Useful Info (Original Patient Education) JASE Medical

How Long Do My Meds Last? A Look at Ciprofloxacin

(How about over 10 years past expiration?)

Ciprofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic, it is used to treat many different types of bacterial infections, and is used to treat biological warfare agent inhalation Anthrax as a post exposure prophylaxis.

How long does ciprofloxacin remain potent?

When stored in a cool, dry, and dark area away from sunlight and capped, ciprofloxacin can retain much of its potency well past expiration date.

Expiration dates reflect the time during which the product is expected to remain stable, or retain its identity, strength, quality, and purity, when it is properly stored according to its labeled storage conditions. According to the Shelf-Life Extension Program, a joint initiative of the FDA and Department of Defense that tested 122 drugs for potency after their expiration date revealed ciprofloxacin maintained its active ingredients with no deterioration in strength for up to 142 months- over 10 years!

Ciprofloxacin is listed in the World Health Organization Model List of Medications for the newly released 2023 edition:

FIRST CHOICE (From WHO 2023 list)

Acute invasive bacterial diarrhea /dysentery
Enteric fever
Low-risk febrile neutropenia
Pyelonephritis or prostatitis (mild to moderate)

SECOND CHOICE (From WHO 2023 list)

Cholera
Complicated intraabdominal infections (mild to moderate)

In addition, ciprofloxacin can be used to treat:

Anthrax exposure
Tularemia
Urinary tract infection

How to Take

Take ciprofloxacin dose 2 hours before or 6 hours after taking other medicines. It may be taken with or without food. Drink plenty of liquids when taking ciprofloxacin.

Side Effects

Fluoroquinolones carry black box warning

Fluoroquinolones (FQ) have been associated with increased tendon ruptures. A tendon rupture is a partial or complete tear of a tendon.

A large study reviewing retroactive patient records was conducted between 2007 and 2016 with over a million subjects from the senior population age 65 and older. This study reviewed the use of FQ against other antibiotics and even similar drugs in the FQ class to assess tendon rupture occurrence. Only one of the FQ antibiotics displayed a significant tendency to tendon rupture- between a 16% (rotator cuff) and fourfold risk (Achilles tendon). That antibiotic was levofloxacin. Neither ciprofloxacin-one of the antibiotics found in the Jase case- or moxifloxacin- which were part of the study- was found to increase tendon rupture.

For more information, please read this post: Does Ciprofloxacin (Cipro) cause tendon rupture?

What To Avoid

Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice.
Avoid antacids that contain calcium, magnesium, or aluminum (such as Maalox, Milk of Magnesia, Mylanta, Pepcid Complete, Rolaids, Tums, and others).
Vitamin or mineral supplements that contain calcium, iron, magnesium, or zinc.
Ciprofloxacin can cause sun sensitivity. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Consult with your care provider before taking if you are taking any of the following:

- Oral diabetes medicine
- Products that contain caffeine
- Medicine to treat depression or mental illness
- Steroid medicine (such as prednisone)
- NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac,
- Clozapine, cyclosporine, methotrexate, phenytoin, probenecid, ropinirole, sildenafil, or theophylline
- A blood thinner (warfarin, Coumadin, Jantoven)
- Heart medication or a diuretic indomethacin, etc.

For a more complete list of drugs that may interact with ciprofloxacin check out this site.

Make your care provider aware if you currently have (or history of)

Low levels of potassium in blood
Muscle weakness, myasthenia gravis
Any history of heart disease
Aneurysm
Diabetes or low blood sugar
You or family history of long QT syndrome
Brain tumor, head injury or seizures
Liver or kidney disease
Nerve problems
If pregnant or breastfeeding consult your primary care provider for guidance. There is evidence that ciprofloxacin can affect the fetus and enter breast milk. Ciprofloxacin carries US FDA pregnancy category C (Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks).

Common ciprofloxacin side effects may include:

Nausea, vomiting, diarrhea, stomach pain
Headache
Abnormal liver function tests

Seek medical attention if you experience:

Signs of an allergic reaction to ciprofloxacin (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction
Low blood sugar – hunger, irritability, nausea, fast heart rate, or feeling shaky
Nerve damage symptoms – numbness, crawling, pins and needles or tingling, burning pain in your hands, arms, legs, or feet
Serious mood or behavior changes – nervousness, agitation, hallucinations, memory problems, thoughts of suicide
Bloody or black, tarry stools

Discontinue and seek immediate medical attention if you experience:

Severe pain in your chest, stomach, or back (a rare but serious side effect of ciprofloxacin) which may damage the aorta, leading to bleeding or death
Fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out)
Muscle weakness
Breathing problems
Little or no urination
Jaundice (yellowing of the skin or eyes)
Increased pressure inside the skull – severe headaches, ringing in your ears, vision problems, pain behind your eyes.

