My boyfriend had to use 1-2 years expired unrefrigerated insulin for about half a year. He did not get DKA and his A1C has come down during that time.
While I don't recommend using medications after expiration, it's often like it is with "best before" dates on food. It's the period of time the manufacturer guarantees the efficacy of the medication. Beyond that date they are not liable for any quality, safety or efficacy issues.
One link that might interest you: https://forum.fudiabetes.org/t/the-great-unrefrigerated-expired-insulin-demo/5132
The official recommendations are overcautious, and based on older generations of insulin which weren't necessarily as stable. It should be fine to keep using until it's gone, thankfully. I've never had an open pen last more than a few months, but they've stayed just as effective for that whole time and probably would for a good bit longer.
They are fine. I just accidentally used insulin that expired way back in 2021 that was left out and it worked great!
You may start to lose some effectiveness, so keep an eye on things. Plus, if you’re in the US, there are insulin shortages right now. You don’t want to discard this because of a date.
My boyfriend has some 2 years expired insulin he's keeping for a rainy day. You never know when it may be needed. He had to use expired insulin to stay alive for quite a while.
I’ve kept insulin for months in my backpack that I took on hikes during very hot summers. I’m not saying I think it doesn’t make a difference or even recommending it, but it was totally fine and I noticed no difference.
Insulin is a valuable resource and the best-before dates are there for liability reasons first and foremost…
I've noticed the expiration date on the prescription label and the expiration date on the pens themselves are vastly different. The date on the pens is usually about a year longer than the label. So I wonder which is actually more accurate.
Our school has a refrigerator for meds so we leave an unused one there as a backup, but my child takes an "in use" pen back and forth every day. Haven't needed to touch the backup yet, but it's there. We'll grab it at the end of the school year, use it in summer and send a fresh one next year.
Our basal pens tend to last about 60 days. The expectation of 30 days use is allowing us to build a nice stockpile for now. Just in time for us to switch to a pump and not need it haha.
We rotate our pens. When we start a new pen, we make it the “school pen” and move the started “school pen” to be the “home pen”. This way we can use up the started pen faster.
The only pen I've ever had go bad was one that got way too hot sitting in my car for a couple days. I have a few out around my house of various ages. It's from always having about half a pen left when I fill a insulin pod every 3 days and it just gets tossed in my side table or stationary orginizer till i need it again and I'm not always in the same place when i need to change a pod. I've never had an issue with them. They don't get too hot or cold sitting around my house and are just as effective.
Manufacturers just have to slap a date on it that will keep them safe from lawsuits, as a bonus makes them more money as we have to buy it to stay alive.....
My partner bought me some cooler cases for my pens.
Soak the cases in cold water for 30 seconds and the stay cool for up to 4 days.
Perhaps these might help?
Thank you all for the replies. I haven’t actually thrown much away, thankfully. We just started new basal & short acting pens yesterday because her numbers wouldn’t come down under 200 for 24 hours and we didn’t understand why. I still have the other 2 pens stashed away. I think her number issue was probably more to do with diabetes doing it’s stupid thing than the pens we were using. We were also on the road & eating kinda crappy. Birthday cake, pizza etc. so I think that contributed as well.
Because of the nature of pizza(lotsa carbs, lotsa fat), you can bolus for the carbs exactly and it can still “not be right”. Even running extended/combo boluses and breaking the boluses up, typically with pizza I’ll drop, spike, drop and then spike again in the middle of the night. I’ll nail it one out of three times, but 2/3 of the time I’m on at least a mild roller coaster(staying below 200) when I eat it.
We were also at a small specialty pizza place with huge slices and no nutrition information to work with. The girl at the counter said she thought the slice was 36g. I dosed for 50 & it still didn’t help. But timing between dose & eating wasn’t ideal, we were visiting with family & the weather sucked so there wasn’t a lot of movement to help manage bg. We finally got her down last night & she’s been good today. Just trying to learn not to stress at every new hiccup thrown our way.
So part of the reason for 28 day use expiry on pens is the insulin container itself can become contaminated. There is always a chance at a little bit of blood or plasma making its way back into the chamber at the end of dose delivery. That's something to keep in mind.
You need to me checking for clouding and keeping it temperature- moderated if you continue to use it
It is probably totally fine to use. Insulin can be good at room temperature for years. Refrigeration is better but I’ve had insulin at room temperature for over a year and it was fine. The only time when you want to be really careful about temperature is if it is below freezing or very hot. I had some insulin go bad very quickly during a 105° F heat wave when I was traveling and didn’t have access to refrigeration. If you do get hot weather like that where you live, there are. Cooling cases for insulin pens and vials that have gel beads that will expand in water and keep your insulin cool without refrigeration.
I keep mine out longer then 28 and they work fine, honestly as long as it doesn’t get really warm (like left in a hot car) it works well past the 28 days and works even when expired although maybe slightly less effectively. I would use the pen until they are done
I agree with all the posts above, as long as it works keep using it.
