NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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How should NPH dose be adjusted when converting to glargine QD?

Use 80% of NPH dose
Use 100% of NPH dose
Increase by 20%
Decrease by 50%

The correct answer is: Use 80% of NPH dose

When converting from NPH insulin to glargine insulin once daily (QD), it is recommended to use approximately 80% of the total daily dose of NPH insulin. This adjustment accounts for the longer duration of action and more consistent absorption profile of glargine compared to NPH insulin. By using 80% of the NPH dose, the likelihood of hypoglycemia can be minimized during the transition. Options B, C, and D are incorrect. It is not recommended to use 100% of the NPH dose when switching to glargine because glargine is typically dosed slightly lower. Increasing by 20% or decreasing by 50% are not standard conversion guidelines and can lead to inappropriate dosing and glucose control.