Instructions for Patient Use - V-Go

Instructions for Patient Use - V-Go
Customer Care
1-866-881-1209
Using the V-Go™ Disposable Insulin Delivery Device
Instructions for Patient Use
Training on the V-Go is important. If you have not been previously trained, speak to a
Valeritas Customer Care Representative at 1-866-881-1209 before using the V-Go.
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Read the entire manual before operating the V-Go™ Disposable Insulin Delivery Device.
CONTENTS
Section 1 (Part 1): Introduction and V-Go Overview. . . . . . . . . . . . . . . . . . . . . . . 4
Healthcare professional prescribing considerations. . . . . . . . . . . . . . . . . . . . 4
Valeritas customer care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Liability disclaimer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Section 1 (Part 2): Before You Begin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Section 2 (Part 1): V-Go Operating Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . 7
V-Go product overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
EZ Fill product overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Aseptic technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Section 2 (Part 2): Filling the V-Go with Insulin Using the EZ Fill. . . . . . . . . . . . 10
Step 1: Remove the plug from the EZ Fill drawer. . . . . . . . . . . . . . . . . . . . . . . . . 10
Step 2: Place the V-Go into the EZ Fill. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Step 3: Place the insulin vial into the EZ Fill insulin vial holder . . . . . . . . . . . . . . 12
Step 4: Fill the V-Go with insulin. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Step 5: Remove the V-Go from the EZ Fill. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Step 6: Store the EZ Fill and unfilled V-Go devices
after each day’s V-Go filling session. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Step 7: Remove an empty vial of insulin from the insulin vial holder
and place a new vial of insulin into the insulin vial holder. . . . . . . . . . . . 16
Step 8: Dispose of the EZ Fill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
The V-Go Disposable Insulin Delivery Device should be used only by people who have been prescribed
the device, and only for intended use.
Section 2 (Part 3): Applying and Using the V-Go. . . . . . . . . . . . . . . . . . . . . . . . . 18
Step 1: Inspect the V-Go before you attach it to your body . . . . . . . . . . . . . . . . . 18
Step 2: Wash your hands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Step 3: Select and prepare the infusion site . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Step 4: Attach the V-Go. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Step 5: Start the 24-hour flow of insulin with the V-Go. . . . . . . . . . . . . . . . . . . . 23
Step 6: Bolus dose with the V-Go at mealtimes. . . . . . . . . . . . . . . . . . . . . . . . . . 24
Step 7: Monitor V-Go progress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Step 8: Remove the V-Go . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Step 9: Dispose of the V-Go . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Section 3: V-Go Safety Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Caution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Indication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Healthcare professional dosing considerations. . . . . . . . . . . . . . . . . . . . . . . 31
Warnings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Adverse reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Section 4: Product Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
EZ Fill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
V-Go . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Delivery accuracy test results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Section 5: V-Go User Assistance Information. . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Section 6: Troubleshooting/Frequently Asked Questions. . . . . . . . . . . . . . . . . . 41
Section 7: Glossary and Packaging Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Terms in bold and italic are explained in the glossary.
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SECTION 1 (Part 1): INTRODUCTION AND V-Go™ OVERVIEW
The V-Go provides a continuous subcutaneous insulin infusion over 24 hours. It uses
a preset basal rate for between-meal and nighttime insulin. The V-Go provides
on-demand bolus dosing to cover glucose intake at meals. The V-Go device is
convenient and easy to operate (see Section 3 for indication).
Here is how to use the V-Go:
• Fill the V-Go with insulin using the EZ Fill
• Attach the V-Go to a selected site (skin area)
• Push in the needle button to deliver the preset basal rate
• Wear the V-Go for one (1) 24-hour period
• Bolus dose at meals as prescribed by your doctor or healthcare professional
• At the end of the 24-hour period, retract the needle and remove the V-Go
from your body
• Discard the device after use (the V-Go is 100% disposable)
• Repeat these steps for the next 24-hour period using a new V-Go
Healthcare Professional Prescribing Considerations
Dosing considerations
• When selecting a V-Go option, healthcare professionals should refer to their
own experience when initiating continuous subcutaneous insulin infusion
therapy with a patient. If unfamiliar, the healthcare professional should refer to
insulin therapy guidelines from diabetes associations.
• The following should be considered when initially prescribing the V-Go:
−− Understand the total daily dose of insulin your patient is actually taking with
their current insulin regimen versus what is being prescribed. Selecting the
correct V-Go option may lessen the risk of hypoglycemia (low blood sugar).
−− It is common practice to reduce the total daily insulin dose when starting
a patient on continuous subcutaneous insulin infusion therapy and this
reduction should be considered when starting a patient on the V-Go.
Other prescribing considerations
• A separate prescription of a U100 fast-acting insulin is required for use with
the V-Go (see Section 3 for insulins tested with the V-Go).
−− Two (2) vials of insulin are required for the V-Go 20 option.
−− Three (3) vials of insulin are required for the V-Go 30 and 40 options.
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The V-Go comes in 3 options for your insulin needs. Your doctor or healthcare
professional has selected the most appropriate V-Go option for you.
The 3 V-Go options are:
• −− 20 Units/24 hr (0.83 U/hr) basal rate and up to 36 Units of on-demand bolus
dosing in 2-Unit increments*
• −− 30 Units/24 hr (1.25 U/hr) basal rate and up to 36 Units of on-demand bolus
dosing in 2-Unit increments*
• −− 40 Units/24 hr (1.67 U/hr) basal rate and up to 36 Units of on-demand bolus
dosing in 2-Unit increments*
*36 Units of insulin are available for on-demand bolus dosing in all V-Go options.
Bolus doses are delivered in 2-Unit increments. You can only push the bolus
delivery button 18 times in every 24-hour period. Each push of the bolus
delivery button delivers 2 Units of insulin (1 push = 2 Units).
IMPORTANT: A separate prescription for insulin is required for use with the
V-Go. A U100 fast-acting insulin should be used to fill the V-Go. (See Section 3
for insulins tested with the V-Go.)
• V-Go 20 requires two (2) vials of insulin
• V-Go 30 and 40 require three (3) vials of insulin
IMPORTANT: Let your healthcare professional know how much insulin you
actually take each day. Your healthcare professional will help select the correct
V-Go option for you.
The correct V-Go option may lessen the risk of hypoglycemia.
IMPORTANT: A V-Go Disposable Insulin Delivery Device that has been properly
prescribed and used will deliver your insulin needs. Wear each V-Go for a full
24-hour period, including while you sleep.
IMPORTANT: Do not use other insulin products while on V-Go therapy.
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Valeritas Customer Care
SECTION 2 (Part 1): V-Go OPERATING INSTRUCTIONS
If you have any questions about using the V-Go™ or EZ Fill, speak to a Valeritas
Customer Care Representative 24/7 at 1-866-881-1209.
If you have a medical emergency while using the V-Go, call 911, your doctor, or go
directly to the hospital.
Liability Disclaimer
Valeritas does not give medical advice about insulin therapy. Discuss all medical
therapies with your healthcare professional.
IMPORTANT: Understanding the button names and locations is important for the
successful use of the V-Go and EZ Fill.
V-Go Product Overview
Button Cover
SECTION 1 (Part 2): BEFORE YOU BEGIN
Step 1: Remove the EZ Fill from the blister packaging
A.Turn the packaging over so you can read the text.
B.Peel back on the lower right corner.
C.Remove the EZ Fill.
