Insulin KwikPens Do Not Include Needles
No, insulin glargine KwikPen devices (Lantus, Toujeo, Basaglar, Semglee) do not come with pen needles—needles must be prescribed and obtained separately. 1
What You Must Prescribe
- Write two separate prescriptions: one for the insulin pen device itself and one for pen needles 1, 2
- Recommended needle specification: Prescribe 4mm × 32G pen needles, which are the safest, most effective, and least painful option for all adults regardless of BMI 2
- Quantity calculation: For a nauseated cancer patient who may need basal insulin once daily, prescribe approximately 30-40 needles per month (allowing for single-use per injection with some extras) 2
- Example prescription: "Insulin pen needles, 4mm × 32G, Dispense: 100 needles, Refills: 3" 2
Critical Prescribing Considerations for This Patient
- Single-use needles are essential: Needle reuse increases lipohypertrophy, injection pain, and bleeding risk—particularly problematic in a cancer patient who may already have compromised tissue integrity 2
- Include sharps container: Prescribe a sharps disposal container for safe needle disposal 2
- Assess dexterity: If the nauseated cancer patient has physical limitations from treatment or disease, insulin pens are strongly preferred over vial-and-syringe because they require less manual dexterity and are easier to operate 1, 3
Why Pens Are Preferred for This Patient
- Insulin pens are the preferred delivery method for patients on multiple daily injections or those with dexterity issues, vision impairment, or physical limitations 1
- KwikPen devices specifically demonstrate lower injection force compared to other disposable pens, making them easier to use for patients with weakness or fatigue 4, 5
- Less painful: Pen devices are associated with less injection pain than vial-and-syringe methods, which is particularly relevant for a nauseated patient who may have heightened sensitivity 3
Common Pitfall to Avoid
The most common error is assuming pen needles are included with the pen device. This results in patients arriving home with insulin but no way to inject it—a dangerous situation for someone initiating basal insulin therapy. Always verify both prescriptions were filled before the patient leaves the pharmacy. 1, 2