How do I order pen tips for a pen injector?

How to Order Pen Needles for Insulin Pen Injectors

Pen needles are prescribed separately from insulin pens and must be ordered as an independent prescription—the most common prescribing error is assuming needles come with the pen device. 1

Specific Prescription Details

First-Line Needle Specifications

• Order 4-mm, 32-gauge pen needles as the standard prescription for all patients, including those with obesity, children, and adults of any BMI 1, 2
• The 4-mm length is the universal first-line recommendation because it safely delivers insulin subcutaneously while minimizing risk of intramuscular injection across all body types 1, 2
• 32-gauge diameter (or 31-gauge as alternative) provides optimal patient comfort and acceptance while maintaining adequate insulin flow 1

Alternative Needle Options

• 5-mm needles are acceptable as a second-line choice, though 4-mm remains preferred 1
• Specify thin-walled or extra-thin-walled needles when available, as they provide better insulin flow while maintaining narrow gauge and reducing injection force 1
• Never prescribe needles longer than 6 mm for children, as this creates excessive risk of intramuscular injection 1

Quantity to Prescribe

• Prescribe one needle per injection since pen needles must be used only once and discarded immediately after each use 3, 1
• Calculate total monthly supply based on the patient's injection frequency (e.g., if injecting 4 times daily, prescribe 120 needles per month)
• Pen needles are no longer sterile after a single use and leaving them attached between injections allows air contamination and medication leakage 3

Prescription Writing Format

Write the prescription to include:

• Needle length: 4 mm (first-line)
• Needle gauge: 32-gauge (or 31-gauge)
• Quantity: Based on injection frequency × 30 days
• Refills: Appropriate for chronic therapy
• Specify "thin-walled" or "extra-thin-walled" if available

Critical Prescribing Pitfalls to Avoid

• Do not assume the pen device includes needles—this is the single most common error that prevents patients from using their insulin 1
• Pen needles are manufactured and distributed separately from pen injector devices and require independent prescription 1
• Avoid prescribing needles >6 mm for pediatric patients (≤18 years) due to intramuscular injection risk 1
• Do not prescribe needles <4 mm, as these are not standard and may not be compatible with all pen devices 1, 2

Patient Education Points to Include

When prescribing, ensure patients understand:

• Remove and dispose of the needle immediately after each injection—never leave it attached to the pen 3, 1
• Use each needle only once; they are not sterile after first use 3, 1
• Prime the pen before each injection to ensure free insulin flow 3, 1
• Never share pens or needles between individuals, even with a new needle, as this transmits blood-borne infections 1
• Count to 10 before withdrawing the needle to ensure complete dose delivery 1