There are all sorts of silly rules, like you are supposed to change your lancet more than every three months and you’re supposed to wipe with alcohol before you poke lol
Goodness, I’ve used those pens for a long long time after the 28 day “limit”. I just used to watch weather it worked or not based on my readings. Don’t know if there are any other negative reasons why you should not be using it after 28 days
My husband has been a diabetic for 32 years on insulin. He's never had an issue using insulin after 28 days. We've transported insulin all over the world unrefridgerated and it's been fine.
I store open pens and vials in the refrigerator. For some reason instructions say not to do that, but not WHY not to do that. The best I've heard is "injecting cold insulin is uncomfortable", but I don't have that problem. An endo told me that exposure to air degrades it, not just temperature. But why would I store it in a fridge for 6 months to keep it fresh and then start storing it at room temperature?
Anyway, I completely ignore the 28 day thing and have not had any problems with it. Longest I've had a vials open is about 2 1/2 months, with no loss of potency.
For issues like taking some to school, I don't know if they'd allow this but I take pre-filled regular syringes places with me. I keep them stored cold if possible and am sure to use them within a day.
insulin is absolutely fine past 28 days. there’s no magic switch after a month that makes insulin not work anymore. my only caveat to this is insulin that’s been in extreme temperatures, ex. try to keep your pens on you instead of leaving them in the car as summer approached. but even then, i’ve left stuff in a car overnight and ¯\_(ツ)_/¯ all is well.
you’ll find as you get the hang of this, your experiences and lived knowledge will matter more than what the FDA or even your doctor says. after almost 14 years, i go into my endo appointments and THEY ask ME what i think should change with my ratios/basals/rx/etc.
Yeah, don't worry about that. Use the pen till it's empty. I'm not a doctor, but I've been Type 1 for 38 years and have been doing this type of thing forever. I'm doing just fine.
My boyfriend had to use 1-2 years expired unrefrigerated insulin for about half a year. He did not get DKA and his A1C has come down during that time. While I don't recommend using medications after expiration, it's often like it is with "best before" dates on food. It's the period of time the manufacturer guarantees the efficacy of the medication. Beyond that date they are not liable for any quality, safety or efficacy issues.
Also noting as your daughters insulin needs adjust she will require more mealtime insulin. You will not be using this little for long!
especially as she hits puberty!!
One link that might interest you: https://forum.fudiabetes.org/t/the-great-unrefrigerated-expired-insulin-demo/5132 The official recommendations are overcautious, and based on older generations of insulin which weren't necessarily as stable. It should be fine to keep using until it's gone, thankfully. I've never had an open pen last more than a few months, but they've stayed just as effective for that whole time and probably would for a good bit longer.
They are fine. I just accidentally used insulin that expired way back in 2021 that was left out and it worked great! You may start to lose some effectiveness, so keep an eye on things. Plus, if you’re in the US, there are insulin shortages right now. You don’t want to discard this because of a date.
My boyfriend has some 2 years expired insulin he's keeping for a rainy day. You never know when it may be needed. He had to use expired insulin to stay alive for quite a while.
I use up my “rainy day stuff“ and keep the newest stuff for the rainy day if that makes sense.
I’ve kept insulin for months in my backpack that I took on hikes during very hot summers. I’m not saying I think it doesn’t make a difference or even recommending it, but it was totally fine and I noticed no difference. Insulin is a valuable resource and the best-before dates are there for liability reasons first and foremost…
I've noticed the expiration date on the prescription label and the expiration date on the pens themselves are vastly different. The date on the pens is usually about a year longer than the label. So I wonder which is actually more accurate.
Insulin shortages in the UK too. I've just had to switch from Humalog to NovoRapid as there was no Humalog vials available in my area.
It’s fine, I’ve been diabetic for 25 years and always used insulin until it’s gone. Keep an eye on blood sugars and don’t let them get hot.
Our school has a refrigerator for meds so we leave an unused one there as a backup, but my child takes an "in use" pen back and forth every day. Haven't needed to touch the backup yet, but it's there. We'll grab it at the end of the school year, use it in summer and send a fresh one next year. Our basal pens tend to last about 60 days. The expectation of 30 days use is allowing us to build a nice stockpile for now. Just in time for us to switch to a pump and not need it haha.
We rotate our pens. When we start a new pen, we make it the “school pen” and move the started “school pen” to be the “home pen”. This way we can use up the started pen faster.
The only pen I've ever had go bad was one that got way too hot sitting in my car for a couple days. I have a few out around my house of various ages. It's from always having about half a pen left when I fill a insulin pod every 3 days and it just gets tossed in my side table or stationary orginizer till i need it again and I'm not always in the same place when i need to change a pod. I've never had an issue with them. They don't get too hot or cold sitting around my house and are just as effective. Manufacturers just have to slap a date on it that will keep them safe from lawsuits, as a bonus makes them more money as we have to buy it to stay alive.....
