More than 30 million Americans are living with diabetes, and around 7.4 million of them rely on insulin to keep their blood sugar levels in check. Unfortunately, obtaining insulin is not always easy. In recent years, insulin prices have skyrocketed, making it difficult for people without adequate insurance coverage or those with limited financial resources to afford it. Complex prescriptions and frequent visits to the doctor only add to the challenges. As a result, many individuals have started exploring alternative options such as over-the-counter (OTC) insulin.

In this article, you will learn about over-the-counter insulin, its differences from prescription insulin, and the essential considerations for safe and effective use. We will guide you through the pros and cons, storage and administration best practices, and scenarios where over-the-counter insulin may be viable.

Key Takeaways

  • Over-the-counter insulin is an accessible and cost-effective option for managing diabetes, especially for those with financial constraints or lacking insurance, as it is available without a prescription.
  • Over-the-counter insulin primarily consists of synthetic human insulin with a different action profile than modern insulin analogs. Due to its slower onset and variable peak times, it requires careful planning around meal times and monitoring of blood glucose levels.
  • Safe use of over-the-counter insulin necessitates close collaboration with healthcare providers. Due to its different characteristics compared to newer insulins, it’s crucial to receive proper guidance on dosage and administration to avoid complications like hypoglycemia.
  • Proper storage of insulin is essential for maintaining its effectiveness. Over-the-counter insulin should be stored in the refrigerator before opening and can be kept at room temperature afterward, with careful attention to expiry dates and visible changes in the insulin.
  • Over-the-counter insulin is a crucial alternative during emergencies, for uninsured patients, or when traveling. However, it should be used under medical advice to ensure it integrates safely into the individual’s diabetes management plan.

What Is Over-the-counter Insulin?

Over-the-counter insulin (OTC) is insulin that can be purchased without a prescription. It’s available for individuals who require insulin to manage diabetes, allowing easier and sometimes more affordable access compared to prescription insulin. In the United States, certain types of human insulin, such as regular, NPH (Neutral Protamine Hagedorn), and premixed versions, can be bought over-the-counter, primarily from older generations of insulin products.

Why Are People Turning to Over-the-counter Insulin?

A bottle of insulin with a syringe

People are increasingly opting for over-the-counter insulin due to the soaring costs associated with prescription insulin. The financial strain is particularly heavy for specific groups. For instance, uninsured patients, who lack the backing of an insurance plan to offset costs, find over-the-counter insulin a viable alternative. Similarly, individuals enrolled in high deductible health plans or those facing steep copay requirements also gravitate towards the more affordable over-the-counter options to manage their expenses better.

According to a study, the price of insulin nearly tripled from 2002 to 2013 with some costing up to $900 per patient per month, putting a significant financial burden on patients requiring insulin for diabetes management. Additionally, Medicare beneficiaries who enter the “donut hole,” a gap in prescription drug coverage where the patient is responsible for a larger portion of medication costs, may find relief in the lower-priced over-the-counter insulin to manage their blood sugar levels.

This group and others facing financial hurdles contribute to the increasing number of individuals seeking over-the-counter insulin as a cost-effective solution for diabetes management, highlighting the critical issue of insulin affordability affecting a wide swath of the population.

What are the Popular Over-the-counter Insulin Brands in the US?

Over-the-counter Insulin BrandsUS Price
Humulin RStarts at $93.72 per insulin pen
Novolin R$165.40 for 1, 10ML of 100UNIT/ML Vial
ReliOn insulin$24.88 per vial

How Does Over-the-counter Insulin Differ from Newer Insulins?

Over-the-counter insulin, also known as synthetic human insulin, works differently from the newer insulin analogs many patients use today. The main types of over-the-counter insulin include regular, short-acting insulin, and NPH, intermediate-acting insulin. A key difference lies in how these older insulins interact with the body compared to newer analogs. For instance, regular over-the-counter insulin requires about 30 to 60 minutes to start lowering blood glucose levels, meaning you need to plan your meals ahead of time to avoid high sugar spikes.

