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Essential Counseling Points

  • Name, indication, and route of administration
  • Frequency and duration of therapy
  • How to use the device and read dose markings
  • Storage and handling
  • Disposal
  • Foods/products to avoid
  • Emphasize importance of returning to DVM for recheck appointments
  • Monitor for signs of efficacy and toxicity
  • Adverse Event Reporting
  • Compounds:
    • Explain limitations compared to commercial FDA approved products
    • Monitor for signs of instability (color, consistency, odor, etc.)


Transdermal Application

  • Very useful for clients that have had issues with previous oral dosage forms (i.e., tablets/capsules/liquids)
  • The biggest concern from a pharmacist’s perspective is efficacy. Most transdermal medications have a much lower bioavailability compared to equivalent oral dosage forms. For that reason, transdermals should NOT be considered a first line treatment option for most patients.
  • Topical = systemic
  • Education:
    • Apply to the pinna of the ear
    • Client should always wear gloves while handling any transdermal
    • Rotate ears with each dose and clean ears regularly to prevent contact irritation
    • Wash hands thoroughly afterward administering



Human Products

(e.g., Lantus, Humulin, Novolog)

Veterinary Products

(e.g., Vetsulin, Prozinc)

  • Some forms do not require any manipulation prior to administration
  • Other forms may require to be gently shaken or rolled in the palms
  • U-100 (100 units/mL)
  • Both vials and pens are commonly used
  • Vetsulin has to be shaken vigorously
  • Prozinc should be gently rolled in the palms
  • U-40 (40 units/mL)
  • Must use appropriate U-40 syringes (normally not stocked in most human pharmacies)


Dismantling insulin pens

  • Most insulin doses, especially for feline patients, are very small (ex. 0.5-1 unit). Therefore, most insulin vials (10mL) are not dispensed due to such a short expiration date once the vials are open
  • Instead, insulin pens (3mL) are often dispensed and used as a vial. Once the cap is removed, an insulin syringe can be inserted into the insulin pen through the rubber septum and the dose can be withdrawn into the syringe.