Pens or Vials?

Pens and vialsA month or so ago, a friend of mine was talking about her insurance changing what their preferred insulin was. She mentioned using vials. I already knew that she used vials but something in the way she said it made me ask why? She is someone that uses small doses of insulin on a daily basis.

I know that some people prefer to use syringes because of being able to get smaller doses than you can with a pen. However, using a syringe is no excuse for continuing to use a vial because you can stick the syringe into the pen and dose just like you would with that vial. Some people also use the regular pen needles but pull out the remaining insulin with a syringe when the pens says it is empty but you can see insulin in there.

Pens are generally 3 ml and labeled 100 units per ml so you get 300 ml per pen. A vial is 10 ml and again 100 units per ml, so you get 1,000 units per vial. My pens normally last about 2 weeks, give or take a couple days. You also need to use some insulin for priming, Although the instructions say 2 units, I use 3 on my Apidra pens otherwise I have to prime a couple times.

On average, I use about 15 units of Apidra per day plus another 3 units to prime. If I have an average week, that 300 units should last me 16 ½ days. That 1000 unit vial on the other hand is a totally different story. The prescribing information for Apidra says that it needs to be used within 28 days. If you divide 1000 units by 28 days, that works out to 35.7 units per day – that is double what I normally use. Using 15 units a day for 28 days only works out to 420 units (I wouldn’t need the units I use to prime if I used a vial).

Apidra storage

I know some people can get more days out of their insulin, but Apidra is a very picky insulin and I know based on past experience, I wouldn’t be able to do that. Out of curiosity, I looked up the life after opening for the most popular insulins. Most of them are 28 days and Levemir is 45.

Apidra 28 days
Humalog 28 days
Novolog 28 days
Lantus 28 days
Levemir 45 days

I know when I was on Lantus, I had to mark on my calendar when I opened a new vial because it would go bad and I have heard other people say the same thing.

If you are still using a vial instead of pens, I would do the math and see how many units you get per day out of that 1000 unit vial compared to five 300-unit pens. You might be surprised that you get more bang for your buck out of that box of pens.
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6 thoughts on “Pens or Vials?

  1. I agree that this was interesting info. I simply do not like the clunkyness of pens or that noise they make when you twist up the dose.
    Give me a little 1/3 CC syringe and I’m happy.
    I write the date opened on the vial with a Sharpie, but almost always use the Humalog for more than 28 days.

    • Kathy, when I first start using the OptiStick pen for Apidra, I couldn’t believe how big it was. They switched to the SoloStar and that one isn’t as big. You can’t get those 1/3 cc doses out of a pen that is one thing syringes will always have over a pen. At least you know when you put insulin in that syringe and stick it in your body, you are getting it.

      I didn’t ever remember having problems with Humalog dying. I know some people say they use it for 2 months without a problem.

    • At least you have them just in case Colleen! There was a discussion after Apidra pens came out that they did not really dispense 1 unit. I actually tested the pen with a syringe and found out that it didn’t. A lot of people didn’t have a syringe to test with.

  2. That’s a really informative post there Kelly. I didn’t know that Novolog (or Novorapid to the world outside of the USA) was only good for 28 days! Learnt something new in your post today. Like you say, if you are on needles, from my math calculations, it’s better to go with the vials for the pen needles. I have to admit, I only prime 1 unit when I’m using my pen needle (I figured when I see a blob of insulin – it was primed properly – but you say you use 3 units).

    For myself as a insulin pump user – averaging 24 units a day – I still use the bottled insulin (Novolog/Novorapid) – since it’s abit cheaper for me ($28 Cdn per bottle) then the vials – but I always keep vials handy incase Salvador Dali goes wonky OR I feel like taking a pump break for a change of pace.

    • I always thought they were 30 days until I started looking them up for this post Anna! I think most people on pumps tend to have the vials. That is what I used because it was easier and cheaper. With my Levemir pen, I can get away with priming with 1 unit but the Apidra pen is funny so I give it more.

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