Keeping it cool
Before the first use, Byetta must be kept between 36F and 46F. When at home, your refrigerator should be fine for keeping your Byetta cool. There have been reports of some refrigerators having areas below 32F, and causing the Byetta to freeze, which ruins it. Once frozen and thawed, there will be no indication of a problem, but it is reported that the Byetta no longer does its job. I got a refrigerator thermometer and have it hung right above my Byetta.
Until approximately February 2007, Amylin/Lilly said that Byetta had to be kept at this temperature after its first use. Around this time, it was announced that, after the first use, during the 30 day usage period, Byetta may be kept at room temperature, not to exceed 77F.
This makes life simpler for Byetta users. However, away from home, in the summer, some cooling is likely to be required to keep the Byetta below 77F, as this temperature is easily exceeded by leaving the Byetta in the sun, especially in a car. Without air conditioning an indoor location might also exceed this temperature easily.
In light of this, I have continued to keep my Byetta in the same manner as I always have.
When away from home, there are several ways commonly used to keep Byetta cool.
The free travel pack
At http://www.byetta.com/welcome/ you can request a travel pack for free. It is a small cooler that contains two gel packs. It has a holder for the pen inside, and it is kept in the refrigerator.
The travel pack will keep your Byetta cool for two to three hours when the travel pack is not exposed to direct sunlight or kept in a hot environment. It's not a solution for the long term, but it is quite handy for quick trips out to a restaurant.
Extending the use of the Travel Pack
When I'm going to be gone longer than an hour or so, I put my Travel Pack in a cooler designed for a six-pack of cans, with a frozen gel pack on the top and the bottom of it.
I've never had trouble with the Byetta freezing, and this extends the cool time to more than eight hours under most circumstances.
A better cooler, perhaps one made of Styrofoam, would undoubtedly keep the Byetta cool longer.
Extending the use of the Travel Pack for a longer period of time
I get my Byetta from a mail order pharmacy (I hate it, but my insurance insists on it). They send the Byetta in a cute little Styrofoam container with a frozen cool pack at the top and bottom, the Byetta is in the middle, in a zip-loc bag, wrapped in bubble wrap. It's shipped overnight.
When it comes, the ice packs usually have just begun to soften up.
I saved one of these coolers to use on trips. There's not enough room to put the travel pack in in the same manner as the Byetta in the zip lock bag.
In fact, to fit it in at all, it has to be put in diagonally, on top of one of the cool packs. There's no room on the top for another cool pack. But there is room on either side of the travel pack to place two more cool packs in.
I've found that I could carry the Byetta for eight hours in the trunk of a car in the sun without the cool packs softening at all. I checked, and the Byetta does not freeze. I presume that it would stay cool for well over 24 hours using this method.
Thermos bottles
Several people have reported good success using thermos bottles to keep their pen cool.
They put a few ice cubes in a zip-lock bag, place it in the thermos, then slip in the Byetta pen, also in a zip-lock bag.
It has been reported that this method can keep the pen cool for approximately 24 hours.
Screw Top Ice Bags
A reader suggested that one purchase a screw-top ice bag and use it instead of cool packs. The advantage is that it can be refilled anywhere a source of crushed ice is available.
This sounds like an excellent idea, but the availability of such ice bags must be regional, s I can't seem to find any here in Kokomo Indiana. I haven't asked at a pharmacy yet, perhaps that might yield one.
Peltier Junction Coolers (12 volt refrigerators)
12 volt coolers are available for use in your car, or anywhere else there is a cigarette lighter style plug. These should do a good job so long as the temperature outside the cooler doesn't get too hot, they are usually rated by how much cooler the inside is from the outside. The hotter the environment, the hotter the contents. This could be a problem in a closed car on a summer day.
The MediCooler
At http://www.medicool.com/diabetes/diabetes_travel_protectallbc.html you can find a cool pack designed for Byetta. It keeps the contents between 36 and 46 degrees.
Eight hours of cooling time is claimed, more than twice that of the free Travel Pack.
Note that there are coolers out there designed for insulin. They would not stay cold enough for Byetta under the old regime, but should probably be investigated now that Byetta is approved for storage up to 77F after its first usage.
Polar Bear Coolers (MedCooler)
At http://www.medcooler.com/byetta.html there is another interesting cooler, one that claims to keep your Byetta cool for 24 hours in 100 degree heat. It also has a built in thermometer and freeze indicator.
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