NPH insulin has a peak action time of around 6 hours after injection, which could lead to unexpected low blood sugar if you’re not prepared. In contrast, newer insulin analogs are designed to act more quickly or have a steadier effect with fewer peaks, closely mimicking the body’s natural insulin release. This means modern insulins can be more predictable and often provide tighter blood sugar control with less planning for meals or activities. Hence, while over-the-counter insulins can be a lifeline for accessibility and affordability, their use requires careful planning and monitoring to avoid fluctuations in blood sugar levels.

What Are the Pros and Cons of Using Over-the-counter Insulin?

A diabetic woman giving her self insulin injection

The chief advantages of over-the-counter insulin are its low cost and easy availability, which can be a lifesaver in emergencies or for those without access to prescription insulin. However, it’s not without risks, particularly for individuals with type 1 diabetes, who may find it harder to manage their blood sugar levels with these older forms of insulin. There’s a higher risk of low blood sugar (hypoglycemia), which can be dangerous over time, leading to serious health issues like seizures and cognitive impairment.

How Should You Use Over-the-counter Insulin Safely?

Using over-the-counter insulin safely is crucial and involves close collaboration with your healthcare provider or diabetes care team. Given that over-the-counter insulin behaves differently than prescription insulin, guidance from a medical expert is critical to tailor the right dosage for you. It’s not a simple switch; the timing, peak, and duration of action can vary significantly, necessitating adjustments to avoid complications such as hypoglycemia or hyperglycemia.

Before making any changes, discuss with your doctor why you’re considering over-the-counter insulin, whether due to financial constraints, travel, or emergencies. Your healthcare provider can offer tailored advice on how to integrate over-the-counter insulin into your current diabetes management plan, including how to adjust meal planning and timing, as well as advice on how to monitor your blood glucose levels more closely to account for the different action profiles of over-the-counter insulin.

Given the variability in individual responses to insulin, and considering factors like diet and lifestyle, it’s essential to approach over-the-counter insulin with careful planning and regular monitoring. There’s no one-size-fits-all recommendation for dosage, as it can widely vary among individuals based on their unique needs and how their bodies respond to insulin, highlighting the need for professional guidance and personalized management strategies.

What Are the Best Practices for Storage and Administration?

insulin bottle medication

The best practices for storing and administering over-the-counter insulin involve proper handling of the insulin vials and understanding how to use a syringe and vial for insulin injection. First, storing insulin vials in the refrigerator before their first use is crucial to maintain their effectiveness.

Once you’ve opened a vial, you may keep it at room temperature (below 86°F or 30°C) to avoid the discomfort of injecting cold insulin, but always check the insulin’s packaging for specific storage instructions, as recommendations can vary. An opened vial of insulin typically remains effective for up to 28 days when stored properly. However, this can differ depending on the type of insulin, so it’s essential to note the expiration date and any changes in the insulin’s appearance.

To administer insulin using a syringe and vial, start by washing your hands thoroughly. Then, if necessary, gently roll the vial between your hands to mix the insulin without creating air bubbles. Clean the top of the vial with an alcohol swab to ensure it’s free from contaminants. Next, draw air into the syringe equal to your insulin dose and inject the air into the vial; this helps prevent a vacuum from forming inside the vial.

Finally, turn the vial upside down, draw the required amount of insulin into the syringe, and check for air bubbles. If bubbles are present, gently tap the syringe to raise them to the top and push the bubbles back into the vial before readjusting the dosage. These steps help ensure accuracy in dosing and support effective diabetes management. Always follow the guidance provided by your healthcare team when handling and administering insulin to ensure your safety and well-being.

When Should You Consider Over-the-counter Insulin as an Option?

Over-the-counter insulin might be a viable option if you’re facing financial hurdles, in an emergency without access to your prescription, or traveling and running out of insulin. However, seeking professional medical advice is imperative even when turning to over-the-counter insulin under these circumstances.

