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How Many Units Of Insulin In A Pen

Is There A Maximum Insulin Glargine (lantus) Dose?

Is There A Maximum Insulin Glargine (lantus) Dose?

Is there a maximum insulin glargine (Lantus) single-injection dose? Anecdotally, I have heard that patients receiving more than 50 units should split the dose from daily dosing to twice-daily. What’s the evidence? The question of a maximum insulin glargine dose is not straightforward because it encompasses several issues: How long does insulin glargine last? Does it ever need to be given twice-daily? Is there a difference in efficacy between daily and twice-daily insulin glargine dosing? Can you administer more than 50 units of insulin glargine as one single injection? Pharmacodynamics and Duration of Insulin Glargine In theory, insulin glargine should last a full 24 hours without a significant peak effect. Glargine forms a depot effect because it is only soluble at an acidic pH.1 In the vial (pH 4), the drug is completely soluble. Once injected, the solution is neutralized to biologic pH (7.4), which causes the insulin molecules to precipitate. These microprecipitates slowly dissolve over a 24-hour period. This slow dissolution results in a slower onset and a lack of a peak effect compared to other insulins, as shown below: Efficacy of Daily versus Twice-Daily Lantus Administration Although insulin glargine should last a full 24 hours, there is some evidence that its duration of action may be reduced to 20-23 hours, particularly following injection due to its delayed onset of activity of about 3-5 hours.2 Currently, the best estimate is that 15-30% of type-I diabetics will have pre-injection hyperglycemia and may benefit from twice-daily dosing. The idea of twice-daily dosing was explored in an 8-week, open-label crossover trial of 20 patients with type-I diabetes.2 Patients received either 100% of a pre-determined dose daily (dinner) or 50% twice-daily (breakfast an Continue reading >>

Indications And Usage For Apidra® (insulin Glulisine [rdna Origin] Injection)

Indications And Usage For Apidra® (insulin Glulisine [rdna Origin] Injection)

Prefilled with Apidra® to help make mealtime more manageable No Co-Pay* offer for qualifying patients Easy to teach2 Can be used in 6 straightforward steps Easy to use1 Only rapid-acting insulin pen in which dose can be set from 1 to 80 units in 1-unit steps, dialed both up and down2 Once opened, Apidra® SoloSTAR® can be used for up to 28 days and is not refrigerated3 Easy to inject1 Dose cannot be dialed past the number of units left in the pen3 It is important to keep the injection button pressed all the way in and to slowly count to 10 before withdrawing the needle from the skin. After a full injection, the number in the dose window will return to zero. These steps help ensure that the full dose has been delivered3 aCertain restrictions apply for the savings program. This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicare, Medicaid, VA, DOD, or TRICARE, or similar federal or state programs including any state medical pharmaceutical programs. Void where prohibited by law. The maximum savings is $100 off per monthly prescription for the duration of the program. Savings may vary depending on patient’s out-of-pocket costs. Upon registration, patient receives all program details. Sanofi US reserves the right to rescind, revoke, or amend the program without notice. As of April 2016. Apidra® is a rapid-acting insulin analog indicated to improve glycemic control in adults with type 2 diabetes or adults and children (4 years and older) with type 1 diabetes. When used as a mealtime insulin, the dose of Apidra® should be given within 15 minutes before or within 20 minutes after starting a meal. Apidra® given by subcutaneous injection should normally be used in regimens that include a longer-acting insulin. Important Safety Info Continue reading >>

