Should Glucagon be refrigerated?

Harold, “should” or “should not”?

@Boerenkool, based on your info, I am now suspecting that, since both Glucagen and Glucagon are actually glucagon, it is likely that:

  1. Both of them preserve better the fridge (up to 3 years?)
  2. All products in the same brand, regardless of country, have the same shelf life
  3. Government regulations/ approvals are actually what limits the listed shelf life

I am wondering why Glucagon actually recommends that it not be refrigerated. I suspect it may be because, if people put it in the fridge, it is not available immediately (wherever you go). So it is due to a usage issue rather than a physical/ chemical issue.

[EDIT] I edited the original post again.

Sorry, should NOT be. My apologies.

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The Lilly glucagon cases are not new: we just don’t have them in Canada, for some inexplicable reason. Here’s a Flickr photo of a Lilly glucagon kit from 2008.

I was so glad when I was prescribed a Novo glucagon kit and got the case! The cardboard package of the Lilly one would just crush as soon as you put it in a bag. It made it impossible to actually carry glucagon anywhere.

(Sort of unrelated but related: in the US EpiPens come with this nice plastic clip that lets you easily clip two together, which we also don’t have in Canada. Luckily I managed to obtain one, and it makes keeping the two autoinjectors together in my bag so much easier!)

As to whether to store it in the refrigerator, I do. The Canadian Novo kit I has says to store in a refrigerator (between 2°C and 8°C) and that it can be stored at up to 25°C for up to 18 months within the shelf life.

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Glass syringes are preferable when the diluent is stored in the syringe for several years. The plastic syringe is what you do NOT want for storage!

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Actually, the syringes from Novo Nordisk are made of glass as well.

Container for GlucaGen:

Vial made of glass type I, Ph. Eur., closed with a bromobutyl stopper and covered with an aluminium cap.

Containers for solvent:

Vial made of glass type I, Ph. Eur., closed with a bromobutyl disc with teflon and covered with an aluminium cap

or

pre-filled syringe made of glass type I, Ph. Eur., with plunger (bromobutyl rubber) and needle.

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I had no idea either and I can’t find any European documentation concerning Lilly glucagon kits. Novo seems to have a monopoly on glucagon in Europe. In other languages (German, French, Italian) I can only find information about the Novo kits and the storage advice is the same as the previously mentioned Dutch and British instructions.

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I have never used that one. Makes sense they would use glass.

The old ones used to have two vials - one with the diluent and one with the glucagon tablet. You had to take it out of the one vial before injecting it into the other to mix it. I guess they started pre-loading the syringe to save time.

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Yes - I remember those two vial kits :slight_smile:

I wasn’t really complaining about the glass - I was complaining about the length and gauge of the needles.

I have no issues with glass in a plastic case, but selling a glass syringe in a cardboard box is a recipe for breakage.

/complain mode off - :unicorn: :rainbow: :lollipop:

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I have never had one with the syringe in the cardboard box. Does that depend on your country?

When they started pre-loading the syringe, I remember it always being in the red plastic case.

(A case that is good to save as a way of transporting vials and other such things rather securely, and protecting stuff. BTW!)

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@Jen pointed out that the no plastic case for Lilly glucagon is just a Canada thing.

In my case, this drove me away from the Lilly product to the NovoNordisk stuff. Bad marketing move Lilly :slight_smile:

Also, the NovoNordisk stuff I have bought was an 18 month shelf life versus the 12 months with the Lilly stuff. I still keep expired glucagon, but I usually have fresh stuff somewhere.

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The printed expiration date is just a misprint. :wink:
https://forum.fudiabetes.org/t/expired-glucagon/1417/9

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:guinea_pig:

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I have never had one with the syringe in the cardboard box. Does that depend on your country?

Maybe that’s what all us poor, hapless Americans are getting when we pay three times as much for our drugs and medical care – better packaging!!

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Hmm. In the US, it appears that I get more than 12 months shelf life for Lilly. Right now I have 2 kits expiring 11/2018. So I am guessing it must be 18 months in the US

Sorry to be the source of wrong information on this thread :slight_smile:

EDIT - We Canadians must be getting a discount for no plastic box and getting all the old stock of American glucagon :slight_smile:

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No no no! I just seems that this is widely varying across countries!

Honestly, the approving authority (FDA, TUV, or country approver) is going to determine the expiration date. So the same product could easily have a different expiration if the approving authority didn’t agree with the data supporting extending the expiration. Also, rare, but a drug could be made in two different factories using different methods, and each could have a different expiration.

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