Hi all,

Our current inpatient practice for insulin detemir (U-100) is unit-dose preparation by pharmacy using vials and 1 mL insulin syringes.

Doses ~greater than 75 units can cause the syringe to become unstable and plunger/stopper to possibly fall out (stopper is close to the end)

Alternative solutions come with pros and cons; curious to see what other facilities are doing for these larger doses.

Examples:
1. Using pens?
2. Concentrated insulin vial (e.g., U-500 with U-500 syringe)?
3. Drawing up in a 3 mL luer-lock syringe with additional warning labeling (e.g., "For Subcutaneous Use")?
4. Multiple 1 mL syringes (split doses)?

Thank you,

Zach