Step 2: Remove the V-Go from the blister packaging
A.Turn the packaging over so you can read the text.
B.Peel back on the lower left corner on one of the
V-Go containers.
C.Remove the V-Go. Do not pull on the adhesive tab
while removing the V-Go from the container.
Bolus
Ready
Button
Insulin Port
Viewing Window
Grey Indicator
Bolus Delivery Button
Needle
Button
NOTE: Only remove one (1) V-Go every 24 hours to fill, apply, and use. Leave the
rest in their containers until you are ready to use them.
Adhesive Pad
and Liner
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Needle Release Button
• Button Cover: Covers the needle button.
Prevents the needle button from being pushed
in. Cover must be removed for V-Go to operate.
• Insulin Port: Location where insulin enters the
V-Go through the EZ Fill.
• Bolus Ready Button: A grey button that lies
flat on one of the long edges of the V-Go. When
activated, it releases the bolus delivery button.
This allows for bolus dosing of insulin.
• Bolus Delivery Button: A grey button next to
the insulin port on one of the short edges of the
V-Go. When pressed after the bolus ready button
activates this button, the V-Go delivers a bolus
dose of 2 Units of insulin (1 push = 2 Units).
• Viewing Window: Shows a view of the insulin
reservoir. A grey indicator in the window
demonstrates that insulin is flowing from the
device.
• Needle Button: When pressed, it inserts the
needle into your skin and begins the flow of
insulin into your body.
• Needle Release Button: A wide white button
with 3 ridges on one of the long edges of
the V-Go. An activated needle release button
removes the needle from your body and stops
the V-Go from delivering insulin.
• Adhesive Pad and Liner: Once the protective
adhesive liner is removed, the adhesive pad
affixes the V-Go to your skin.
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EZ Fill Product Overview
EZ Fill Top
Finger Groove
Insulin Supply Window
Insulin Vial Holder
Plunger
Grip
Use aseptic technique when you are preparing, filling, and attaching a new V-Go.
Drawer
Cap
Ribbed Drawer Handle
Plug
EZ Fill Bottom
• Cap: Protects the needle inside the EZ Fill (bottom of insulin vial holder).
• Finger Groove: Opening to allow for easy removal of the insulin vial.
• Insulin Vial Holder: Opening in the EZ Fill where the insulin vial is placed
upside down.
• Insulin Supply Window: Shows a view of the insulin remaining in the insulin vial.
• Plunger: When you pull this handle slowly up (about 5 seconds) and then push
it down (about 25 seconds), insulin transfers from the vial into the V-Go™.
• Grip: The left thumb occupies this groove throughout most of the
filling process.
• Drawer: The V-Go is placed in this drawer for filling. The plug sits in the
drawer when the EZ Fill is not in use.
• Ribbed Drawer Handle: A grooved piece at the bottom end of the EZ Fill
that helps with opening and closing the drawer.
• Plug: When placed in the drawer, the plug protects the EZ Fill components
between each fill.
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Aseptic Technique
Aseptic technique helps keep the V-Go and the EZ Fill devices clean during
preparation, filling, and application. Following this technique requires hand-washing
and wiping the application site with an alcohol swab. It may involve wiping the V-Go
device with an alcohol swab if the device comes into contact with anything else.
1.Inserting a needle into your skin creates an opening where germs can enter
your body. This could cause an infection at the infusion site. Always use aseptic
technique. The V-Go, EZ Fill, and other supplies come to you sterilized. To keep
them that way, follow these precautions:
a.Always wash your hands thoroughly before preparing, filling, and attaching
the V-Go.
b.The infusion needle is sterile and protected within the V-Go. Do not touch the
underside of the V-Go after you remove it from the sterile blister packaging.
If you place the V-Go on a surface, do not let the underside touch that surface.
Gently lay the V-Go on the front side of the device.
2.If the underside of the V-Go touches something, you must wipe the underside
with an alcohol swab.
3.Do not touch the circular opening on the top of the EZ Fill plug. If you place the
plug on a surface, do not let the circular opening touch that surface. If the
circular opening touches something, you must wipe the circular opening with
an alcohol swab.
4.Wipe the infusion site of your skin with an alcohol swab. Let the alcohol dry
before you attach the V-Go. Do not touch this site again before putting the V-Go
on your skin.
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SECTION 2 (Part 2): FILLING THE V-Go™
WITH INSULIN USING THE EZ FILL
IMPORTANT:
The EZ Fill is intended to fill one (1) V-Go each day.
Use the EZ Fill to fill 30 V-Go devices, one (1) V-Go each day. Then discard the
EZ Fill after 30 fills.
A new EZ Fill will be included in each month’s supply of V-Go devices.
Do not fill and store V-Go devices ahead of time. That may result in the loss of
insulin effectiveness.
Remove the EZ Fill from the refrigerator, allowing the insulin to reach room
temperature (about 20 minutes) before filling the V-Go.
Step 2: Place the V-Go into the EZ Fill
A.Hold the EZ Fill so that the plunger is on the top
right side of the EZ Fill.
B.With your other hand, place the V-Go into the
EZ Fill drawer upside down. Place the adhesive
side facing up with the plastic tab toward the
bottom of the EZ Fill. The button cover should be
facing down into the drawer and toward the top of
the EZ Fill.
C.Slide the V-Go up into the EZ Fill drawer. Press
the V-Go flat with the top of the drawer. Hold the
V-Go down with your thumb.
• Make sure that the adhesive backing on the
V-Go fits inside the drawer.
Step 1: Remove the plug from the EZ Fill drawer
NOTE: On day 1 when you remove the EZ Fill from the packaging, the plug will
be separate from the EZ Fill; therefore, you can skip Step 1.
A.Place your thumb over the plug tab and your
forefinger underneath the ribbed drawer handle.
Pull the drawer out until it stops. The plug will
pop up from the drawer.
B.Lift the plug out of the EZ Fill using your thumb
and forefinger. Set the plug aside. You will
replace the plug into the EZ Fill after you fill
the V-Go with insulin.
D.Push the drawer all the way closed.
IMPORTANT: Shut the EZ Fill drawer only when
the V-Go is completely inside the drawer. The
drawer is shut when it cannot be pushed any
further forward or in.
IMPORTANT: People should not touch the circular opening on the top of the plug.
Touching the circular opening may compromise the sterility of the EZ Fill.
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Step 3: Place the insulin vial into the EZ Fill insulin vial holder
NOTE: Before placing a new vial into the EZ Fill, check to make sure the insulin
vial is not expired and that it will not expire during the time period that the vial
will be used in the EZ Fill.
A.Remove the protective cap from the insulin vial.
Wipe the top with an alcohol swab.
Step 4: Fill the V-Go with insulin
A.Hold the EZ Fill upright over a counter or table by placing your thumb across the
grip. The grip is just below the insulin vial holder and the plunger. Use the rest of
your hand to support the back of the EZ Fill.
• Do not block light from the back of the EZ Fill. Light from the back will help you
see the viewing window.
NOTE: Keep the EZ Fill in a vertical, fully upright position during filling.
Keep the viewing window at eye level. Direct the backside of the EZ Fill toward
a brightly lit area when you fill the V-Go. This makes it easier to see the flow of
insulin. Seeing the flow of insulin helps you fill the V-Go properly and completely.
B.Slowly pull the plunger up to its full upright
position with your free hand and wait 5 seconds.
B.Pull the EZ Fill cap out of the insulin vial holder
and discard.