- Brooke Lounsbury, RN

Medical Content Writer

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After School and Home Alone – Do Your Children Know What to do in an Emergency?

As summer winds down and focus on starting a new school year is right around the corner, many parents and children are getting ready- adjusting bedtimes, school lunches, transportation to and from school, and in some instances, starting a new school. Along with this, many children will spend some time at home alone after school.

About 3.5 million American children between the ages of 5 and 12 spend time at home alone after school. The average amount of time isn’t much—only about an hour a day, according to a U-M study presented in Chicago at the Society for Research on Adolescence biennial meeting. This number represents about 26 percent of American children who spend time after school alone, including time spent getting from one place to another (from school to home, for example) on their own.

Many children are ready to be home alone for an hour or so; however, a lot can depend on the maturity and ability level of the individual child.

In addition, each living situation is unique. Families living in apartments and condominiums have a different lifestyle and circumstances than their suburban and rural counterparts. Even geographic locations-where you live-playa large part in readying your child to stay home alone.

No matter what age your children are, or type of housing, there are still many situations in common that you can ready your child for, ensuring their safety while home.

Assess your children’s age and ability

Ability doesn’t necessarily come with age. A lot depends upon your child’s temperament, emotional maturity, and physical ability. For instance, children with special needs- whether physical, mental or emotional-should be factored into how much time they can be home alone. For example, a 9-year-old child on the autism spectrum may not be able to stay at home alone, whereas a 9- year-old without special needs could be left alone for a short period of time.

Geographical location

Do you live in an area that has extreme heat or cold spells? Do you live in a flood zone? Do you live in a hurricane or tornado-prone area? If so, does your child know what to do if these situations arise? What if you cannot get home because of an adverse weather event? Does your child know what to do?

Weather events are the most likely emergency- assess the most likely weather that your children could encounter, during a severe weather event, the power may go out, phones may not work, and heat and air conditioning may also not be working. In addition, if there is severe weather and you can’t get home to your children in the usual time frame, would your children know what to do? Knowing what to do is important if cell phone service goes down and there’s no way to communicate with each other.

Home-alone emergency supplies

Basic first aid kit with basic supplies. Instruct your children how to use it in case of a minor emergency and when they should be calling 911. Laminate a card to keep in the first aid kit with these instructions.
Two flashlights with extra batteries
Bottled water
Prepackaged snacks
Portable radio with extra batteries with the emergency services bands
Portable cellphone battery chargers for each cell phone in the home. Test periodically and ensure they have a charge. Keep an additional cable with them for easy access.
Extra blankets and cold weather gear- and a small tent that can be set up in the bedroom or living room to contain heat in case you aren’t able to get home in a timely fashion

In case of evacuation

Evacuation should not be taken lightly. Most of the time, your child is safer in their home than in the great outdoors. Fires, power outages that affect heating, and even door-to-door evacuation orders are reasons your child needs to be prepared. Luckily, having to evacuate is not very likely. But it is always better to be prepared than to have regrets.
Put together a go-bag for each child in the home. Have the child put the bag on and ensure it isn’t too heavy and fits their frame. In the bag, place a laminated card with their name, address, medications, allergies, parents’ names, and phone numbers.
Two bottles of water for each go bag
Two or more prepackaged snacks-Lara bars are a great nutritious snack
Child’s medication for at least three days in clearly labeled bottles
A change of clothing-socks, pants, underwear, shirt, hat, gloves, and coat/sweater, depending on your climate.
Headlamps and extra batteries (headlamps free hands for tasks)
Reflective tape on the go bag, or purchase reflective tape and apply it to the backpack for visibility
Laminated map of the immediate area that you live in
Rechargeable hand warmers (with recharging cables) if you live in a cold weather area
Phone and portable recharger with cable

Put together a plan and practice.