The differences in action times, peak effects, and overall body behavior between over-the-counter insulin and prescription insulin analogs mean that switching to or starting on over-the-counter insulin without expert guidance could pose significant health risks.

Engaging with a healthcare provider ensures you understand the proper dosage, timing, and monitoring required when using these older insulin types. This professional oversight is crucial for safely incorporating over-the-counter insulin into your diabetes care plan, ensuring its use is tailored to your health needs.

Conclusion

Over-the-counter insulin is a crucial option for individuals managing diabetes, especially those dealing with accessibility or affordability issues with prescription insulin. While it serves as a lifeline for many, it is essential to approach over-the-counter insulin with a well-informed perspective, recognizing its distinctions from newer insulin formulations. The advantages of over-the-counter insulin, such as cost savings and enhanced access, need to be balanced against potential drawbacks like the need for more precise blood glucose monitoring and the chance of less predictable glycemic control compared to newer analogs.

Ensuring the safe use of over-the-counter insulin is of utmost importance. This involves comprehensive education on correct dosing, strict adherence to storage guidelines, and regular consultations with healthcare professionals to guarantee optimal diabetes management. By following best practices for administration and engaging in continuous self-education, individuals can effectively incorporate over-the-counter insulin into their diabetes care routine.

Like any other aspect of diabetes management, personal experiences with over-the-counter insulin will differ. Therefore, when contemplating over-the-counter insulin as an option, one should consider one’s specific health requirements and lifestyle in consultation with healthcare professionals. Ultimately, over-the-counter insulin is not just an alternative but a vital element of diabetes care for many, highlighting the significance of accessible, affordable, and safe solutions for diabetes management for everyone.

FAQs About Over-the-counter Insulin

Is there an over-the-counter insulin at Walmart?

Over-the-counter insulin is sold more often at Walmart than at other pharmacy chains, most likely because of its lower cost and patients’ inability to afford co-pays for prescription insulin

What is the insulin OTC available?

The two types of human insulin available over the counter are human insulin regular (Humulin R, Lilly; and Novolin R, Novo Nordisk) and human insulin NPH (Humulin N, Lilly; and Novolin N, Novo Nordisk).

Can I buy Humulin N over the counter?

Humulin N (human insulin) is available over the counter without a prescription. It is a type of insulin used to control blood sugar over an extended period, but finding the right dose for your body may take time.

In what states can you buy insulin over the counter?

In the United States, human insulins such as NPH and Regular insulin (and 70/30 mixtures) are available over the counter in every state except Indiana.

Can I buy Lantus insulin over the counter?

Lantus is solely available through a prescription. While there isn’t a generic version, there is a biosimilar called insulin glargine-yfgn, marketed as Semglee.

Is insulin glargine over the counter?

Insulin glargine requires a prescription for purchase. Only a licensed healthcare provider can authorize its use.

Can I buy Novolin R over the counter?

Novolin R and Humulin R, both brand-name forms of regular insulin, are accessible without a prescription from a healthcare provider. They are short-acting insulins, starting to work within about 30 minutes and lasting several hours.

Can you buy Humulin N over the counter?

Humulin N, a type of human insulin, is available over the counter without needing a prescription. It is used to manage blood sugar levels throughout the day, though finding the correct dosage may require adjustment.

Can I buy NovoLog over the counter?

NovoLog is a rapid-acting insulin analog requiring a prescription for purchase.

Sources

Yunusa, I. (2021, November 18). Fewer diabetes patients are picking up their insulin prescriptions – another way the pandemic has delayed health care for many. USC News & Events | University of South Carolina. https://sc.edu/uofsc/posts/2021/11/11_conversation_insulin.php

National Center for Biotechnology Information. (2020, January). Insulin insulated: barriers to competition and affordability in the United States insulin market – PMC. PubMed Central. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249113/