IMPORTANT: Make sure you slowly pull the
plunger up as far as it can go.
C.Make sure the viewing window is at eye level so
you can watch the V-Go fill with insulin.
Check
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C.Turn the insulin vial upside down so the top of the
vial faces downward.
D.Place the insulin vial into the EZ Fill. Push the
vial firmly straight down into the insulin vial
holder until you feel it attach and you cannot
push it further.
E.Check the insulin supply window to make sure
there is enough insulin to fill the V-Go™.
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D.Slowly and steadily push the plunger down over
a minimum of 25 seconds to fill the V-Go™ with
insulin.
• The V-Go should be filled with insulin in a
continuous flow of droplets, not in a solid,
steady stream. Make sure you don’t fill the
V-Go with a steady stream of insulin. If you
push too fast or too hard the insulin will
become foamy. Foamy insulin may lead to an
incomplete fill. If the insulin turns foamy, push
the plunger more slowly.
IMPORTANT: Watch the insulin fill the V-Go to make sure you get a complete fill.
E.Push the plunger until it is all the way down.
• When the position of the plunger is all the way down, the V-Go should be full.
IMPORTANT: Make sure the V-Go fills with insulin in a continuous flow of
droplets, not in a solid, steady stream. Make sure the insulin is not foamy.
Foam will not damage the V-Go or the insulin, but may lead to an incomplete
fill of the V-Go.
Step 5: Remove the V-Go from the EZ Fill
A.Hold the EZ Fill in a sideways position.
B.Pull the EZ Fill ribbed drawer handle all the way
out. Pull until the V-Go pops up from the drawer.
C.Remove the filled V-Go from the EZ Fill by lifting it
up with your thumb and forefinger.
• Leave the plunger in the down position.
REMINDER: Fill only one (1) V-Go each day. Fill
the V-Go on the day you use it, and attach the
V-Go to your skin immediately after filling it
with insulin.
Count to about 25 seconds when you push the plunger down to make sure the
V-Go is filled with insulin.
F. Check that the V-Go is filled properly. Ideally you should see only fluid and no air
space. You may see tiny air bubbles smaller than a grain of rice.
• If the V-Go is not filled fully, check to see if you still have insulin in your vial.
−− If you do not, replace vial (Step 3) and repeat Step 4A to 4F.
−− If you do, repeat Step 4A to 4F.
IMPORTANT: Make sure the V-Go is completely full of insulin before removing from
the EZ Fill. If the V-Go does not appear completely full, repeat Step 4A to 4F.
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Step 6: Store the EZ Fill and unfilled V-Go™ devices after each day’s
V-Go filling session
A.Grasp the vial along the finger and thumb grooves.
Pull up the vial to remove it from the EZ Fill.
A.Place the plug back into the EZ Fill. Follow the
directions for filling Step 2A to 2D. This time use
the plug and not a V-Go.
NOTE: Do not remove the insulin vial from the
EZ Fill. The insulin vial should be removed only
when the vial is empty.
B.To place a new vial of insulin into the EZ Fill,
follow filling Step 3A to 3E.
IMPORTANT: To make sure the EZ Fill remains
sterile:
• Replace the plug after each fill.
• Wipe the circular opening on top of the plug
with an alcohol swab before placing the
plug back into the EZ Fill.
Step 8: Dispose of the EZ Fill
B.Store the EZ Fill with the insulin vial and plug attached in a clean, dry area of
the refrigerator between each fill. Store unfilled, unused V-Go devices in a dry,
safe place until your next fill. Please refer to Section 4 for additional storage
information.
Additional Steps
Step 7: Remove an empty vial of insulin from the insulin vial holder and place
a new vial of insulin into the insulin vial holder
NOTE: Before placing a new vial into the EZ Fill, check to make sure the insulin
vial is not expired and that it will not expire during the time period that the vial
will be used in the EZ Fill.
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A.After the 30-fill use period, discard the EZ Fill, with
the insulin vial attached, according to local disposal
requirements. The insulin vial should be discarded
even if there is insulin remaining in the vial.
IMPORTANT: The EZ Fill is only intended to fill a
30-day supply of V-Go devices (1 V-Go per day).
A new EZ Fill will be provided with each monthly
prescription of the V-Go.
Do not use the same EZ Fill for more than
30 fills.
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SECTION 2 (Part 3): APPLYING AND USING THE V-Go™
Step 1: Inspect the V-Go before you attach it to your body
A.Look at the entire viewing window to make sure
that the V-Go has been filled completely with
insulin. You should see only fluid and no air space.
}
Viewing
Window
B.Rotate the V-Go and look in the viewing window. The viewing window will show
you if there are any large air bubbles.
IMPORTANT: If you see air bubbles larger than a grain of rice, the V-Go may
not be filled completely. Repeat Step 4A to 4F in Section 2 (Part 2) to ensure a
complete fill.
Having a few small bubbles is normal and harmless.
As discussed in Section 2 (Part 2), you should slowly and steadily push the
plunger down for about 25 seconds to reduce air bubbles as you fill the V-Go.
C.When the insulin is full in the viewing window, you are ready to attach the V-Go to
your body.
IMPORTANT: To receive your total 24-hour dose of insulin, always start with a
V-Go that has been completely filled with insulin.
Do not attach a partially filled or empty V-Go to your body. If the V-Go is not filled
completely with insulin, repeat Step 4A to 4F in Section 2 (Part 2).
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Step 2: Wash your hands
Always wash your hands thoroughly before preparing the V-Go for use. Use aseptic
technique when you are preparing and applying a new V-Go. See the end of
Section 2 (Part 1) for a description of aseptic technique.
Step 3: Select and prepare the infusion site
IMPORTANT: The place on your body where you attach the V-Go is important for
the success of your therapy. Choose a location that remains flat when you are
sitting down, standing up, or lying down. Discuss the best location for you with
your doctor or healthcare professional.
A.The V-Go can be worn any place that insulin can
be injected or infused. Insulin is injected or
infused into the subcutaneous tissue.
• You may wish to attach the V-Go:
−− On the abdomen. The abdomen has ample
flat surface area, and is an accessible and
comfortable location. Insulin absorption
is fast, predictable, and less affected by
exercise when administered through
the abdomen.
If the V-Go is worn on the abdomen,
keep it horizontal above the belt line.
−− On the backside of the arm, not on the
muscle.
If the V-Go is worn on the backside of the
arm, keep it in the up and down direction.
Make sure you can see the grey indicator
in the viewing window directly by rotating
your arm, or indirectly through the use
of a mirror. Attach the V-Go in the up and
down position as your arm hangs down.
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B.When choosing the location for the V-Go™, consider the following:
• Make sure you are able to view the grey indicator in the viewing window,
either directly or indirectly through the use of a mirror.
• That you can comfortably reach the V-Go and all of the buttons, for easy
operation and removal.
• That you apply the V-Go to a flat area of skin, not on a fold of the skin, muscle,
or bone.
• That the site is flat when you are in any of the following positions: sitting down,
standing up, or lying down.
C.When choosing the location for the V-Go,
avoid the following:
• The belt line or waistline, or other areas where
clothing may rub or constrict.
• Areas with excessive hair. You may shave the
area to help the V-Go attach to your skin.
• Areas that are curved or rigid due to muscle
or bone.
• Areas within a 1-inch circle around the belly
button or surgical scars.
• Skin that is tender, bruised, red, or hard or has any skin disease or infection.