Post on the refrigerator or a conspicuous place emergency phone numbers, relatives, trusted friends, and neighbors that your children can contact or go to in the event they need to leave home. Make the people on this list aware that your children will contact them in an emergency.
Pull out the first aid kit, go through all the items in the kit, and practice using them—role play. Purchase extra gauze and bandages for your children to use and practice with. As you go through scenarios, advise them to treat only minor cuts and injuries. Give examples of a minor injury and when they should call 911 or seek a trusted adult if phone service or power is out. Ideally, take your child to a local first aid course.
Have your children operate the portable radio. Have them remove and replace the batteries, and demonstrate they know how to find the emergency station(s) for information about local weather events.
Practice removing and replacing flashlight batteries. Make sure they know how to operate them.
Review and rehearse what your child would do if phone service were unavailable. For example, not to panic, and if able to safely make it to a trusted neighbor’s home.
If your child has misplaced or lost their key, have an alternate area to access a key, not just under a mat or a rock near the house. These would be obvious places for intruders to gain access to your home by finding that key.

Backup plans Kids should know where a key is hidden in case they’ve lost theirs, where to go in the neighborhood if they need help, and who to call if there’s a problem and they can’t be reached.

- Brooke Lounsbury, RN

Medical Content Writer

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Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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How Long Do My Meds Last? A Look at Azithromycin

(They may last longer than you think)

Azithromycin blister pack with tablets in doctor's hand

Azithromycin is a type of macrolide antibiotic. It works by decreasing the production of protein and stopping bacterial growth. Other macrolide antibiotics include clarithromycin and erythromycin.

Because of the anti-inflammatory and antiviral properties of Azithromycin, this antibiotic was used extensively for mild to moderate symptoms of Covid during the pandemic; however, a study published by the American Family Physician showed no difference in symptoms or mortality when compared to a placebo in hospitalized patients(patients with severe symptoms).

Azithromycin is listed in the World Health Organization Model List of Medications for the newly released 2023 edition:

FIRST CHOICE (From WHO 2023 List)

Cholera
Enteric fever
Gonorrhea
Chlamydia trachomatis
Trachoma (a contagious bacterial infection of the eye in which there is inflamed granulation on the inner surface of the lids)
Yaws (a tropical infection of the skin, bones, and joints caused by the spirochete bacterium)

SECOND CHOICE

Acute invasive bacterial diarrhea
Dysentery
Gonorrhea

In addition, Azithromycin can be used to treat

Pneumonia and
Urinary tract infections

How long does Azithromycin remain potent?

The potency of antibiotics can be affected by factors such as temperature, light, moisture, and storage conditions. Inappropriate storage and transportation of antibiotics may lead to loss of potency earlier than the expiry date. Keep dry and at stable room temperature away from light.

Expiration dates reflect when the product is expected to remain stable or retain its identity, strength, quality, and purity when properly stored according to its labeled storage conditions.

According to the Shelf-Life Extension Program, a joint initiative of the FDA and Department of Defense that tested 122 drugs for potency after their expiration date revealed that erythromycin powder, a macrolide antibiotic in the same family as Azithromycin, retained its potency up to 83 months (over 7 years). Given that powder forms of antibiotics lose potency sooner than tablet form, this family of antibiotics may likely retain its potency past 7 years.

It is a general consensus that even though antibiotics are safe to take past their expiration date, they may lose potency.

How to take

Azithromycin is usually taken once a day.

Take capsules whole with a large glass of water and 1 hour before or 2 hours after meals.

Side effects

Common side effects include nausea, vomiting, diarrhea and an upset stomach.

An allergic reaction, such as anaphylaxis, QT prolongation, or a type of diarrhea caused by Clostridium difficile is possible.

What to avoid

Do not take Azithromycin if you have hypersensitivity or allergy to erythromycin or other macrolide antibiotics.

Do not take antacids that contain aluminum or magnesium within 2 hours before or after you take Azithromycin, as these can make it less effective. This includes Gaviscon, Maalox, Milk of Magnesia, Mylanta, Pepcid Complete, Rolaids, and others. These antacids can make Azithromycin less effective when taken at the same time.

Consult with your care provider before taking if you have:

Liver disease.
Kidney disease.
Myasthenia gravis.
A heart rhythm disorder.
Low levels of potassium in your blood.
Long QT syndrome (in you or a family member).

