LANTUS INSULIN:� CAUTIONS

����������� �ISMP MEDICATION SAFETY ALERT,� Vol. 5, No. 9, for May 2000, published by the Institute for Safe Medication Practice, contained the following note of caution about Aventis' new LANTUS insulin:

����������� LANTUS is administered subcutaneously once daily, at bedtime.� Unlike other insulins, it maintains a relatively constant level over 24 hours, with no pronounced peak.� Concern is mounting that oral or written orders for LANTUS may be mistaken as "Lente" insulin, which has a more rapid effect and shorter duration of activity than LANTUS.� Furthermore, prescribers have been known to designate the type of insulin by using the associated one-letter abbreviation appearing on insulin vials.� For example, 16 units of Lente insulin is sometimes written as "L-16 units."� Since LANTUS also begins with an "L," it is possible that mix-ups with Lente insulin may occur.� We've communicated these concerns to the FDA and the manufacturer.

����������� In addition to concerns about the name, wrong time errors are also possible, as LANTUS is given at bedtime, not in the morning like other insulins.� Therefore, special consideration must be given to the way prescribers communicate orders.� If the drug is simply labelled "daily," those administering the drug may assume it should be given in the morning.