NOTE: If you have sensitive skin or your skin becomes irritated, ask your doctor
or healthcare professional about skin barrier products.
D.Clean the area where you will attach the V-Go with
an alcohol swab.
• The alcohol swab will remove all lotions and
oils. Let the area dry. This helps the adhesive
stick properly to the skin.
• Practice aseptic technique as described in
Section 2 (Part 1).
Step 4: Attach the V-Go
Actions in this step describe how to attach the V-Go to your abdomen. As noted in
Section 2 (Part 3) Step 3, there are a couple of places you can attach the V-Go.
A.Practice placing the V-Go before you actually remove the protective liner.
Practice helps you to make sure you can reach and operate the bolus ready
button, bolus delivery button, needle button, and needle release button.
• To practice with your right hand, hold your thumb on the needle release button,
your index finger near but not on the bolus delivery button, and middle finger
near the bolus ready button.
• Hold the V-Go on the selected body site to make sure that you can reach all
necessary buttons when you wear the V-Go.
Now you are ready to attach the V-Go.
IMPORTANT: Be careful not to press any buttons when you practice attaching
the V-Go.
NOTE: Change the location of the V-Go slightly every 24 hours. Needle insertion
sites should be at least 1 inch away from the last site.
This may mean moving it from the right to the left side of the abdomen. It
does not require attaching the V-Go on the abdomen one day then on the arm
the next.
20
21
B.Remove the button cover.
1.Hold the V-Go™ with one hand and pull the
button cover with the other hand. Pull the button
cover in a quick, straight direction up and away
from the V-Go.
Pull
Cover Pin
2. Check to see if the cover pin came off with the
button cover.
• If the cover pin is not attached and has
remained inside the V-Go, try to remove the
pin manually; otherwise discard this
V-Go and start over with a new V-Go.
D.Without touching the adhesive pad, press the
V-Go against the skin at the cleaned needle
infusion site.
E.Hold the V-Go in place for 5-10 seconds. Run your
finger around the entire edge of the adhesive pad
to make sure it is attached to your body. Do not
accidentally press any of the buttons.
NOTE: When you apply the V-Go to the abdomen,
attach the V-Go horizontally at a slight downward
angle. This allows any tiny air bubbles to travel
away from the needle.
Step 5: Start the 24-hour flow of insulin with the V-Go
Press down on the raised bump of the needle button
with one firm quick motion. Needle button needs to
be pressed completely into the V-Go until you hear a
click or button locks in place. This begins the flow of
insulin. The V-Go delivers a continuous preset basal
rate of insulin over 24 hours.
IMPORTANT: If you bend the button cover
backwards, as you would a soda pop can top,
you could damage the V-Go.
Press
C.Lift the adhesive tab and completely peel off the
adhesive liner from the bottom of the V-Go.
Removing the liner exposes the adhesive.
1.Do not touch the adhesive surface. Touching
the adhesive surface can reduce the strength
of the adhesive.
2.Keep the adhesive pad intact and clean before
you place it on the infusion site.
22
NOTE: Grasp the side of the V-Go as you press
the raised bump of the needle button to keep the
V-Go in place.
Be careful not to press any other buttons during
this process.
Locked
Needle
Button
IMPORTANT: Needle button must lock in place to
begin the flow of insulin.
23
A.To administer 2 Units of insulin at mealtime:
1.Slide your finger with pressure to locate and
press the bolus ready button on the long edge
of the V-Go.
IMPORTANT: Avoid exposing the V-Go™ to direct sunlight. Avoid extremely hot
temperatures. Remove the V-Go prior to hot tub, whirlpool, or sauna use and
replace with a new filled V-Go afterward.
IMPORTANT: If the needle button does not fully depress or does not remain in
the down position, the V-Go cannot function. You will not receive the preset basal
rate of insulin. Do not use the V-Go if the needle button does not stay down.
Remove and discard that V-Go. Start over with a new V-Go.
Once the needle button is pushed down and locks into place, insulin is now
flowing into your body. The needle within the V-Go remains in your body for the
entire 24-hour use of the V-Go. The V-Go design helps to minimize discomfort.
Slide with Pressure
• The bolus delivery button located at the
end of the V-Go will pop out. You will hear
a click.
Pop Out
IMPORTANT: Stop all your previous insulin injections and do not use any other
insulin in conjunction with the V-Go Disposable Insulin Delivery Device.
NOTE: You should check the area around the V-Go at regular intervals for
redness, irritation, and inflammation.
Needle Release Button
Step 6: Bolus dose with the V-Go at mealtimes
Your doctor or healthcare professional should have instructed you on how and when
to use the V-Go and how many bolus doses to administer at mealtimes. Consult your
doctor or healthcare professional if you have questions regarding your specific bolus
dosing needs.
IMPORTANT: Each V-Go has a total of 36 Units of insulin available for on-demand
bolus dosing per 24-hour period. The 36 Units of insulin can only be delivered in
2-Unit increments (1 push = 2 Units). You can only push the bolus delivery button
18 times in every 24-hour period. After 18 uses, the bolus delivery button will
pop out and lock, preventing further bolus doses. Plan your day so that you have
enough insulin for each meal.
24
Push
2. Push the bolus delivery button all the way into
the V-Go until it stops. You will hear another
click.
• You have just delivered 2 Units of insulin
(1 push = 2 Units).
IMPORTANT: Do not touch the needle release
button (button with ridges) while giving yourself
bolus doses. This may cause you to retract the
needle before the end of its 24-hour use and stop
the delivery of insulin to your body. If this occurs
and the needle button pops out, remove the V-Go
and replace it with a new one.
25
B.Repeat Step 6A until you reach the number of bolus doses prescribed by your
doctor or healthcare professional for that specified time.
NOTE: Each push of the bolus delivery button delivers 2 Units of insulin
(1 push = 2 Units).
IMPORTANT: If you do not know the number of insulin units you have just delivered
or if you lose count, STOP bolus dosing, monitor your blood glucose, and follow the
plan agreed upon with your doctor or healthcare professional. If you have not agreed
upon a plan already, consult your doctor or healthcare professional for guidance.
IMPORTANT: If the bolus ready button or bolus delivery button does not press
in or does not click when pressed, you may have used all of the available bolus
doses. If you require additional bolus doses, do not continue to use this V-Go™.
Replace it with a new filled V-Go.
Step 7: Monitor V-Go progress
A.While wearing the V-Go, you should check your blood glucose at regular
intervals to make sure the V-Go is working properly. Refer to Section 3 for
recommendations on blood glucose monitoring.
B.You can also check the movement of the grey
Grey Indicator
indicator in the viewing window to make sure
the V-Go is working properly. After several hours,
you should see a slight change in the location
of the grey indicator as it moves toward the
needle button.
• The exact location of the grey indicator will
vary based on the number of bolus doses you
have used.
26
IMPORTANT: The indicator moves very slowly over the 24-hour period. It will
take time to notice the change in the indicator location.
Monitoring the V-Go progress is important to make sure the V-Go is delivering
insulin. If the indicator does not appear to be moving after several hours of wearing
the V-Go, consider checking your blood glucose levels. If your levels are abnormally
high after normal V-Go use as prescribed by your doctor or healthcare professional,
you should remove the V-Go and replace it with a new one.
Step 8: Remove the V-Go
IMPORTANT: After 24 hours of use it is time to replace the current V-Go with
a new filled V-Go. Remember to fill the V-Go with insulin using the EZ Fill, and
attach the V-Go to your skin immediately after filling.