Levemir® Flextouch® Is Ready To Use In Just A Few Steps

Levemir® Flextouch® Is Ready To Use In Just A Few Steps

Levemir® FlexTouch®, a prefilled insulin pen with no push-button extension, requires low force to inject at all doses and is ready to use in just a few steps.a In fact, Levemir® FlexTouch® has up to 77% less injection force than Lantus® SoloSTAR®. From the makers of the world’s #1-selling prefilled insulin pen,b Levemir® FlexTouch® is: Accurate—Accurate dosing from 1 to 80 units Prefilled—Each pen is prefilled with 300 units of Levemir® Discreet—Fits in your pocket, purse, or nightstand On the go—Take it with you almost anywherec aPlease see the Patient Information for complete Instructions For Use. cOnce in use, Levemir® FlexTouch® must be kept at room temperature below 86°F for up to 42 days. Injecting with Levemir® FlexTouch® You may have concerns about using an injectable medicine for type 2 diabetes. But it’s important to realize the positive effect it may have on the management of your diabetes. And once you gain a little practice in giving injections on your own, Levemir® injections will become part of your daily routine. If you were given instructions from your health care provider on how to use Levemir® FlexTouch® and you have read the Instructions for Use in the Patient Information, you may be ready for your first injection. Your health care provider will tell you what dose of Levemir® is right for you and how many times to take it each day. Your dose may be adjusted based on your blood sugar. Please consult your health care provider prior to adjusting your dose. No compatible source was found for this video. Levemir® can be injected in the thigh, abdomen, or upper arm. It’s important to change the injection site within your injection area each time you inject and not inject into the exact same spot each time. Rotating where yo Continue reading >>

U-500 Insulin: How Much Do You Know?

U-500 Insulin: How Much Do You Know?

In the case of significant insulin resistance (defined as needing more than 200 units per day), multiple injections of insulin are needed throughout the day to keep the blood sugar in check. There is no written rule about the maximum volume of insulin that can be absorbed by the subcutaneous tissue at one time, but many prescribers will split an insulin dose into multiple injections when dose requirements are approaching 70 units in a single administration. An insulin pen can deliver 80 units, and the largest size insulin syringe can hold 100 units. So if your insulin dose is somewhere between 60 and 100 units, you might need more than one injection to deliver all of that insulin at one time. In order to avoid becoming a human needle cushion, concentrated insulins like Humulin R U-500 were developed. What is the difference in insulin concentrations? Most of the insulins on the market today are U-100 strength, meaning there are 100 units of insulin per mL. Examples are Regular insulin, NPH, 70/30 and other mixed insulin, glargine and detemir. U-500 concentrated insulin has 5 times the potency of U-100 insulin, giving 500 units per mL. By reducing the injected volume, better absorption, less injection discomfort and decreased number of injections can be experienced. Until recently, U-500 was the only concentrated form of insulin. Since 2015, two concentrated basal insulins U-300 {Glargine (Toujeo)} and U-200 {Degludec (Tresiba)} have become available in the US. These have a strength of 300 units per mL and 200 units mL, also resulting in smaller volumes injected. Dosing conversion charts are used to safely move from a U-100 insulin to U-500 insulin. Who needs U-500 insulin? Good candidates for U500 insulin are those whose total daily insulin dose exceeds 200 units per day Continue reading >>

Math Calculations With Diabetes Insulin

Math Calculations With Diabetes Insulin

www.TakeRx.com Calculate the total quantity and the total days supply for the following Rx: Humalog 75/25 30U sq am/pm #3 vials ------------------------------------------------------------ The doctor has prescribed 3 vials of Humalog Mix 75/25 Each vial of Humalog Mix has 10 mL of insulin 1 vial = 10 mL and then 3 vials = 30 mL So, the total quantity to be dispensed will be 30 mL The sig says: inject 30 units subcutaneously in the morning and in the evening In other words, the patient will inject 60 units per day. Now, we need to convert 60 units into mL We know that the ratio is 1mL/100U x / 60U = 1mL / 100U x = (60 * 1) / 100 x = 0.6 mL So, the patient will inject 0.6 mL per day. Now, the total days supply will be 30mL divided by 0.6mL which is 50 days. Calculate the total quantity and the total days supply for the following Rx: Levemir insulin qty: 1 inj 60 units sc qd ------------------------------------------------------------ The doctor has prescribed the brand-name drug Levemir insulin. The doctor wants the pharmacist to dispense one vial. One vial has 10 mL of insulin. So, the total quantity to be dispensed is 10mL The sig says: inject 60 units subcutaneously every day The ratio for the insulin is 1 mL per 100 units. We need to convert 60 units into mL x / 60 U = 1 mL / 100 U x = (60U * 1mL) / 100U x = 60 / 100 x = 0.6 mL In turn, the patient will use 0.6 mL per day. Now, the total days supply will be 10 mL divided by 0.6 mL which is 16 days. Calculate the total quantity and the total days supply for the following Rx: Levemir flexpen #15 mL 70 U qd ------------------------------------------------------------ The doctor has prescribed Levemir flexpen injection (U-100) 5X3mL prefilled pens. The package has 5 pens and each pen has 3mL and, thus, we can say the pack Continue reading >>

