits the body’s needs when it is not functioning properly.
Blood sugar levels start to rise and can do so very quickly. When blood sugar levels rise and other causes are ruled out, such as illness, changes in diet and exercise, or new medication, you start to suspect that your insulin is getting worse.
I switched to a new vial or pen and confirmed that when my blood sugar levels returned to normal “magically” I was actually damaged.
It is important to note that insulin can get worse before its expiration date. This is very rare, but if you feel that insulin is not working as well as it needs to be, try switching to a new vial or pen.
How can you tell if insulin has worsened?
There are two ways to know if your insulin is getting worse.
The first method is visual inspection. Do not use if insulin appears to be cloudy or discolored. If there is a chunk, or if there is something inside it that looks like a small “string”, it is probably not safe to use.
The second way to know insulin is, as mentioned above, unexplained hyperglycemia.
How to store insulin
Proper insulin storage is important to ensure that insulin is effective.
Avoid exposing insulin products to extreme temperatures. Because insulin is a protein, if the temperature is too high or too cold, it can be affected by deterioration (failure). Additionally, keep insulin products away from direct sunlight. This is because it can cause insulin breakdowns.
Proper insulin storage is so important, the FDA recently confirmed that insulin pens should be distributed at all times in the “original box” and ensured that instructions for proper use and storage of insulin are always included. This means that the pharmacy is not allowed to provide two insulin pens from a six-pen box.
Unused insulin Should be stored in a refrigerator between 36°F and 46°F (2°C to 8°C). A safe distance from the back and top of the cooling element can bring temperatures closer to freezing.
Refrigerator butter compartments or production drawers are usually a good option for insulin storage.
update: A new study in 2021 shows that insulin is stored at 77° to 98.6°F (25°C to 37°C) for four weeks, exhibiting the same stability as currently recommended drug protocols, and is open at 36° to 46°F (2°C to 8°C).
Any “In Use” insulin vial or pen Can be stored outside the fridge at temperatures up to 86F or 30c (always check the manufacturer’s product insert for accurate instructions).
The reason for storing insulin during use at room temperature is that cold insulin can cause more painful injections.
When should I throw away an open insulin vial or pen?
Many insulin pens can last outside the fridge for 7-28 days.
Specific recommendations for insulin storage that can be followed are listed below. As always, check the instructions in the box for specific guidance.
New insulins are rapidly coming to the market, but instructions may vary slightly with different formulations and brands.
All of the following are when opening the vial or pen.
Lily insulin
- Insulin Glargine (Basaglar®): Discard pen/vial after 28 days.
- Insulin lispro (humalog®): Discard pen/vial after 28 days of use.
- Humulin R: Discard the vial after 31 days of use. If you have a pen, throw it away after 28 days.
- Humulin N: Discard the vial after 31 days of use. If you have a pen, discard it after 14 days.
- Humulin 70/30: Discard the vial after 31 days of use. If you have pens, discard them in 10 days, even if you still have insulin.
Novo Nordisk Insulin
- Insulin Aspart (FIASP®, Novolog®, Novorapid®): Pen and vial, discarded after 28 days.
- Insulin Degludec Injection (TRESIBA®): Pen and vial, discarded after 56 days.
- Insulin DETEMIR Infusion (LEVEMIR®): Pen and vial, discarded after 42 days.
- Isofhan Insulin Human Suspension (Novilin®NNPH): Vial – 42 days. Pen – 28th.
- Insulin Human Injection (Novolin®R): Vial – 42 days. Pen – 28th.
- 70% human insulin isophane suspension and 30% human insulin injection (Novolin® 70/30): Vial – 42 days. Pen – 28th.
- Novolin NPH and R also represent the Relion® brands available at Wal-Mart.
Sanofi insulin
- Insulin Lispro Injection (ADMELOG®): Pen and Vial, discard after 28 days
- Insulingurysine Injection (Apidra®): 28 days
- Insulin Glargine Injection (Lantus®): 28 days
- Insulin Glargine Injection (Toujeo®): 28 days
For questions about insulin, issues, or specific brands regarding product stability, please ask the manufacturer for help (link above) and in some cases a replacement.
Products that help you store insulin safely
Just as new insulins were rapidly developed, more efficient ways to keep insulin safe have also evolved.
These products offer a unique and simple way to carry insulin products, whether for short hikes or global travel.
Medangel This is a convenient “smart thermometer” for medicines that need to be stored within a specific temperature range. Store next to insulin. If the temperature is out of range, your mobile phone will alert you. You can customize the temperature range for a specific drug. This is great.
Cold Cooling Pack It can operate up to five times longer than ice packs, and appears to keep your insulin products at a more consistent temperature. They can last up to 45 hours or more, are easy to store and use, and come in a variety of styles and colors. As directed on the website, you must soak in water before use.
Live Cap A cooling device for insulin pens. Simply click on the insulin pen instead of the cap and press a button and the device works to keep insulin at the right temperature for as long as necessary. No ice packs or preparations are required. The battery lasts as long as a device that can become active for several years.