The V-Go is meant to be worn for 24 hours only. Establishing a daily routine will
help remind you to change the V-Go every 24 hours.
A.Start by filling a new V-Go with insulin. Follow previous instructions in
Section 2 (Part 2) Steps 1 to 6.
• Make sure the V-Go is completely filled with insulin before you attach.
B.Set the new filled V-Go aside until you remove the used V-Go from your skin.
NOTE: Do not block the needle button with your finger or any part of your hand
or clothing while releasing the needle via the needle release button.
27
Slide
C. To remove the used V-Go™, place thumb on the
ridged section of the needle release button. Slide
the needle release button along the side of the
V-Go. In a continuous motion, press the needle
release button directly into the V-Go until you
hear a click. This motion retracts the needle.
E. To remove the V-Go from your skin, run a finger
under an edge of the adhesive pad.
Lift
F. Press lightly on the skin adjacent to the V-Go with
one hand and peel the V-Go away from your skin
with the other hand.
Press
Peel
D.At this point the needle button will pop out
automatically.
Pop Out
NOTE: After you remove the V-Go, the adhesive
may leave behind a sticky residue. Use warm
soapy water and roll your finger around the
attachment site. This motion will remove the
sticky adhesive residue.
You could use a medical adhesive remover
instead. Ask your doctor or healthcare
professional to recommend an adhesive remover.
Step 9: Dispose of the V-Go
Discard the used V-Go according to local disposal requirements.
NOTE: When used as directed, the V-Go needle
is never exposed. It comes out only when the
device is attached to the skin. After use, the
needle is retracted back into the V-Go and locked.
Once retracted, the V-Go needle is completely
contained/covered.
Check to make sure the needle is retracted. If it is
not, repeat Step 8C prior to disposal of the V-Go.
28
29
SECTION 3: V-Go™ SAFETY INFORMATION
The V-Go is a safe and reliable device. As with many medical devices, you must be
aware of safety-related issues to make sure that you are using the V-Go correctly.
Always consult with your doctor or healthcare professional if you have any questions
regarding the functions and operation of the V-Go.
Caution
Federal (United States) law restricts this device to sale by or on the order of a
physician or properly licensed practitioner (prescription only).
Indication
V-Go 20:
The V-Go Disposable Insulin Delivery Device is indicated for continuous
subcutaneous infusion of 20 Units of insulin in one 24-hour time period (0.83 U/hr)
and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour
time period) in adult patients requiring insulin.
V-Go 30:
The V-Go Disposable Insulin Delivery Device is indicated for continuous
subcutaneous infusion of 30 Units of insulin in one 24-hour time period (1.25 U/hr)
and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour
time period) in adult patients requiring insulin.
V-Go 40:
The V-Go Disposable Insulin Delivery Device is indicated for continuous
subcutaneous infusion of 40 Units of insulin in one 24-hour time period (1.67 U/hr)
and on-demand bolus dosing in 2-Unit increments (up to 36 Units per one 24-hour
time period) in adult patients requiring insulin.
A U100 fast-acting insulin should be used with the V-Go. Humalog® (insulin lispro,
rDNA origin) and NovoLog® (insulin aspart, rDNA origin) have been tested by Valeritas,
Inc. and found to be safe for use in the V-Go Disposable Insulin Delivery Device.
Healthcare Professional Dosing Considerations
When selecting a V-Go option, healthcare professionals should refer to their own
experience when initiating continuous subcutaneous insulin infusion therapy with
a patient. If unfamiliar, the healthcare professional should refer to insulin therapy
guidelines from diabetes associations.
The following should be considered when initially prescribing the V-Go:
• Understand the total daily dose of insulin your patient is actually taking with
their current insulin regimen versus what is being prescribed. Selecting the
correct V-Go option may lessen the risk of hypoglycemia.
• It is common practice to reduce the total daily insulin dose when starting a
patient on continuous subcutaneous insulin infusion therapy and this reduction
should be considered when starting a patient on the V-Go.
Warnings
Insulin requirements
If you have to make regular adjustments or modifications to your basal rate during
a 24-hour period, or if the amount of insulin used at meals requires adjustments of
less than 2-Unit increments, use of the V-Go may result in hypoglycemia.
The following conditions may occur during insulin therapy with the V-Go.
• Hypoglycemia:
−− Intensive management of diabetes with too much insulin has been
associated with an increase in the incidence of hypoglycemia (low
blood sugar).
• Hyperglycemia and diabetic ketoacidosis (DKA):
−− Any insulin delivery interruption may result in hyperglycemia (high
blood sugar) or the onset of diabetic ketoacidosis.
If you have a medical emergency while using the V-Go, call 911, your doctor, or go
directly to the hospital.
Before using different insulin with the V-Go, you should check the insulin label to
make sure it can be used with this device.
30
31
Precautions
General
The following are a number of general precautions you should consider when using
the V-Go™ Disposable Insulin Delivery Device.
The V-Go is magnetic resonance (MR) unsafe.
You should remove the V-Go before having an X-ray, MRI, or CT scan (or any similar
test or procedure). Replace with a new V-Go after the test or procedure is completed.
You should monitor your blood glucose levels based on your doctor’s or healthcare
professional’s recommendation. American Diabetes Association guidelines suggest
that patients test blood glucose 3 or more times daily.
You should act quickly to respond to abnormal blood sugar levels.
• Notify your doctor or healthcare professional of any serious hypoglycemia or
hyperglycemia. Tell your doctor or healthcare professional of any increased
frequency in abnormally high or low blood glucose test results.
You should create a plan with your doctor or healthcare professional in case a
problem occurs when you are unable to reach him or her for advice.
You should create a plan with your doctor or healthcare professional on how to
manage your bolus (mealtime) dosing using the V-Go, including what to do if you
lose count while bolus dosing or if you forget to take a bolus dose.
You should carry an emergency kit of insulin supplies, if instructed by your doctor
or healthcare professional, in case you develop a problem with the V-Go that stops
your insulin delivery. Tell a family member or friend where you keep your emergency
kit items.
• You should speak with your doctor or healthcare professional regarding what
to have in the emergency kit, which often includes the following items:
−− Fast-acting glucose tablets
−− Blood glucose and urine ketone monitoring supplies
−− Back-up insulin, insulin syringe, and needles with directions from your
doctor or healthcare professional regarding how much insulin to take
−− Dressing and adhesive
32
You should avoid exposing the V-Go to direct sunlight.
You should avoid exposure to extremely hot temperatures. Remove the V-Go prior
to hot tub, whirlpool, or sauna use and replace with a new filled V-Go afterward.
You should check that the V-Go is securely in place during and after periods of increased
physical activity. Check that the V-Go is securely in place if it has been exposed to water
or gone under water to the depth of 3 feet, 3 inches (1 meter). The V-Go can go under
water and will continue to work safely.
You should follow these precautions to help prevent problems with the V-Go
placement:
1.Never use insulin that appears cloudy. Cloudy insulin may be inactive. Do not use
cloudy insulin with the V-Go.
2.Do not expose the insulin to extreme changes in temperature. Check the insulin
package insert for temperature variation.
3.Practice aseptic technique when preparing, filling, and attaching the V-Go.
4.Check the adhesive site for redness, irritation, and inflammation when you
remove a used V-Go and before you attach a new V-Go.