95% Of New Start Basal Insulin Patients Rated Toujeo® Solostar® As Easy To Use After Training And 4 Weeks Of Use1,a

95% Of New Start Basal Insulin Patients Rated Toujeo® Solostar® As Easy To Use After Training And 4 Weeks Of Use1,a

Toujeo® is a long-acting human insulin analog indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use: Toujeo® is not recommended for treating diabetic ketoacidosis. Contraindications Toujeo® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or any of its excipients. Warnings and Precautions Toujeo® contains the same active ingredient, insulin glargine, as Lantus®. The concentration of insulin glargine in Toujeo® is 300 Units per mL. Insulin pens and needles must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimens cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Changes in insulin regimen may result in hyperglycemia or hypoglycemia. Unit for unit, patients started on, or changed to, Toujeo® required a higher dose than patients controlled with Lantus®. When changing from another basal insulin to Toujeo®, patients experienced higher average fasting plasma glucose levels in the first few weeks of therapy until titrated to their individualized fasting plasma glucose targets. Higher doses were required in titrate-to-target studies to achieve glucose control similar to Lantus®. Hypoglycemia is the most common adverse reaction of insulin therapy, including Toujeo®, and may be life-threatening. Medication errors such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label bef Continue reading >>

How To Use An Insulin Pen

How To Use An Insulin Pen

Whether you're at home or on the go, an insulin pen offers the benefits of accuracy, convenience, and confidence to people with diabetes. Here's how to use one safely and easily. Whether you're at home or on the go, an insulin pen offers the benefits of accuracy, convenience, and confidence to people with diabetes. Here's how to use one safely and easily. Whether you're at home or on the go, an insulin pen offers the benefits of accuracy, convenience, and confidence to people with diabetes. Here's how to use one safely and easily. Whether you're at home or on the go, an insulin pen offers the benefits of accuracy, convenience, and confidence to people with diabetes. Here's how to use one safely and easily. Continue reading >>

Insulin Pens

Insulin Pens

Managing diabetes often requires taking insulin shots throughout the day. Insulin delivery systems such as insulin pens can make giving insulin shots much easier. If you currently use a vial and syringe to deliver your insulin, switching to an insulin pen may make it easier to take your insulin and increase your compliance. Insulin pens do not eliminate your need to poke yourself with a needle. They simply make measuring and delivering your insulin easier. Insulin pens deliver anywhere from .5 to 80 units of insulin at a time. They can deliver insulin in increments of one-half unit, one unit, or two units. The maximum dose and the incremental amount vary among pens. The amount of total insulin units in the cartridges vary as well. The pens come in two basic forms: disposable and reusable. A disposable insulin pen contains a prefilled cartridge, and the entire pen is thrown away when the cartridge is empty. Reusable pens allow you to replace the insulin cartridge when it’s empty. The insulin pen you use depends on the type of insulin you require, the number of units you typically need per insulin shot, and the available pens for that insulin type. The needles on insulin pens come in different lengths and thicknesses, and most fit on all of the available insulin pens. Talk to your doctor or healthcare provider to decide which pen is best for you. Similar to vials of insulin, insulin pens do not require constant refrigeration once they’ve been opened. Insulin pens only require refrigeration before their first use. After its initial use, simply keep your insulin pen out of direct sunlight and in a room-temperature setting. Insulin pens typically stay good for 7 to 28 days after the initial use, depending on the type of insulin they contain. However, if the expiration da Continue reading >>

