Switching between insulins can lead to mix-ups or dose errors.
Insulin is a "high-alert" med. A small error can cause blood sugar levels to drop dangerously low...or shoot sky high.
Help your pharmacist avoid problems with insulin changes.
Be familiar with insulin types to help quickly detect a mix-up.
Lantus and Levemir are LONG-acting insulins...they last up to 24 hours. NPH (Humulin N, etc) is INTERMEDIATE acting.
Regular insulin (Humulin R, etc) is SHORT acting, working in about 30 minutes. RAPID-acting insulins (Humalog, Apidra, NovoLog) work even faster...within 10 to 15 minutes.
Combos (Humulin 70/30, etc) are premixes of two insulin types.
When entering orders, double-check that you have the right form. There are huge differences between some insulins that look and sound similar...Humalog, Humulin R, Humulin 70/30, Humalog Mix 75/25, etc.
Stay alert for dose or frequency changes when patients switch.
In most cases, doses will be the same with similar insulins. A person switching from Lantus to Levemir will start with the same dose.
But expect dosing to change when people go to a new insulin type. For example, a person changing from NPH to Lantus will usually go from twice-daily to once-daily dosing...and possibly a slightly lower dose.
Avoid unintended duplicate therapy with similar insulins...such as dispensing Lantus AND Levemir or Humalog AND Apidra together.
In the community, "zero out" any refills of the old insulin in the computer so it doesn't get filled by mistake in the future.
In the hospital, pull old doses from med carts or patient-care areas to be sure the discontinued insulin doesn't reach the patient.
Use labeling to help prevent errors. For example, apply a "change in Rx" auxiliary label to a newly switched insulin Rx.
In the hospital, apply "high-alert" stickers or put insulin in a red bag...to warn staff to take a second look before administration.
Find out which doses and forms are equivalent in our new chart, How to Switch Between Insulin Products. Get more tips on avoiding mix-ups in our Technician Training Tutorial: Dispensing Insulins.
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