How do I write an order for Lantus (insulin glargine) 10 units subcutaneously once daily?

How to Write an Order for Lantus 10 Units Daily

To write an order for Lantus (insulin glargine) 10 units daily, write: "Insulin glargine (Lantus) 10 units subcutaneously once daily." 1, 2

Complete Order Components

When writing the order for Lantus, include these essential elements:

1. Medication name: Use both generic and brand name

   • Generic: Insulin glargine
   • Brand: Lantus

2. Dose: 10 units

3. Route: Subcutaneously (SC or SQ)

4. Frequency: Once daily

5. Additional instructions (optional):

   • Specify administration time if desired (e.g., "at bedtime" or "in the morning")
   • Note that the time should remain consistent daily 2

Administration Guidelines

• Injection site: Specify that Lantus should be administered into the abdominal area, thigh, or deltoid 2
• Site rotation: Instruct to rotate injection sites within the same region to reduce the risk of lipodystrophy 2
• Timing consistency: Emphasize that Lantus should be administered at the same time every day, though the specific time can be any time of day 1, 2

Important Considerations

• Starting dose: 10 units is an appropriate starting dose for many patients, aligning with guidelines that recommend starting with 10 units per day or 0.1-0.2 units/kg per day 1

• Titration instructions: Consider including instructions for dose adjustment based on fasting blood glucose levels:

  • Increase by 2 units every 3 days until target fasting glucose is reached 1
  • For hypoglycemia, reduce dose by 10-20% 1

• Monitoring: Include instructions for blood glucose monitoring, particularly during initiation and dose adjustments 2

Medication-Specific Warnings

• Do not dilute or mix: Lantus should not be diluted or mixed with any other insulin or solution 2
• Visual inspection: Instruct to use only if solution is clear and colorless with no visible particles 2
• Storage: Specify proper storage conditions (refrigerated until opening, then at room temperature for up to 28 days)

Common Pitfalls to Avoid

• Failing to specify "subcutaneous" route: This is critical as insulin should never be given intravenously as a standing order
• Omitting "units" or using abbreviations: Always write out "units" rather than using "U" to prevent dosing errors
• Not specifying consistency in timing: Lantus should be administered at the same time each day for optimal glycemic control 2
• Forgetting to include monitoring parameters: Blood glucose monitoring is essential during initiation and dose adjustments

By following these guidelines, you can ensure a clear, complete, and safe order for Lantus insulin therapy that will help achieve optimal glycemic control while minimizing the risk of adverse events.