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® (insulin aspart injection) 100 U/mL is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus. NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is re Continue reading >>

Get Familiar With The Xultophy® 100/3.6 Pen

Get Familiar With The Xultophy® 100/3.6 Pen

WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide, one of the components of Xultophy® 100/3.6, causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Xultophy® 100/3.6 causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Xultophy® 100/3.6 is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Xultophy® 100/3.6 and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Xultophy® 100/3.6. Xultophy® 100/3.6 (insulin degludec and liraglutide injection) 100 units/mL and 3.6 mg/mL is a combination of insulin degludec and liraglutide and is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on basal insulin (less than 50 units daily) or liraglutide (less than or equal to 1.8 mg daily). Xultophy® 100/3.6 is not recommended as first-line therapy for patients who have inadequate glycemic control on diet and exercise. Xultophy® 100/3.6 has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Xultophy® 100/3.6 is not recommended for use in combination with any other product containing liraglutide or another Continue reading >>

Insulin Pens

Insulin Pens

Tweet Insulin pens are common in the United Kingdom, and are generally characterised by a different shape and the fact that they use an insulin cartridge as opposed to a vial. Some insulin pens use replaceable cartridges, and others use non-replaceable cartridges and must be disposed of after being used. Most insulin pens use replaceable insulin pen needles, which have become extremely short and thin. The replaceable cartridges for insulin pens come in 3 and 1 ½ ml sizes, although 3 is more common and has become dominant. Prefilled insulin pens are disposed of when the insulin within the cartridge is used up. Prefilled pens are often marketed for type 2 diabetics who need to use insulin. Insulin Pens Browse through our list of insulin pen reviews. You can also buy the insulin pens from the Diabetes Shop. Simply click on an insulin pen name to read the guide. How do I use an insulin pen to treat my diabetes? Using a pen is a relatively easy process. Some pens require gentle shaking before use. Once the cartridge is loaded, screw on a needle and prime the pen to clear air. Then dial in the exact dose that you require to deliver the insulin to the body. What is good about insulin pens as opposed to syringes? Insulin pens are very easy to use. They are great for young diabetics who need to deliver insulin at school. Furthermore, many diabetics find insulin pens almost painless. They are also portable and discreet, as well as not being as time-consuming as syringes. An accurate dose can be pre-set on the dosage dial, which can be useful for diabetes sufferers who also have impaired vision. Why might I not like insulin pens? Insulin pens are not right for 100% of diabetes patients. Insulin in pens and cartridges is generally more expensive than bottled insulin and syringes. Continue reading >>

Selected Important Safety Information

Selected Important Safety Information

Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening Tresiba® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus. Tresiba® is not recommended for treating diabetic ketoacidosis or for pediatric patients requiring less than 5 units of Tresiba®. Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment Accidental mix-ups betwe Continue reading >>

