Dosing Increments for Insulin Pens

While insulin pens allow ease and convenience for diabetic patients, they also come with increased audit risks, for a variety of reasons, including dosing.

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Prescribers are often unaware of what each insulin pen is capable of dispensing. Pharmacies must be hypervigilant of possible instructions that the insulin pen would not be able to deliver. Clinically, the patient would not be able to receive the prescribed number of units, and an audit discrepancy could be flagged. Appealing these types of discrepancies can often be very difficult.

While most insulin pens can be dialed in 1-unit increments, this is not the case for all pens. There are strengths of insulin pens that can only be dialed in 0.5-unit, 2-unit and 5-unit increments. Prior to dispensing these exceptions, the pharmacy must ensure the instructions for use are administrable with the pen prescribed. If the directions don’t coincide with the dosing increments (e.g., 57 units of Tuojeo® Max Solostar®), contact the prescriber for a correction.

Insulin Dosing Increments
Humalog® Junior KwikPen® 0.5 units
Toujeo® Max Solostar® 2 units
Tresiba® Flextouch® 200units/mL 2 units
Humulin® R U-500 KwikPen® 5 units

PAAS Tips:

  • Educate all pharmacy staff on the different insulin pens and their dosing ability
  • Contact prescribers if dosing or strength must be adjusted and add a clinical notation
    • Clinical notes should contain the date/time, person to whom the call was made (and their title), a brief summary of the discussion, and the pharmacy employee’s name/initials
    • Ensure the patient label is updated, and patients are counseled, accordingly
  • Be sure to utilize our Insulin Medication Days’ Supply Chart, available on the PAAS Member Portal, for additional insulin information

Dana Westberg, CPhT