Step 1: Determine whether the patient will be using insulin VIALS or CARTRIDGES (in an insulin pen)
most patients on insulin use pens/cartridges
Step 2: Specify how much will be dispensed
insulin cartridges come in a BOX of 5 x 3 mL cartridges, at a concentration of 100 U/mL (thus 1 box = 1500 U)
be sure of what BRAND of insulin the patient is using and if they already have a pen. Novolin (e.g. Aspart/Novorapid, Toronto, NPH, Detemir/Levemir) will only work in Novolin pens. Humulin (e.g. Lispro/Humalog, R, N) will only work in Humulin pens. Glargine/Lantus and Glulisine/Apidra have their own pens.
vials can be dispensed in any amount. One 10 cc vial will have 1000 U
Step 3: Dont forget to include test strips, lancets, pen needles/tips
For patients receiving Ontario Drug Benefits, you may need to add a Limited Use code for certain insulins (Humalog, Humalog Mix 25, Novorapid, Novomix 30). Contact your pharmacist for details.
Novolin NPH penfills supply: 1 box of 5 x 3 cc cartridges, Repeat x #
Humalog penfills supply: 1 box, Repeat x #
Humulin N vial supply: 1 vial, Repeat x #
Pentips/pen needles supply: 1 box, Repeat x #
Lancets supply: 1 box, repeat x #
Alternatively, feel free to print and use the following excellent insulin prescription form from the Ontario College of Family Physicians:
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