b12 vials multiuse

[Purplegirl2]

my doctor prescribed my b12 as multiuse vials and I’m having trouble not bending the needle as I stick it in. I use insulin needles since I injection subcutaneously (it is the most comfortable way of receiving it). I am a little concerned about reusing the same vial multiple times with multiple needles. Should I ask for my dr to order single use vials instead? And does anyone know of needles I can buy (1ml) that have removable needles so I can use a thicker one to draw up the b12 from the vial and then replace with a thinner one to actually inject it? When I buy the insulin needles at the pharmacy they only come as individual non-removable needles and the specs are 8 mm length, 1 ml capacity and 31 G.

[Nackapan]

31G is too fine to draw up B12

27-30 G best for sc B12

Insulin is thinner and far less volume

I would definitely ask for single use B12 ampoules.

Much safer .

I think your doctor can look down the prescribing list further.!

I'm in the UK

I get single use 1mg/1ml hydroxcobalamin ampoules prescribed .

For some reason prescribing needles more difficult.

I buy them from medisave . Lots of places online .

Not bothered pushing for the needles.

I buy 21G for withdrawing the b12

A 2ml syringe

A 30G needle

1/2 " long

( needles compatible to syringes)

27-30G suitable

1/2" to 5/8" long.

Hope you get it sorted

[PinkPeony23 in reply to Nackapan]

I too get the vials, my GP has said I can’t get syringes and needles on prescription,?!

Very strange. Said I should see a pharmacist.

Will check out medisave.

[FlipperTD]

Scientist, not medic.

In my opinion, multi-use vials are best reserved for places with aseptic cabinets; ideally, hospital pharmacies. The risk of infection is simply too great. Life's difficult enough!

Nackapan's advice, as always, is very good.

Needles and syringes are made with a Luer taper, so they're easily interchangeable. Luer Lock syringes exist, and they're designed so that the needle won't fall off; they 'screw' into the syringe end. There is another taper, which is considerably smaller, [Record] but I doubt you'll find those anywhere other than museums.

Trying to aspirate through a 31g needle is, in the words of a late, old and wise colleague of mine, 'like trying to suck a tennis ball up a garden hosepipe.'

I'll leave you with that image!

[wedgewood]

Single use ampoules are obviously preferable to multi-use vials . But if you are unable to get them , you should be able to get I ml syringes ( luer lock are best ) Then you can use a coarse long needle to withdraw the B12 from the vial say 20G x 1 1/2 inches Then you can use a fine needle 30G x 1/2 inch for the sun-cutaneous injection

The same kit would be good to use if you manage to get the single use ampoules .

I don’t know which country you are in , but i think it’s not the U.K. , as I’ve never heard of a doctor prescribing B12 in a multi-use vial .

If you are in USA you can obtain needles and syringes from

allegromedica.com

bulksyringes.com

Single use ampoules of Cynocobalamin B12

from biosenseclinic.com

[Dwestgate]

i use the multiuse vials for cyanocobalamin in Canada with 30g 1/2” 1ml needles all in one (sol care 1000821m) without any problem. Ive never had a problem with the needle bending or problems injecting. I had more problems with switching needles frankly. Ive used these needles on two types of cyanocobalamin. I order the needles online.

[scnuke]

If you are using 1000 mcg/ml B12 and injecting 1ml, it is not advisable to use a 1ml(cc) syringe. Filling a syringe to max capacity is not recommended and can cause issues with the plunger since it is very thin. I would recommend a 3ml Luer Lock syringe with a 20 - 23g 1" needle to draw, then switch the needle to 25g 1" needle for IM injection or 28 - 30g 1/2" needle for subq injection. You don't mention the size of your vial, but a multi-use vial should not be used beyond 30 days after the first dose is drawn. (CDC recommendation is 28 days, but I say 30 for ease of keeping track.) If you inject daily, a vial will last a month, if EOD, you will use 15ml in a month and discard the remainder. You must be sure to store the B12 properly and swab the stopper with alcohol thoroughly before each use. Do not share your B12 with anyone else obviously. I have used the 30ml vials without problem for several years, but I have a vigorous injection routine (2x/day) and use it before the 30 day window. Single use vials reduce the risk of bacterial contamination, but for me it would require keeping 180 of them in my storage for a ninety day supply. I am formally trained in safe pharmaceutical handling and injection techniques, so I am comfortable using a multi-dose vial. I order my supplies from Amazon or a local medical supply house I have used through the years.