5.Change the application site each time you change the V-Go. See Section 2
(Part 3) Step 3. Changing the site will ensure proper absorption of insulin.
The new site should be at least 1 inch away from the previous site.
6.Do not apply the V-Go to a site that has excess hair or is irritated, infected, or
unhealthy for any reason. Consult with your doctor or healthcare professional
about how to prepare and maintain these sites.
7.Avoid attaching the V-Go to sites that may interfere with your clothing,
accessories, or car seatbelts.
8.Do not attach the V-Go to sites with rigorous movement and stretching due to
exercise or job-related activities.
33
Hypoglycemia
Low blood sugar is the most common side effect associated with any insulin,
including the insulin delivered using the V-Go™. Symptoms of low blood sugar
may vary and can happen suddenly.
To help prevent hypoglycemic episodes, follow these precautionary steps:
1.Know the symptoms of hypoglycemia. Do not ignore these symptoms, no matter
how mild they may be.
2.Always carry a fast-acting sugar replacement (such as candy, juice, or glucose
tablets) in the event of a hypoglycemic episode.
3.The V-Go delivery rate can vary by up to +/- 10% from device to device. Even though
the chance of this happening is remote, you should monitor your glucose level at
least 3 times per day or as recommended by your doctor. Your doctor or healthcare
professional may recommend specific times for you to check your blood glucose.
4.Check your blood glucose before driving or operating heavy machinery. Appropriate
blood glucose levels are required to maintain alertness.
IMPORTANT: If your glucose level falls below 70 mg/dL, you may be hypoglycemic
(low blood sugar) and you should take immediate action to raise your blood glucose
level. This may be done by taking glucose tablets, eating candy, drinking juice, or
doing as your doctor or healthcare professional instructs. You should retest your
blood glucose after 15 minutes and if it is still below 70 mg/dL continue to take
steps to increase your blood glucose level until it reaches your normal level.
Consult with your doctor or healthcare professional to understand how to best
recognize and manage low blood glucose.
Hyperglycemia and Diabetic Ketoacidosis (DKA)
To help prevent serious hyperglycemia (high blood sugar) and the possibility of
diabetic ketoacidosis (DKA), follow these precautions:
IMPORTANT: Nausea and vomiting are often the first signs of DKA. To avoid DKA,
be prepared and act quickly. Don’t assume your blood glucose is high because
you are under stress, have the flu, or miscalculated your last meal bolus.
2.Be sure you know when to test for ketones and when your doctor or healthcare
professional expects you to call with results.
3.Know your blood glucose target ranges and when your doctor or healthcare
professional expects you to report trouble. When your blood glucose is high,
be prepared to administer insulin. If you suspect that the V-Go is not delivering
insulin, refer to the Troubleshooting section of this manual on page 41.
4.Keep yourself well hydrated, especially during illness or exercise.
5.Do not treat DKA yourself. If you suspect DKA, contact your doctor or healthcare
professional.
Adverse Reactions
Site Infection/Abscesses
Infections at the infusion site may occur. Proper site preparation and frequent site
rotation (refer to Section 2 (Part 3) Step 3A to 3D) can minimize infections. Remove
the V-Go immediately if the area around the V-Go becomes sore, red, or swollen.
Apply a new V-Go to a new, clean site away from the suspected infected area. Do
not discontinue therapy without the advice of your doctor or healthcare professional.
Skin Irritation
A more common problem than infection is skin irritation. Skin may become irritated
by the adhesive pad on the V-Go or by the way the V-Go is positioned on your skin.
Skin irritation can occur but does not lead to any further clinical complication.
NOTE: If you have sensitive skin or your skin becomes irritated, ask your doctor
or healthcare professional about skin barrier products.
1.Check your blood glucose frequently based on your doctor’s or healthcare
professional’s recommendation. Your doctor or healthcare professional may
recommend specific times for you to check your blood glucose.
34
35
V-Go™
SECTION 4: PRODUCT SPECIFICATIONS
EZ Fill
Storage Conditions —
Unused Device Only
Operating Conditions
Insulin
Duration of Use
Disposal
-4°F (-20°C) to +140°F (+60°C)
20% to 90% relative humidity
+40°F (+5°C) to +99°F (+37°C)
20% to 90% relative humidity
Warm to room temperature to optimize fill quality
Each time before placing a new vial into the EZ Fill, check
to make sure the insulin vial is not expired and that it will
not expire during the time period that the vial will be used
in the EZ Fill
30 fills
Local disposal requirements
Basal Delivery,
Continuous Subcutaneous
Bolus Delivery, On-Demand
V-Go Minimum Capacity Reservoir
V-Go Size
V-Go Weight
Storage Conditions —
Device Only
Storage Conditions —
Filled with Humalog®
Storage Conditions —
Filled with NovoLog®
Operating Conditions
Operating Atmospheric Pressure
Duration of Use
Bolus Delivery Accuracy
(For all 3 V-Go options)
Basal Delivery Accuracy
(For all 3 V-Go options)
V-Go Power Source
Enclosure Protection
Needle
Disposal
36
20 Units/24 hr (0.83 U/hr)
30 Units/24 hr (1.25 U/hr)
40 Units/24 hr (1.67 U/hr)
Each push of the bolus delivery button provides 2 Units
Each V-Go contains 18 uses for a maximum of 36 Units per V-Go
0.56 mL V-Go 20
0.66 mL V-Go 30
0.76 mL V-Go 40
2.4 x 1.3 x 0.5 inches
(6.1 cm x 3.3 cm x 1.3 cm)
0.7 to 1.8 ounces
(20 to 50 grams)
+10°F (-12°C) to +140°F (+60°C)
20% to 90% relative humidity
Avoid prolonged exposure to the extremes of
the storage temperature range
The V-Go may be filled with Humalog for up to 24 hours prior to
use if refrigerated or if left at room temperature
The V-Go may be filled with NovoLog for up to 5 days prior
to use if refrigerated
The V-Go may be filled with NovoLog for up to 3 days prior
to use if left at room temperature
+40°F (+5°C) to +99°F (+37°C)
20% to 90% relative humidity
Do not expose the V-Go to temperatures over 99°F for prolonged
periods of time (beyond 14 hours) as this may lead to degradation of
the insulin (check the insulin manufacturer’s instructions for use for
temperature details) and may cause the V-Go to run at a basal rate
slightly greater than the specified range
697 hPa to 1,013 hPa
(Equivalent to altitudes up to
10,000 feet [3,048 meters])
24 hr
+/-10%
+/-10%
Mechanical
Protects against the effects of submersion at depths
up to 3 feet, 3 inches (1 meter) for 24 hours.
(IPX8)
4.6-mm, 30-gauge needle with sharps injury prevention features
and floating needle technology
Local disposal requirements
37
Delivery Accuracy Test Results
The following graphs show the basal flow rate accuracy for all 3 V-Go™ options
(20/30/40) for the given time periods.
The bolus accuracy is +/-10% for all 3 V-Go options.
Flow Rate Start-up Graphs
38
Flow Rate Test Period Graphs
39
SECTION 5: V-Go™ USER ASSISTANCE INFORMATION
SECTION 6: TROUBLESHOOTING/FREQUENTLY ASKED QUESTIONS
Valeritas Customer Care
You may have questions or concerns when you use a new product. Please contact
us for advice or assistance. A trained staff member will help you with any questions
on how to fill, apply, or use the V-Go.
How do I know how much insulin to put into the V-Go?