Seek medical attention if you experience:

Allergic reaction to Azithromycin: (hives, difficult breathing, swelling in your face or throat)
Severe skin reaction: (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling)

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Jase Founder Dr. Rowland Deploys with Aerial Recovery Group to Lahaina

When Dr. Shawn Rowland heard of the fire in Lahaina, and thousands were displaced, he wanted to offer his home on nearby Oahu for a displaced family or two to stay. He had no idea that he would be a part of the rescue and recovery efforts of a global outreach group called Aerial Recovery Group. Dr. Rowland had contacted their chief medical officer, Aaron Asay, physician assistant and friend that had lived on Maui, to offer his home for a displaced family or two.

Aaron had planned to be out of the country on assignment and would not be available to deploy to Lahaina. He asked his friend if he could be their physician for the group going to Lahaina, which Dr. Rowland readily accepted, and within two hours, a team had activated and organized. Once in Lahaina, the group connected with the Maui chief of police, who had locked down the city to prevent looters and onlookers that could prevent EMS and recovery workers from performing their jobs.

Drone mapping and real-time satellite imagery helped put together a scenario of the extent of the fire and where people might be that needed help. At that point, there was no electricity, communications, or cell phone service. Initially, they treated acute injuries such as broken bones, smoke inhalation, and minor injuries to those who stayed behind in the town. Many people remained in the Lahaina area because they could not return if they left.

That evening, Dr. Rowland heard about a man who could not leave his home because he had an infected foot. In the pitch dark, with no electricity, they made their way through the neighborhoods and up the dirt road, where they encountered many people sitting along the sides of the road who greeted them. “At first, I thought these were people that were housing others in their homes who had been displaced by the fire and were just sitting outside talking and visiting,” he said, “however, once we took care of the man with the infected foot and came back down, we were told that these were some of the people who had lost everything, including family members and all their possessions. I still get emotional talking about it.”

As one of the first independent disaster response teams, Dr. Rowlands’ role quickly became that of resource allocation and coordination. Volunteers from the community – from physicians to nurses, medics, firefighters, and volunteers poured into the area and needed guidance on where to go and what to do. At the same time, relief was coming in from harbors, planes, and local groups. As Dr. Roland put it, “It was organized chaos.” They needed to quickly establish an infrastructure that could distribute and set up tents and supplies in each designated area and for medical teams to go door to door in the immediate area to see if anyone needed medical care.

Over the coming days, as supplies, tents, and distribution centers were set up, Dr. Rowland noticed that the most pressing need was for people’s medications. They needed their blood pressure medicines, diabetic supplies, antidepressants, and other drugs. It made him more aware of why Jase Daily (having a year’s supply of your prescription medication) existed. As founder and CEO of Jase Medical, he went over as a volunteer and came back, knowing that the mission of Jase Medical was to help people prepare in the event of any emergency or natural disaster.

When asked what people could do to help or donate, Dr. Rowland said that, for now, all their physical needs were being met. It will take months, if not years, for these people to be back in a home environment.

He suggests, in addition to charities, such as the Red Cross, that gift cards through a reputable source that can get directly to the people would be the best way to help them with their personal, everyday needs. He also advises exercising caution when donating. Opportunistic scammers come out and take advantage of others in times like these.

He reports that there was plenty of food, water, clothing, diapers, and other essential supplies for the time being. There will be an ongoing need for a long time, however.

Dr. Rowland plans to return in the coming weeks, and we will keep you posted.

To learn more about the Aerial Response Recovery group and their missions, please visit their website.

“Aerial Recovery trains and deploys Humanitarian Special Operators to effectively respond to natural disasters and man-made disasters and combat sex trafficking. Made up of Veterans and First Responders, Aerial tackles some of the most difficult rescue and response missions globally.”

Postscript

As of this writing,

Ninety-nine people were reported dead. The death toll is expected to climb by 10-20 more daily.
Names of those deceased and identified to start being released today (Tuesday, August 15)
According to Maui Police Chief John Pelletier, only 25 percent of Lahaina has been searched. They expect to complete the recovery process by the weekend.
According to Hawaii Electric, 80 percent of power has been restored.
Even though the power has mostly been restored, many families have no way to communicate with loved ones. Many people lost phones in the fire while fleeing for their lives, according to Governor Josh Green
This has been the largest loss of life to a fire in over a hundred years of US history.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Order Today

Join Our Newsletter

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Are You Happy? 7 Tips to Happiness

“Folks are usually about as happy as they make their minds up to be.” – Abraham Lincoln

“Happiness Happens Day” ,celebrated on August 8th of each year was founded by Pamela Gail Johnson. She started the Secret Society of Happy People in 1998, “to provide a missing voice for those who are happy and want to express it without having other people rain on their parade.” It is a day dedicated to recognizing and promoting happiness in our lives and encouraging people to share their positive moments and emotions. On her website she goes on to say, “We spend so much time focusing on our “what’s wrong” moments that we ignore many of our happy moments, so our happiness became a secret — even to us.”