Insulin Pens

Insulin Pens

WHAT YOU NEED TO KNOW: What is an insulin pen? An insulin pen is a device used to inject insulin. The pen contains a cartridge of insulin. The pen may be reusable or disposable. You may need a different pen for each type of insulin you use. How do I get the insulin ready to use? Check the label and color of the insulin. Check that you have the correct type and strength of insulin. Insulin pens are available as U100 and U500 strengths. Also check the expiration date on the label. Use a new cartridge or pen if the expiration date has passed. Short or rapid-acting insulin should be clear, colorless, and free of particles or clumps. Use a new cartridge or pen if the insulin does not look right. Follow the pen manufacturer's instructions for inserting a new cartridge into a reusable pen. Mix cloudy insulin. Gently roll the pen back and forth between the palms of your hands. Repeat this 10 times. Do not shake the pen. This can make the insulin clump together. Next, gently tip the pen up and down 10 times. Do not use the insulin if there are clumps in it after you mix it. How do I get the pen ready to use? Remove a new pen from the refrigerator 30 minutes before you use it. Insulin should be injected at room temperature. Wash your hands. Use soap and water or an alcohol-based hand rub. This will help decrease your risk for an infection. Remove the cap from the pen. Wipe the needle attachment area with an alcohol swab. Attach a needle to the pen. Remove the tab from the needle. Do not remove the outer cap on the needle. Push the needle straight onto the pen. Turn the needle clockwise until you cannot turn it more. Make sure the needle is straight. Remove the needle caps. Remove the outer cap and save. Remove the inner cap and throw it away. Remove air from the pen. Air may caus Continue reading >>

Lantus 100 Units/ml Solution For Injection In Solostar Pre-filled Pen

Lantus 100 Units/ml Solution For Injection In Solostar Pre-filled Pen

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged. Below is a text only representation of the Patient Information Leaflet, the original can be viewed in PDF format using the link above. The text only version may be available from RNIB in large print, Braille or audio CD. For further information call RNIB Medicine Leaflet Line on 0800 198 5000. The product code(s) for this leaflet are: EU/1/00/134/030, EU/1/00/134/037, EU/1/00/134/031, EU/1/00/134/033, EU/1/00/134/036, EU/1/00/134/034, EU/1/00/134/035, EU/1/00/134/032. Lantus 100 Units/ml solution for injection in SoloStar pre-filled pen Package leaflet: Information for the user Lantus® SoloStar® 100 units/ml solution for injection in a pre-filled pen insulin glargine Read all of this leaflet carefully including the Instructions for Use of Lantus SoloStar, pre- filled pen, before you start using this medicine because it contains important information for you. Keep this leaflet. You may need to read it again. If you have any further questions, ask your doctor, pharmacist or nurse. This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. 1. What Lantus is and what it is used for Lantus contains insulin glargine. This is a modified insulin, very similar to human insulin. Lantus is used to treat diabetes mellitus in adul Continue reading >>

How Do I Use Them?

How Do I Use Them?

How Do I Use Them? “My Doctor Says I Should Begin Using an Insulin Pen...†BD Getting Started™ Using Insulin Pens and Pen Needles An insulin pen is a convenient way to give yourself an insulin shot or injection. It looks like a large fountain pen and comes in two basic types: disposable and reusable. Disposable pens come already filled with insulin. When a pen is empty or expired, it is simply discarded. Reuseable pens have a replaceable cartridge of insulin. The cartridge is replaced when the insulin is used or expired. Whichever type of pen you use, you will need to attach a new pen needle onto the pen with each injection and remove it after every use. The pen may be kept in your pocket or purse at room temperature while in use. The insulin should not get warm or be exposed to direct sunlight. Store unused insulin pen cartridges and pre-filled pens in the refrigerator. Note: Pens from different manufacturer’s operate differently. Check pen manufacturer’s guidelines for operating instructions and insulin expiration details. Dosers are larger and easier to handle than insulin pens. They have clear, readable dials and easy-to- grip shapes that are designed for people with vision problems and poor hand control. An insulin doser works like a re-useable pen. It holds a replaceable cartridge of insulin. The dose is dialed and delivered through a pen needle. Insulin Pens and Dosers – easy to carry, dose and use Parts of a Pen Needle Each pen needle has an outer shield, an inner shield, and a paper tab. How to attach the needle to a pen 1. Remove the paper tab from the outer shield. 2. Push the needle straight onto the pen and twist until it is tight. 3. Pull off the outer shield and set it aside. You will need it later to remove the needle Continue reading >>

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