Novopen Echo issues

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Lucy12

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Hi,

My DSN recently gave me a Novopen echo to use instead of the novorapid flexpen that I was previously using, so that I’m able to give half units on insulin.

However I’m finding that sometimes there’s no insulin coming out of the needle. I’ve tried taking the cartridge out and putting it back in, and reattaching the needle which has worked a couple of times but not every time. It’s incredibly frustrating and stressful not being able to reliably get insulin from the pen. Luckily I still have a few flex pens so I do have a back up but these are only able to give full units not half units which isn’t ideal for me.

I’m just wondering if anyone else has this issue or whether I could be doing something wrong?

I’d be grateful for any advice!
 
Are you sure it isn't something wrong with the needles? I've been using NovoPen Echo for over 5 years and never had a problem like this with them, if the mechanism is ok then it shouldn't be a pen issue
 
Check that the plastic holder for the cartridge isn't cracked. Might be worth reporting it to Novo Nordisk.

I had one that was cracked which proved to be very erratic but other than that only had a few duff needles.
 
Hi, just wondering if you might be doing something wrong (maybe).

When you separate the top half of the pen from the bottom, you should see the plunger: this will be either fully recessed into the bottom half, or protruding, potentially a lot. If you have pushed the plunger back in, which you need to do when replacing an empty cartridge, then the pen needs "priming" to bring the plunger back up to push insulin from the cartridge. I select 4 units and watch, if no insulin repeat, until insulin squirts out.

I'm short sighted and have to watch carefully to confirm the insulin is flowing (or take my glasses off). Then I need to put them back on to see where I'm jabbing !!!

Once, I had 7 units left but needed 10. So I put in a new cartridge and kept the nearly empty cartridge for my next bolus. When I replaced the nearly full with the nearly empty cartridge the plunger was barely out of its housing and I had to wind the dose selection to max and plunge - about 9 times - seeing the plunger steadily emerge from the housing until I got it just in contact with the near empty cartridge. Then 2 units to prove flow and 5 units for my bosul. No waste (said smugly!).

The other thing is to make sure the needle is being fitted properly. I've had a few disposable pens fail to produce insulin and on close scrutiny I've found that the thin filament, that is concealed within the needle housing and gets screwed into the pen or cartridge, was bent - almost certainly because I'd screwed the needle on poorly and got it misaligned.

If none of this applies you probably have a duff pen. But you should have 2 NovoEcho pens anyway: one for use today and the other as an essential reserve, in case you have a pen failure! If you weren't provided with 2 pens from the outset then ask your GP to prescribe a 2nd as a matter of routine; in this case you need a 3rd, so you always routinely have 2 pens available. This is necessary safe practice, not a luxury. At some point your NovoEcho pen will inevitably fail, even if that isn't for 3 or more years. That fail moment is not the time to be waiting for a replacement from your pharmacy.

Good luck. Do let us know how you resolved things.
 
I’ve had one vial where I had issues but I just swapped it out and have never had any problems so it may be the vial not the pen. But yes you should always have a spare.
 
I've been using the Echo pens for years with no problems except one which finally 'broke'. Yes, the other post about the plunger is important. I always let the plunger get pushed back by the cartridge so it is ready to push on the cartridge.
 
Thanks everyone for all the quick replies!!

I’ve managed to sort it, the problem was the plunger being all the way pushed in so needed bringing back up! Glad it was my mistake not the pen being broken!
 
Have you been told to do an ‘air shot’ of a unit or two before each injection @Lucy12 ?

This allows you to see that the plunger is correctly in connection with the cartridge before you deliver your dose as you will see the drops of insulin flying out of the pen.

It’s important to do it before each dose, especially as the weather warms, as expansion and contraction in the heat can cause the bung and plunger to become minutely separated at random times during use.
 
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