How to write a prescription for Lantus (insulin glargine) 15 units subcutaneously every night at bedtime for a 1-month supply?

How to Write a Prescription for Lantus 15 Units at Bedtime for 1 Month

Write the prescription as: Lantus (insulin glargine) 100 units/mL, 15 units subcutaneously once daily at bedtime, dispense one 10 mL vial (or two 3 mL pens), with appropriate refills for ongoing therapy. 1

Prescription Components

Drug Name and Concentration

• Specify "Lantus (insulin glargine) 100 units/mL" to ensure the correct formulation is dispensed 1
• Always verify insulin labels before administration, as this is critical for patient safety 1

Dosing Instructions

• Write "15 units subcutaneously once daily at bedtime" 1
• The FDA label specifies that Lantus should be administered at the same time every day, though it can be given at any time of day 1
• Bedtime dosing is a common and appropriate timing for basal insulin 1

Route and Site of Administration

• Specify subcutaneous administration into the abdominal area, thigh, or deltoid 1
• Include instruction to rotate injection sites within the same region to reduce risk of lipodystrophy and localized cutaneous amyloidosis 1

Quantity to Dispense

For a 1-month supply at 15 units daily:

• Total units needed = 15 units/day × 30 days = 450 units
• Dispense one 10 mL vial (contains 1000 units, sufficient for >2 months) 1
• Alternative: Dispense two 3 mL SoloStar pens (each contains 300 units = 600 units total, sufficient for 40 days) 1

Additional Prescription Elements

• Include appropriate refills (typically 11 refills for chronic therapy)
• Add "Do not dilute or mix with any other insulin or solution" 1
• Note that needles/syringes must never be shared between patients 1

Critical Safety Considerations

Monitoring Requirements

• Instruct patient to increase frequency of blood glucose monitoring during initial therapy 1
• Dosage adjustments should only be made under medical supervision with appropriate glucose monitoring 1

Important Warnings

• Lantus is contraindicated during episodes of hypoglycemia 1
• Do not administer intravenously or via an insulin pump 1
• The solution should be clear and colorless with no visible particles before use 1

Common Pitfalls to Avoid

• Never prescribe without specifying the concentration (100 units/mL) to avoid confusion with Toujeo (300 units/mL) 1
• Do not write "qhs" alone - specify "once daily at bedtime" for clarity 1
• Ensure adequate supply - prescribing exactly 450 units would leave no margin for error; a full vial or pen package is more practical 1
• For patients with visual impairment using SoloStar pens, note that the pen dials in 1-unit increments and caution is needed 1