Words that can describe happiness are:

Joy- a feeling of great pleasure
Contentment-A sense of satisfaction and being at peace with what one has.
Bliss- extreme happiness and joy
Fulfillment– A sense of achievement and satisfaction derived from reaching goals and aspirations.
Harmony- A sense of balance and alignment that contributes to inner happiness.
Serenity-A state of calm and tranquility that brings a peaceful happiness.
Optimism- A positive outlook on life- a belief that all will work out for the best

Happiness comes by focusing on the positive aspects of life, no matter how small or seemingly insignificant.

7 ways to nurture happiness in your own life

Fulfilling relationships and strong emotional connections

Fulfilling and close relationships keeps loneliness and isolation away. We are wired for connection.

Personal accomplishments- both great and small

Celebrate your personal accomplishments- no matter how small they are. Every great accomplishment is the result of placing one foot in front of the other (small accomplishments add up)

Cultivate gratitude

Gratitude- the act of being grateful for both the tangible and intangible. Research has repeatedly shown the strong correlation between gratitude and happiness. One way to practice gratitude is to start a daily gratitude journal and list 5 things, no matter how small that you are grateful for. Even the tea or coffee you are drinking while working on your journal is something to be grateful for. The journal can be as simple as a small notebook or pick up a gratitude journal that has daily affirmations and exercises to encourage you.

Limit negative influences in your life– Influences, such as tv, social media and even consistently negative people can dampen and make achieving personal happiness difficult to attain and maintain. Everyone has a “bad day” or experience; however, when possible, guard your thoughts and eyes from unnecessary drama. The “what ifs” on the tv or social media do nothing but prey on the fight or flight center of your brain. Analyze relationships and how they affect you. When possible, limit those relationships that cause unnecessary distress in your life.
Practice self-care- Self care can mean engaging in satisfying hobbies, time alone, lunch with a friend, a hot bath or anything that brings pleasure, and you look forward to doing. If you aren’t sure what to do, take time to really think about what brings you pleasure and satisfaction- and make time for it!
Help others- Helping others or volunteering, builds relationships and strengthens bonds , leading to a feeling of fulfillment.
Learn and practice resilience- Resilience is the ability to bounce back from setbacks and challenges. Cultivate resilience learning from failures and maintaining a positive outlook.

Being happy is linked to improved outlook of health

Studies have shown that being happy can have positive effects on physical and mental well-being.

Some ways in which happiness contributes to health:

Stress reduction- Happiness reduces stress. Chronic stress leads to increased cortisol levels. Chronically high cortisol levels can lower immune function, raise blood pressure, and contribute to raised blood glucose levels. Being happy counteracts the effects of stress.
Better lifestyle choices leading to longevity– When you are happy, you tend to eat better, are more motivated to exercise and connect with those in your life that you value. In fact, regular, consistent exercise produces mood enhancing endorphins.
There is a strong correlation between pain and emotions. Powerful pain-relieving endorphins- natural painkillers-are released while engaging in pleasurable activities. These endorphins reduce the perception of pain.
Happiness produces positive emotions– These emotions can promote resilience and help cope with the ups and downs of everyday life. Positive relationships are linked to improved mental health and overall cognitive function. In addition, problem solving abilities are enhanced when happy.
Happiness isn’t something that just “happens”. Personal responsibility and getting to know yourself- your genetics, overall health and personality, environment and abilities all play an important role in happiness. However, taking a proactive role in your personal happiness will yield a more fulfilled (and happy) life.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Order Today

Join Our Newsletter

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What Would You Do if Your Insulin Supply Was Disrupted for an Extended Length of Time?

