Insulin and syringes - storage and safety

INSULIN STORAGE

Insulin is sensitive to temperature and light. Sunlight and temperatures that are too hot or too cold can affect how well insulin works. This could explain changes in blood glucose control. Proper storage will keep insulin stable.

Your health care provider may suggest storing the insulin that you are using now at room temperature. This will make it more comfortable to inject.

Below are general tips for storing insulin. Be sure to follow the manufacturer's instructions for the insulin.

• Store opened insulin bottles or reservoirs or pens at a room temperature of 59°F to 86°F (15°C to 30°C).
• You can store most opened insulin at room temperature for a maximum of 28 days.
• Keep insulin away from direct heat and sunlight (do not keep it on your windowsill or on the dashboard in your car).
• Discard insulin after 28 days from the date of opening.

Any unopened bottles should be kept in a refrigerator.

• Store unopened insulin in the refrigerator at a temperature between 36°F to 46°F (2°C to 8°C).
• Do not freeze insulin (sometimes insulin can freeze at the back of the refrigerator). Do not use insulin that has been frozen.
• You can store insulin until the expiration date on the label.
• Always check the expiration date before using insulin.

For insulin pumps, recommendations include:

• Insulin removed from its original vial (for pump use) should be used within 2 weeks and discarded thereafter.
• 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.
• Discard insulin if the storage temperature goes above 98.6°F (37°C).

HANDLING INSULIN

Before using insulin (vials, pens, or cartridges), follow the instructions below:

• Wash your hands well.
• If you use a cloudy insulin, mix the insulin by rolling the vial between your palms.
• Do not shake the container as it can cause air bubbles.
• The rubber stopper on multi-use vials should be cleaned with an alcohol swab before each use. Wipe for 5 seconds. Let air dry without blowing on the stopper.
  

Before using, check the insulin to make sure it is clear. Do not use if the insulin is:

• Beyond its expiration date
• Unclear, discolored, or cloudy (Note that certain insulin [NPH or N] is expected to be cloudy after you mix it)
• Crystallized or has small lumps or particles
• Frozen
• Viscous
• Bad smelling
• The rubber stopper is dry and cracked

SYRINGE AND PEN NEEDLE SAFETY

Syringes are made for single use. However, some people reuse syringes to save costs and reduce waste. Talk with your health care provider before you reuse syringes to see if it is safe for you. Do not reuse if:

• You have an open wound on your hands
• You are prone to infections
• You are ill

If you do reuse syringes, follow these suggestions:

• Recap after every use.
• Make sure the needle touches only the insulin and your clean skin.
• Do not share syringes.
• Store syringes at room temperature.
• Using alcohol to clean the syringe may remove the coating that helps the syringe easily enter the skin.

SYRINGE OR PEN NEEDLE DISPOSAL

Safely disposing of syringes or pen needles is important to help protect others from injury or infection. The best method is to have a small 'sharps' container in your house, car, purse or backpack. There are many places to get these containers (see below).

Dispose of needles right after use. If you reuse needles, you should dispose of the syringe if the needle:

• Is dull or bent
• Touches anything other than clean skin or the insulin

There are different options for syringe disposal depending on where you live. These may include:

• Drop-off collection or household hazardous waste collection sites where you can take discarded syringes
• Special waste pick-up services
• Mail-back programs
• Home needle destruction devices

You can call your local trash or public health department to find out the best way to dispose of syringes. Or check out the US Food and Drug Administration webpage Safely Using Sharps -- www.fda.gov/medical-devices/consumer-products/safely-using-sharps-needles-and-syringes-home-work-and-travel for more information on where to dispose of syringes in your area.

Here are some general guidelines for disposal of syringes:

• You can destroy the syringe using a needle clipping device. Do not use scissors or other implements.
• Recap needles that have not been destroyed.
• Place syringes and needles in a 'sharps' disposal container. You can get these at pharmacies, medical supply companies, or online. Check with your insurer to see if the cost is covered.
• If a sharps container is not available, you may be able to use a heavy-duty puncture-resistant plastic bottle (not clear) with a screw top. Used laundry detergent bottles work well. Be sure to label the container as 'sharps waste.'
• Follow your local community guidelines for disposing of sharps waste.
• Never throw syringes in the recycle bin or loose in the trash.
• Do not flush syringes or needles down the toilet.

Diabetes - insulin storage

American Diabetes Association website. Insulin storage and syringe safety. diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-storage-and-syringe-safety. Accessed November 7, 2022.

US Food and Drug Administration website. Best way to get rid of used needles and other sharps. www.fda.gov/medical-devices/safely-using-sharps-needles-and-syringes-home-work-and-travel/best-way-get-rid-used-needles-and-other-sharps. Updated April 28, 2021. Accessed November 7, 2022.

US Food and Drug Administration website. Safely using sharps (needles and syringes) at home, at work and on travel. www.fda.gov/medical-devices/consumer-products/safely-using-sharps-needles-and-syringes-home-work-and-travel. Updated November 19, 2021. Accessed November 7, 2022.

US Food and Drug Administration website. Information regarding insulin storage and switching between products in an emergency. www.fda.gov/drugs/emergency-preparedness-drugs/information-regarding-insulin-storage-and-switching-between-products-emergency. Updated September 19, 2017. Accessed November 7, 2022.

Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.