[Sunnysidoop in reply to scnuke]

Please could you explain how to store the multi use vial properly? Do you use an alcohol wipe to swab the stopper? Thank you

[scnuke in reply to Sunnysidoop]

Multi-use vials should always have the stopper swabbed with alcohol before each use. Hint: allow the alcohol to dry before drawing a dose as the alcohol can mix with the dose and cause more sting when injected, same with your skin if you use one before injection. After use, vials should be stored in a cool, dry place. Normal room temp is fine, up to 78 degrees, but follow manufacturers label directions. I store mine in a dresser drawer with no problems and I live in a very hot climate, but with AC at all times.

[Sunnysidoop in reply to scnuke]

Thank you. My doctor didn't tell me this. Is swabbing with an alcohol wipe sufficient?

[scnuke in reply to Sunnysidoop]

Yes, that's the standard method.

[Sunnysidoop in reply to scnuke]

Thanks so much

[Litatamon]

I have used multi-use vials for close to four years. No issues whatsoever. I mean there has to be precarious situations in the world where this has to be the norm on a daily basis. I am not suggesting anyone switch over from single-use - the obvious better choice, but I just don't think it is the acute danger it is made out to be.

Also, there is no way I would be able to keep up with the cost of single-use for my scheduling, grateful that multi-use vials are readily available and so cheap here in Canada. Every time I buy one I am shocked by the lack of greed.

(I have not been great at this lately but I used to always label and throw out at 30 days. If I even got to 30 days of course.)

[mcg-woo]

Hello! You should definitely use a larger gauge needle to draw as you don’t want to dull or bend the injection needle. Just swap the needles. I use 25X1 for IM and have used 23x1 for drawing but had some issues with needle top coming off during injection Just make sure it’s on really tight before injecting. I don’t swap needles anymore. If I’m careful, I can use the 25x1 without bending it. Saves a step. I have also used 1ml but since covid had to switch to 3ml because I’ve been unable to obtain 1ml. No problems.

I have used multi-use vials for over six years, no problems. Insulin vials are multi-use and diabetics use them all the time and have been doing so for many, many years. My mom is a type 1 and has used multi use vials for 50 years or so-no problems. And remember these patients are prone to not recovering well from infection so much more susceptible than others.

Single use vials are preferable if available—safer and potency is better preserved. If I had a choice I would want single use just because I think the strength degrades over time in multi use. On the down side—from my experience, it can be difficult to fully empty a 1ml vial. However, single use vials of hydroxo aren’t available in the US, so I use multi-use vials as only single use cyano is available here.

Wash your hands, use alcohol swab to clean top before needle insertion, refrigerate vial after opening and toss after 28 days and you’ll be fine. Good luck!

[Nackapan in reply to mcg-woo]

I'm really suprised type 1 diabetics using a multi vial still in some countries. Pen syringes and cartridges sk contained with a new needle used here in the UK for decades now.

B12 multi vials not even used at the surgery .

My friend in Canada uses singe use ampoules.

Does have cyanocobalamin as tried all of the sorts and she finds this just as effective and cheaper.

I have no problem emptying a single vial.

So glad prescribed here as I'd want a seperate medicine fridge otherwise as they do in s clinical setting.

The variation amazes me .

Suppose it's what we are taught and get used to.

[mcg-woo in reply to Nackapan]

Thanks for your response. It’s always nice to have different perspectives.

Are diabetics not using insulin pumps in the UK? I know that your healthcare system is very different from ours in the US and that pumps are very expensive—reserved for young and severe diabetics here.

My mom’s pump must be refilled with insulin every few days when it runs out. Multi-use vials of insulin are used to do that. Many, many years ago before she had a pump, she used multi use for injections. Even insulin has changed in her lifetime. It used to be sourced from animals and is now produced in a lab. Now there is also short and long acting insulin.

Times have certainly changed but here in the US multi-use insulin vials are quite common. Perhaps some diabetics use pens but my mom has never used such a device and so I’m unfamiliar with it?

[Wheat]

Hello, i use a multi use vial and insulin syringes every day for subcutaneous injections with no problem. I sterilize top of vial. Unlike single use ampules there is no broken glass or touching of sides and blunting needle, so I cannot see need to use two needle system. I can understand your concerns though. Also I was worried about bending such a fine needle and have found it takes pliers and force to remove needle from syringe body. Hope this helps.

[B12life]

are you in the US? If so, probably can't get single use vials. Reusable vials are plenty safe if you use the proper protocols of sterilizing the membrane before each withdrawal.

However not sure about needles that fine having replaceable tips. Medvet or other vet supplies suppliers may have what you need. Google if there is a needle that even exists first to find the name then you can s arch for where to buy them.