You always fill the V-Go completely. The V-Go comes in 3 options and your doctor or
healthcare professional will select the option you need.
For specific treatment questions, information on insulin, or medical advice, call your
doctor or healthcare professional.
If you have any questions regarding the operation of the V-Go or EZ Fill, speak to a
Valeritas Customer Care Representative 24/7 at 1-866-881-1209.
Customers can visit the Valeritas website (www.valeritas.com) for additional
information about disposable insulin delivery with the V-Go.
If you have a medical emergency while using the V-Go, call 911, your doctor, or go
directly to the hospital.
40
Why does insulin leak from the EZ Fill?
Check to make sure a V-Go is placed in the EZ Fill before a new insulin vial is placed
into the insulin vial holder. This may reduce any insulin leak that can happen when
extra pressure is built up in the vial upon initial puncture. Also, make sure the plug is
properly inserted into the EZ Fill between fills.
It looks like the V-Go has not filled completely.
There are 5 reasons the V-Go may not fill completely:
1.The insulin vial is not completely pushed down into the insulin vial holder.
• If this is the case, push the vial firmly straight down into the insulin vial holder
until you feel it attach and cannot push it further.
2.You have run out of insulin in your vial. You have to switch vials before you can fill
the rest of the V-Go.
• If this is the case, keep the V-Go in the EZ Fill drawer. Remove the insulin vial
from the EZ Fill insulin vial holder, replace with a new vial, and refill the V-Go.
3.You did not completely pull the plunger to its full upright position.
• If this is the case, slowly pull the plunger up completely and repeat the filling
process for the V-Go.
4.You have pushed down the plunger too quickly, which turned the insulin foamy.
The foam could become an air bubble larger than a grain of rice.
• If this is the case, the EZ Fill cannot correct this error at this time. Set the V-Go
aside for use on the next day and start over with a new V-Go.
−− The V-Go with the foamy insulin should be stored with the insulin port up.
Before using this V-Go, refill it completely with insulin. See Section 2 (Part 2)
Step 4A to 4F. Refer to the V-Go storage conditions in Section 4.
41
5.The EZ Fill drawer may not be completely closed.
• If this is the case, check again to ensure the drawer is pushed all
the way closed.
In any of these situations follow Step 4A to 4F to make sure you have a complete fill.
I am looking in the viewing window while pushing the plunger down, but I
don’t see the V-Go™ filling.
There are 2 reasons you may not see any insulin fill the V-Go.
1.You have run out of insulin in your vial. You have to switch vials before you can fill
the rest of the V-Go.
• If this is the case, keep the V-Go in the EZ Fill drawer. Remove the insulin vial
from the EZ Fill insulin vial holder, replace with a new vial, and refill the V-Go.
2.You did not completely shut the EZ Fill drawer.
• Grip the ribbed drawer handle and push the drawer completely into the EZ Fill.
The ribbed drawer handle should not stick out past the bottom of the EZ Fill.
If there is insulin in the vial and the drawer is completely shut, try to fill a new V-Go.
If you are unable to fill a new V-Go, speak to a Valeritas Customer Care Representative
at 1-866-881-1209.
What happens if I do not pull the plunger completely up when I fill the V-Go?
If the plunger is pulled only part of the way up during the fill process, you will get
only a partial fill of the V-Go. You will see air bubbles in the V-Go viewing window.
Keep the V-Go in the EZ Fill drawer and slowly pull the plunger up completely again.
Make sure the plunger is completely up. Slowly and steadily push the plunger back
down over about 25 seconds until it is in the complete down position.
I tried to pull the plunger up and it snapped back down. What should I do?
Try slowly pulling the plunger up again, but count the full 5 seconds before releasing
or reversing the direction of the plunger. The plunger snaps back down if you try to
pull the plunger up and release it in less than 5 seconds.
After I place the V-Go into the EZ Fill drawer, what happens if the plunger is
already in the up position?
You can still fill the V-Go. Hold the EZ Fill upwards and slowly and steadily push the
plunger down over about 25 seconds until it is in the complete down position. As
you push the plunger down, check to make sure insulin enters the V-Go. Repeat the
plunger cycle if no insulin entered the V-Go or if additional insulin is required to fill
the V-Go. See Section 2 (Part 2) Step 4A to 4F.
There are bubbles in the insulin vial.
The most common reason for bubbles in the insulin vial is filling more than 1 V-Go at
a time. The EZ Fill is designed to fill only 1 V-Go per day.
I did not apply the V-Go directly after filling. Do I have to throw it away?
It is preferable to apply the V-Go immediately after filling. However, refer to the
V-Go storage conditions in Section 4 and the specific insulin’s storage conditions
for more information.
It is harder to push the plunger when it gets closer to the downward position.
This is normal. When the V-Go is full or close to full, you should expect to
push a little harder. You may need a little extra pressure to push the plunger
completely down.
I believe an item is missing or appears to be damaged.
If you suspect an item is damaged, do not use the damaged piece. Replace this with
a new one (V-Go or EZ Fill). EZ Fill replacements can be requested from a Valeritas
Customer Care Representative at 1-866-881-1209.
42
43
I believe I have broken the EZ Fill. How do I get another one to fill the
V-Go™?
EZ Fill replacements can be requested from a Valeritas Customer Care
Representative at 1-866-881-1209. You will be asked to return the unusable EZ Fill.
Valeritas Customer Care will provide you with further details.
When I went to give myself a bolus dose of insulin, the bolus delivery button
was already popped out.
If the bolus delivery button was already popped out, the bolus ready button was
already activated. Press the bolus delivery button to deliver 2 Units of insulin when
the next bolus dose is needed.
The inner package for the V-Go is torn or damaged.
If you suspect the package containing the V-Go has been torn or damaged, do not
use this V-Go. Replace with a new V-Go.
The bolus delivery button will not pop out.
First check that you are pressing the bolus ready button fully. If the bolus delivery
button fails to pop out after you activate the bolus ready button, you have used all of
the available insulin for bolus dosing (36 Units or 18 uses per 24 hours). Replace this
V-Go with a new V-Go before your next meal. Plan your day so that you have enough
insulin for each meal.
After I removed the button cover, the cover pin was not attached to the button
cover and is still inside the V-Go.
If the cover pin is inside the V-Go, the V-Go will not work correctly. Try to remove the
pin manually; otherwise discard this V-Go and start over with a new V-Go.
It is difficult to press down on the needle button.
Be sure you are pressing the raised bump of the needle button. If the needle button
does not move when pressed, the needle button may have already been activated.
Do not use this V-Go. Replace with a new V-Go.
The needle button will not stay in the down position.
The needle button must be pressed down fully to be locked into place. If you cannot
get the button to stay down, do not use this V-Go. Replace with a new V-Go.
The V-Go won’t remain securely attached to my skin for the duration of use,
which sometimes causes poking of the needle.
If the V-Go will not remain secure, replace with a new V-Go.
When replacing the V-Go, please review Section 2 (Part 3) Step 3A to 3D.
Do not touch the adhesive pad before you attach the V-Go to your skin. Thoroughly
clean the site with an alcohol swab. Let the site dry before attaching the V-Go.
Many lotions and ointments may keep the V-Go from sticking to your skin.
Be sure that you have properly attached the V-Go to a flat surface on your body.
If the site is covered with hair, this could also affect whether the V-Go sticks. You
may shave the area to help the V-Go attach to your skin.
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What should I do if I forget the number of Units I have delivered when bolus
dosing or if I forget to take a bolus dose?
