Rusty Lantus Dosing

[emilyrose]

Hi all,

It was recommended that I post asking for advice on dosing for the new Lantus brand name pens (5x3mL pens) I am waiting for Walgreens to fill tonight, starting doses in the morning.

Vet recommended 0.5u 2x daily, although the script says 1u for filling purposes.

Spreadsheet is up to date, and his numbers have been all over the place.

 

[Chris & China (GA)]

Since the numbers have been all over the place, and 1U of Vetsulin dropped him so low today, I'd start with 0.5 of Lantus twice a day.

One thing to remember, Lantus works entirely different from Vetsulin. It can take 5-7 days before you'll know how well the starting dose will work, so don't get discouraged.

Housekeeping note: On your spreadsheet, you have it set up so that "anybody with the link can edit". You need to change that to "anybody with the link can view".

 

[emilyrose]

Since the numbers have been all over the place, and 1U of Vetsulin dropped him so low today, I'd start with 0.5 of Lantus twice a day.

One thing to remember, Lantus works entirely different from Vetsulin. It can take 5-7 days before you'll know how well the starting dose will work, so don't get discouraged.

Housekeeping note: On your spreadsheet, you have it set up so that "anybody with the link can edit". You need to change that to "anybody with the link can view".

Thank you. And do I need to keep this pen in the fridge? I'm entirely new to pens and how to use this off-label with u100 syringes.

I have it set that way because unfortunately it keeps setting itself to View Only even for me, as I'm doing this 100% on mobile. I can change it back though.

 

[Chris & China (GA)]

And do I need to keep this pen in the fridge? I'm entirely new to pens and how to use this off-label with u100 syringes.

Yes, keep the pens in the fridge so they last longer. 1 pen is 300 units so if you only give 1U twice a day, that's 5 months worth in 1 pen!

You just pull the cap off the pen and there's a rubber stopper just like there is on a vial. You insert the needle into the pen and draw back to the dose you want. Don't push insulin back into the pen. I usually drew just a little past the dose I wanted so I could get any bubbles out and then slowly and carefully waste the little bit extra, leaving it at the dose I wanted to give.

You'll want to have 3/10ml, 30 or 31 gauge insulin syringes with half unit marks. You can get the Relion brand from Walmart for $12.58 for a box of 100. Just ask for the Relion 3/10ml insulin syringes, preferably 31 or 30 gauge that hold a max of 30 units. Don't mention the half unit marks because most of their employees don't know they even come with half unit marks and will assume you don't know what you're asking for and will try to convince you that you must mean 1/2ml (which hold a max of 50 units and don't have half unit marks).

Either of these are fine. As long as the box has a purple stripe, they are the correct syringes.

 

[emilyrose]

Yes, keep the pens in the fridge so they last longer. 1 pen is 300 units so if you only give 1U twice a day, that's 5 months worth in 1 pen!

You just pull the cap off the pen and there's a rubber stopper just like there is on a vial. You insert the needle into the pen and draw back to the dose you want. Don't push insulin back into the pen. I usually drew just a little past the dose I wanted so I could get any bubbles out and then slowly and carefully waste the little bit extra, leaving it at the dose I wanted to give.

You'll want to have 3/10ml, 30 or 31 gauge insulin syringes with half unit marks. You can get the Relion brand from Walmart for $12.58 for a box of 100. Just ask for the Relion 3/10ml insulin syringes, preferably 31 or 30 gauge that hold a max of 30 units. Don't mention the half unit marks because most of their employees don't know they even come with half unit marks and will assume you don't know what you're asking for and will try to convince you that you must mean 1/2ml (which hold a max of 50 units and don't have half unit marks).

Either of these are fine. As long as the box has a purple stripe, they are the correct syringes.

View attachment 68724

I didn't get this message until after the dose, the syringe immediately pushed past the 0.5u mark and I did have to push some back into the pen because there was too much medicine and bubbles. The half unit mark is so small. Did I ruin the pen?

 

[tiffmaxee]

You did not ruin the pen. If you were to do that over and over again the insulin might not last as long. You should be able to use every pen to the last drop. BTW welcome to the FDMB. Likewise if you forget to refrigerate the pen it won’t ruin the insulin either.

When you have a chance please leave some space between your last dose of Vetsulin and first dose of lantus on your spreadsheet and write switched to lantus. I’ll see you on the lantus forum.

 

[emilyrose]

You did not ruin the pen. If you were to do that over and over again the insulin might not last as long. You should be able to use every pen to the last drop. BTW welcome to the FDMB. Likewise if you forget to refrigerate the pen it won’t ruin the insulin either.

When you have a chance please leave some space between your last dose of Vetsulin and first dose of lantus on your spreadsheet and write switched to lantus. I’ll see you on the lantus forum.

Will do, I did try to make a line break but mobile didn't give me the option to remove all of the column and row lines.

I'll be more careful with the pen but it is difficult since he's not even getting a whole unit. The biggest problem I had this morning was just the immediate bubbles

 

[tiffmaxee]

Bubbles drove me crazy! Here’s one way to try and get rid of them.
bubbles aren’t dangerous because you are giving a subq injection but it’s best not to squirt insulin back into the pen. Try this (written by another member):

Bubbles aren’t dangerous because you are giving a subq injection but it’s best not to squirt insulin back into the pen. Try this (written by another member):

“To start draw a bit more insulin than his dose and then hold the syringe needle up, give a good flick or two so that all the bubbles are at the tip by the needle.
Now pull the plunger a bit as if drawing more insulin, now you should have one bigger space with air or one big bubble.
Make sure there are no other bubbles just the one big one, if you need to pull down further it kinda joinsall the bubbles into one and then slowly shoot out the air until your dose and if all goes well…no morebubbles!”

Bubbas decided to continue the bounce on his curve day so we really can’t tell much. I wouldn’tincrease the dose since he was just in green. Great job with the curve. He’s gradually been coming downso I would definitely get a few tests in tonight.

To be honest I was not always successful so if there was a tiny one I just ignored it.

 

[Chris & China (GA)]

I have it set that way because unfortunately it keeps setting itself to View Only even for me, as I'm doing this 100% on mobile. I can change it back though.

If you're using a phone/tablet, that's a glitch that happens to a lot of people. If you have access to a PC, you won't have the "view only" problem. Even on mobiles, it usually lasts a cycle or two (or maybe a day or two) but then all the sudden it's working again. We've tried getting help from Google...that was useless.

Will do, I did try to make a line break but mobile didn't give me the option to remove all of the column and row lines.

Since it is still on "anybody with the link can edit", I added a "break" line for Starting Lantus for you.