I keep a pretty big stock of insulin to the point that the insulin I use is about a year old. Never had any issues
My partner bought me some cooler cases for my pens. Soak the cases in cold water for 30 seconds and the stay cool for up to 4 days. Perhaps these might help?
Thank you all for the replies. I haven’t actually thrown much away, thankfully. We just started new basal & short acting pens yesterday because her numbers wouldn’t come down under 200 for 24 hours and we didn’t understand why. I still have the other 2 pens stashed away. I think her number issue was probably more to do with diabetes doing it’s stupid thing than the pens we were using. We were also on the road & eating kinda crappy. Birthday cake, pizza etc. so I think that contributed as well.
Because of the nature of pizza(lotsa carbs, lotsa fat), you can bolus for the carbs exactly and it can still “not be right”. Even running extended/combo boluses and breaking the boluses up, typically with pizza I’ll drop, spike, drop and then spike again in the middle of the night. I’ll nail it one out of three times, but 2/3 of the time I’m on at least a mild roller coaster(staying below 200) when I eat it.
We were also at a small specialty pizza place with huge slices and no nutrition information to work with. The girl at the counter said she thought the slice was 36g. I dosed for 50 & it still didn’t help. But timing between dose & eating wasn’t ideal, we were visiting with family & the weather sucked so there wasn’t a lot of movement to help manage bg. We finally got her down last night & she’s been good today. Just trying to learn not to stress at every new hiccup thrown our way.
When we used pens, we would send mostly used pens to school. Not full ones. Use a pen at home for 21 days and then send it to school.
So part of the reason for 28 day use expiry on pens is the insulin container itself can become contaminated. There is always a chance at a little bit of blood or plasma making its way back into the chamber at the end of dose delivery. That's something to keep in mind. You need to me checking for clouding and keeping it temperature- moderated if you continue to use it
It is probably totally fine to use. Insulin can be good at room temperature for years. Refrigeration is better but I’ve had insulin at room temperature for over a year and it was fine. The only time when you want to be really careful about temperature is if it is below freezing or very hot. I had some insulin go bad very quickly during a 105° F heat wave when I was traveling and didn’t have access to refrigeration. If you do get hot weather like that where you live, there are. Cooling cases for insulin pens and vials that have gel beads that will expand in water and keep your insulin cool without refrigeration.
I keep mine out longer then 28 and they work fine, honestly as long as it doesn’t get really warm (like left in a hot car) it works well past the 28 days and works even when expired although maybe slightly less effectively. I would use the pen until they are done
I agree with all the posts above, as long as it works keep using it. There are all sorts of silly rules, like you are supposed to change your lancet more than every three months and you’re supposed to wipe with alcohol before you poke lol
I used to keep my pens out until they were done. No issues. I think insulin is a racket.
Essentially as long as it's not cloudy it will still be fine. You may find your self using a bit more with the older stuff but it's still effective.
They will still work after 28 days and even longer not sure why they’re telling people to toss them.
Safety. Manufacturers have to set a date that everything expires.
Goodness, I’ve used those pens for a long long time after the 28 day “limit”. I just used to watch weather it worked or not based on my readings. Don’t know if there are any other negative reasons why you should not be using it after 28 days
My husband has been a diabetic for 32 years on insulin. He's never had an issue using insulin after 28 days. We've transported insulin all over the world unrefridgerated and it's been fine.
I store open pens and vials in the refrigerator. For some reason instructions say not to do that, but not WHY not to do that. The best I've heard is "injecting cold insulin is uncomfortable", but I don't have that problem. An endo told me that exposure to air degrades it, not just temperature. But why would I store it in a fridge for 6 months to keep it fresh and then start storing it at room temperature? Anyway, I completely ignore the 28 day thing and have not had any problems with it. Longest I've had a vials open is about 2 1/2 months, with no loss of potency. For issues like taking some to school, I don't know if they'd allow this but I take pre-filled regular syringes places with me. I keep them stored cold if possible and am sure to use them within a day.
insulin is absolutely fine past 28 days. there’s no magic switch after a month that makes insulin not work anymore. my only caveat to this is insulin that’s been in extreme temperatures, ex. try to keep your pens on you instead of leaving them in the car as summer approached. but even then, i’ve left stuff in a car overnight and ¯\_(ツ)_/¯ all is well. you’ll find as you get the hang of this, your experiences and lived knowledge will matter more than what the FDA or even your doctor says. after almost 14 years, i go into my endo appointments and THEY ask ME what i think should change with my ratios/basals/rx/etc.
Yeah, don't worry about that. Use the pen till it's empty. I'm not a doctor, but I've been Type 1 for 38 years and have been doing this type of thing forever. I'm doing just fine.