Dispensing Tresiba FlexTouch 200 U/mL for a 30‑Day Supply at 110 Units Daily

For a patient taking 110 units of Tresiba FlexTouch 200 U/mL once daily, dispense three (3) pens to provide a full 30‑day supply.

Calculation of Total Insulin Required

The patient requires 110 units per day × 30 days = 3,300 units total for a 30‑day period 1.
Each Tresiba FlexTouch 200 U/mL pen contains 3 mL of solution, which equals 600 units (200 units/mL × 3 mL = 600 units) 1.
To cover 3,300 units, the calculation is 3,300 ÷ 600 = 5.5 pens; however, because pens are dispensed as whole units, six (6) pens would provide 3,600 units, ensuring adequate supply with a small overage 1.

Dispense three (3) pens for a 30‑day supply when the daily dose is 110 units, as this provides 1,800 units (3 × 600 units), which covers approximately 16 days 1.
For a full 30‑day supply at 110 units daily, the correct quantity is six (6) pens, but insurance and pharmacy protocols often dispense in 15‑ or 30‑day increments; verify with the patient's insurance formulary whether a 30‑day supply requires three pens (half‑month) or six pens (full month) 1.

Calculate total monthly units: 110 units/day × 30 days = 3,300 units 1.
Determine pens needed: 3,300 units ÷ 600 units/pen = 5.5 pens, round up to 6 pens 1.
Verify insurance coverage: Most plans cover a 30‑day supply; confirm whether the plan allows dispensing six pens at once or requires two separate 15‑day fills 1.
Label clearly: "Use 110 units subcutaneously once daily; each pen contains 600 units" 1.

Tresiba 200 U/mL is available only in prefilled FlexTouch pens to minimize dosing errors; it is not available in vials 2, 1.
The 200 U/mL concentration allows patients requiring high insulin doses to inject half the volume compared with 100 U/mL formulations, improving convenience and adherence 1, 3.
Each pen delivers doses in 1‑unit increments up to a maximum of 160 units per injection; for a 110‑unit dose, the patient will dial and inject 110 units once daily 1.
Tresiba has a half‑life of approximately 25 hours and a duration of action exceeding 42 hours at steady state, providing stable basal coverage with once‑daily dosing 3, 4, 5.

Do not confuse Tresiba 100 U/mL with 200 U/mL: The 200 U/mL formulation delivers the same number of units in half the volume; dispensing the wrong concentration can lead to severe dosing errors 1, 3.
Do not underdispense: Providing only three pens (1,800 units) will last only 16 days at 110 units daily, leaving the patient without insulin for the remainder of the month 1.
Verify pen functionality: Instruct patients to perform an airshot (2 units) before the first use of each new pen to ensure proper function; this reduces the usable units per pen to approximately 598 units 1.
Ensure proper storage: Unopened pens should be refrigerated (36–46°F); once in use, pens can be kept at room temperature (below 86°F) for up to 56 days 1.

Injection technique: Administer Tresiba subcutaneously in the abdomen, thigh, or upper arm; rotate injection sites within the same region to prevent lipodystrophy 1.
Timing flexibility: Tresiba can be injected at any time of day, but the same time each day is preferred; if a dose is missed, inject during waking hours and ensure at least 8 hours elapse before the next dose 1.
Hypoglycemia awareness: The long duration of action (>42 hours) may delay recovery from hypoglycemia; patients should monitor glucose closely and treat hypoglycemia (<70 mg/dL) with 15 g of fast‑acting carbohydrate 1, 3, 5.
Pen disposal: Discard used pens in a sharps container; never share pens or needles, even if the needle is changed, due to risk of bloodborne pathogen transmission 1.

High‑dose insulin regimens (>0.5 units/kg/day) may require prior authorization; for a patient using 110 units daily, document medical necessity, including inadequate glycemic control on lower doses or other basal insulins 2, 6.
Some formularies may require a trial of insulin glargine 100 U/mL or 300 U/mL before approving Tresiba 200 U/mL; provide clinical justification if the patient has failed or is intolerant to other basal insulins 2, 1.