Tresiba 100 to Tresiba 200

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Xinte

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Type 2
Good Evening all, After a Diabetes review with the nurse, she decided to change my Tresiba 100 to Tresiba 200 because of the amount of units I was using a day (60) She told me to use the same 60 units on my new 200 pen and that the pen actually calculates the units so that I would be injecting less liquid. Went to pick up the new prescription of Tresiba 200 pens and the pharmacist tells me to remember to halve the 60 unit dose as the Tresiba 200 is twice the strength of the 100! Now that has me totally confused . To add, the nurse also prescribed Novorapid Flexpen which I haven't used yet, It will be at least a week before I can get another telephone appointment with my Diabetes nurse so can anyone tell me if I halve the dose of the Tresiba 200 or not? thanks in advance
 
Xinte said:
Good Evening all, After a Diabetes review with the nurse, she decided to change my Tresiba 100 to Tresiba 200 because of the amount of units I was using a day (60) She told me to use the same 60 units on my new 200 pen and that the pen actually calculates the units so that I would be injecting less liquid. Went to pick up the new prescription of Tresiba 200 pens and the pharmacist tells me to remember to halve the 60 unit dose as the Tresiba 200 is twice the strength of the 100! Now that has me totally confused . To add, the nurse also prescribed Novorapid Flexpen which I haven't used yet, It will be at least a week before I can get another telephone appointment with my Diabetes nurse so can anyone tell me if I halve the dose of the Tresiba 200 or not? thanks in advance
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I think your nurse is right. This is taken from the Patient Information leaflet, which should be included in your new pack. Basically, it says inject the same number of units you used to, and do not recalculate the dose.
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Robin said:
It obviously has caused confusion in the past, here is a safety notice on the subject, reinforcing that you should take the same number of units irrespective of the strength.
www.patientsafetyinstitute.ca

GPSA: Doubt about dosage when switching between Tresiba® 100, FlexTouch® and Tresiba® 200, FlexTouch® | CPSI

This alert discusses the dosing errors when using an ultra-long-acting insulin as Tresiba®. Tresiba® FlexTouch® is available in two strengths – 100
www.patientsafetyinstitute.ca
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I presume the actual volume of insulin is less for for Tresiba 200 compared with the Tresiba 100 as it is twice the strength, so for a 60U dose you end up only injecting half the volume of the Tresiba 200. It sounds like the pen will still show 60U for this reduced volume.

It certainly is confusing though for the patients! Especially if the pharmacist said to halve the dose. But it does sound like your nurse is correct.
 
Eternal422 said:
I presume the actual volume of insulin is less for for Tresiba 200 compared with the Tresiba 100 as it is twice the strength, so for a 60U dose you end up only injecting half the volume of the Tresiba 200. It sounds like the pen will still show 60U for this reduced volume.

It certainly is confusing though for the patients! Especially if the pharmacist said to halve the dose. But it does sound like your nurse is correct.
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Yes, 60 units is half the volume of liquid, but it still contains 60 units of insulin. Like diluting your orange squash with half as much water, so it tastes really strong. The pen holds 160 units, and clicks up in increments of 2 instead of 1, but what appears in the dosing window is the number of units of actual insulin you are going to get injected into you, irrespective of the amount of liquid it’s dissolved in.
 
agree with everyone else you just dial the 60. If you’re visually impaired and counting clicks then only count 30
 
I think the pharmacist may have been confusing the situation because of the possibility of using u200 insulin in reusable (u100 calibrated) pens or other injection devices.

I think this has been a worry in hospitals where u100 syringes might be used with a u200 insulin, and if staff aren’t aware they risk giving double-sized doses!

If you are using a prefilled pen, this has already been accounted for in the engineering of the injection device, as @Amity Island says above. 🙂
 
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