Follow the plan you created with your doctor or healthcare professional for such
situations. If you have not created a plan already, consult your doctor or healthcare
professional for guidance.
The area of skin around the V-Go is red and sore to the touch.
Skin may be irritated by the adhesive pad on the V-Go. There are a number of
skin barrier products available to help prevent irritation and treat sensitivity
problems. Contact your doctor or healthcare professional for specific products
and recommendations.
Infections at the site may also occur. If you experience redness, irritation,
or inflammation around the V-Go (specifically the end closest to the needle),
immediately replace the V-Go with a new V-Go on a new body site. Contact your
doctor or healthcare professional for the best way to treat infection and irritation,
especially if the inflamed site appears bigger than a dime.
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I dropped the V-Go™.
Check to see if there is any damage to the V-Go. If you suspect that the V-Go was
damaged or became dirty as a result of the fall, do not use this one. Replace with a
new V-Go.
I dropped the EZ Fill.
Check to see if there is any damage to the EZ Fill or the insulin vial, if it was
attached. If the insulin vial came out of the EZ Fill, wipe the top of the vial with
an alcohol swab and watch closely for leaks when you place the vial back into
the EZ Fill. If insulin is leaking, replace the insulin vial with a new one. If you
suspect that the EZ Fill was damaged, speak to a Valeritas Customer Care
Representative at 1-866-881-1209.
The V-Go was exposed to water. Is this a problem?
The V-Go can go under water up to 3 feet, 3 inches (1 meter), and will continue
to work safely. You should check to see that it stays in place. Depending on the
cleanliness of the water, you may be at an increased risk for an infection at the
needle infusion site.
Can I swim, scuba dive, shower, or bathe while wearing the V-Go?
The V-Go has been successfully tested in water to depths of 3 feet, 3 inches
(1 meter) for 24 hours, and therefore can be worn during normal daily activities,
such as showering and bathing as well as activities near the surface of the water,
such as swimming.
The V-Go has not been tested and therefore should not be used in the following
conditions:
• Water activities below 3 feet, 3 inches (1 meter), such as scuba diving.
• Extremely hot water temperatures, such as hot tubs or whirlpools.
Remove the V-Go prior to scuba diving, hot tub use, or whirlpool use, and replace
with a new filled V-Go afterward.
46
Can I wear the V-Go for longer than 24 hours – for example, if I sleep an extra
hour on the weekend?
The V-Go has been designed for 24-hour wear. You should change it at the same
time each day. After 24 hours, the V-Go may no longer deliver a continuous preset
basal rate of insulin.
How do I travel with the V-Go?
Use the same precautions that you would when traveling with other insulin supplies.
Speak with your doctor or healthcare professional about extra precautions you may
need to take while traveling.
When traveling with the EZ Fill, with an insulin vial attached, it should be refrigerated
at all times. Empty V-Go devices do not require refrigeration. They should be stored
according to the storage conditions in Section 4. For information on storing filled
V-Go devices refer to the V-Go storage conditions in Section 4.
Can I wear the V-Go on an airplane?
Yes, the V-Go can safely be worn on an airplane.
Should I wear the V-Go to bed?
Yes, you should wear the V-Go for a full 24 hours, even while you sleep.
The needle will not retract back into the V-Go.
Try to slide and press the needle release button again. See Section 2 (Part 3) Step 8C.
If the needle still will not retract into the V-Go, dispose of the V-Go in a sharps container.
47
SECTION 7: GLOSSARY AND PACKAGING SYMBOLS
Aseptic technique: This process helps keep the V-Go™ and EZ Fill devices clean
during preparation, filling, and application. Following this technique requires handwashing and wiping the application site with an alcohol swab. It may involve wiping
the V-Go device with an alcohol swab if the device comes into contact with anything
else.
Basal rate: The basal rate is the amount of insulin delivered at a preset rate by the
V-Go over 24 hours. Your basal rate is the amount of insulin required to maintain
your target glucose values when you are not eating. Basal rate may also be referred
to as background, continuous, or long-acting insulin.
Blood glucose levels: Blood glucose levels are the measure of how much sugar is
in the blood.
Bolus: A bolus is an amount of insulin delivered at one time. A bolus is usually taken
before a meal to cover your body’s insulin needs. A bolus of insulin can also be
taken when blood glucose levels are abnormally high. Bolus may also be referred to
as mealtime, prandial, short-acting, or rapid-acting insulin.
Diabetes mellitus: Diabetes is a disease in which the body cannot maintain its own
healthy blood glucose levels. Either the body cannot produce enough insulin or the
body cannot properly use insulin. There are two main types of diabetes:
Type 1 diabetes: In Type 1 diabetes, the body does not produce enough
insulin. People with Type 1 diabetes must use insulin to regulate their blood
glucose levels.
Type 2 diabetes: In Type 2 diabetes, the body does not produce enough insulin
or use it properly. People with Type 2 diabetes can usually regulate their blood
glucose levels by following an individual meal plan, exercising, and taking
certain medicines, including insulin, if needed. It usually occurs in people
40 years or older.
48
Diabetic ketoacidosis (DKA): DKA occurs when the blood glucose level is elevated
and the insulin level is low. The body does not have enough insulin to help the
glucose enter the cells. Glucose in the cells is used for energy. During this situation,
the body begins to burn muscle and fat for energy. A waste product of fat burning
is ketones. Ketones accumulate in the blood and are passed through the urine and
lungs. This condition can be identified by urine and/or blood tests. DKA usually
requires hospitalization and can lead to a life-threatening situation if not promptly
treated.
Glucose: Glucose, a sugar, is a main way the body takes in carbohydrates. Glucose
is the body’s most important source of energy. It is produced from digested food, by
the normal action of the liver. Glucose is carried by the blood throughout the body.
Hyperglycemia: Hyperglycemia or high blood sugar occurs when blood glucose
levels rise above normal (approximately 250 mg/dL). Hyperglycemia is the result
of the body not having enough insulin or not being able to use insulin to process
glucose.
Hypoglycemia: Hypoglycemia or low blood sugar occurs when blood glucose levels
drop below normal (approximately 70 mg/dL). Hypoglycemia may result from too
much insulin and/or exercising more than usual.
Infusion site: The infusion site is the place on the body where the V-Go is attached,
specifically the end of the V-Go where the needle is inserted under the skin.
Insulin: Insulin is a hormone produced by the pancreas. Insulin is needed by the
body to regulate the production and use of glucose.
Ketones: Ketones, or ketone bodies, are substances produced by normal liver
activity, and used by muscle tissue. When blood glucose levels are elevated, the
body’s normal process is unbalanced and ketones can accumulate in the blood, pass
through the urine, and ultimately result in diabetic ketoacidosis (DKA).
Subcutaneous: Subcutaneous means beneath the layer of the skin. The V-Go
infusion needle delivers insulin subcutaneously. Subcutaneous injections are not the
same thing as intravenous (IV) or intramuscular (IM) injections.
49
Packaging Symbols
Rx Only
Store at
Unless opened or damaged, contents are sterile
Do not reuse
Dispose of after 30 fills
Use by
Before using contents, read the Instructions for Patient Use
Lot code
50
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Humalog is a registered trademark of Eli Lilly and Company.
NovoLog is a registered trademark of Novo Nordisk A/S.
www.go-vgo.com
ART-037 Rev: H
09/2011
www.valeritas.com
© 2011 Valeritas, Inc.
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