If you have been diagnosed with insulin dependent diabetes you most likely have had extensive education on administration, use and storage of your insulin. However, in a grid down or emergency/supply chain disruption or while traveling, how you normally handle and store your insulin may not be available. Have a back up plan for safe storage and transport of your insulin- it could save your life. Always rotate and keep an ample supply of insulin on hand.

Proper insulin storage is essential to maintain its effectiveness and stability. Here are some detailed guidelines for storing insulin:

Storage and use of insulin – under normal, controlled conditions and emergency situations

Under normal conditions:

Ideal storage and temperature

According to all 3 manufacturers of insulin:

Unopened insulin vials or pens in use can be kept at room temperature (between 59°F to 86°F or 15°C to 30°C) for up to 28 days.
Store unopened insulin in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C).
Try to avoid excessive heat and direct sunlight. by storing in a temperature-controlled environment. Don’t store in a car or near heat source.
If insulin vial has been opened or diluted it must be used within 14 days.
If any type of insulin- in vial, powder or in an insulin pump freezes it becomes inert- freezing renders it ineffective. It will not work- do not use.
The American Diabetes Association offers these guidelines to tell if insulin has gone bad: “If you use regular, check for particles or discoloration of the insulin. If you use NPH or lente, check for “frosting” or crystals in the insulin on the inside of the bottle or for small particles or clumps in the insulin. If you find any of these in your insulin, do not use it, and return the unopened bottle to the pharmacy for an exchange and/or refund.”

Infusion pump sets have different parameters

According to the National Library of Medicine: “Insulin stored in the reservoir or infusion set of an insulin pump should be discarded after 72 hours, even if it is stored at the proper temperature.” In addition, discard if temperature reaches above 98.6 at any time it is in any part of the pump.

Emergency situations

It is strongly advised to follow manufacturers advice, but in a real, extended emergency situation use your discretion:

If you are unable to obtain refills for any reason- supply chain disruption, natural disaster preventing access to refills- you must use your judgement and discretion about using insulin exposed to excessive heat- or expired insulin.

If insulin freezes it becomes inert- freezing renders it ineffective. It will not work. DO NOT USE.
If your insulin is exposed to excessive heat, it degrades and can make it less effective. You may need more insulin than what you usually use.
According to the American Diabetic Association “Under emergency conditions, you might still need to use insulin that has been stored above 86°F”. Once you can refill insulin, discard insulin that has been exposed to extreme conditions.
Try to avoid excessive heat and direct sunlight. by storing in a temperature-controlled environment. Don’t store in a car or near heat source.
There are several anecdotal stories of people who have used insulin exposed to excessive heat and even used expired insulin when unable to get refills with some success.
If you are unable to obtain the insulin you normally use, consult your primary care provider and follow the FDA guidelines for switching between insulin types and manufacturers. Do this only if absolutely necessary.

Grid down and travel storage options

There are some options on the market that can help maintain acceptable temperature limits.

For completely off grid use:

Frio ice pack free insulin storage case

“The FRIO Insulin Cooling Case is a reusable evaporative cooler whose cooling properties do not come from an icepack – or anything that needs refrigeration. Its cooling properties come from the evaporation of water. When activated, it keeps its low temperature for a minimum of two days, even in temperatures of 100 degrees Fahrenheit.” The reusable pack can be reactivated indefinitely by soaking for 5-10 minutes in water. They offer many different styles and sizes to choose from. According to their website their product can stay cool five times longer than just ice packs.

Refrigerator needed:

Another option is a DISONCARE 60H 4 Insulin Pens Cooler Travel Case Medicine Cooler for Travel TSA Approved Diabetic Insulin Cooler. This type of cooler works after you place in the refrigerator for 6 hours, allowing the gel to cool. Its larger capacity keeps insulin pens and injectables cool for up to 48 hours. The drawback to this device is the requirement of needing a refrigerator for it to work.

Another option is one of the many plug into the car travel refrigerators. These run on the car battery and are very handy if you plan on being in your car during grid down or during travel. Given the many models and wide price range your best bet is to research and purchase one that would fit your needs. Just be sure to find one that can keep insulin within recommended temperature range without freezing.

For specific questions about your insulin and whether or not it can be used, contact the manufacturer:

(These 3 manufacturers represent over 90 percent of the US insulin market)

Lilly: 1-800-545-5979
Sanofi-Aventis: 1-800-633-1610
Novo Nordisk: 1-800-727-6500

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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