Name: Insulin Administration - Endocrinology Advisor
Published: 2012-11-14T19:30:00+00:00

INSULIN ADMINISTRATION
Prepar– ation	Brand		Route	Adminis– tration	Mixing Insulins	Comments
RAPID-ACTING
insulin	Afrezza	Rx	oral inh	At the beginning of a meal	—	Loss of drug effect if inhaler is mishandled. See full labeling.
insulin aspart	Fiasp	Rx	SC, IV*	At the beginning of a meal or within 20mins after starting a meal	Do not dilute/mix with other insulins	Should look clear, colorless. SC: use with intermediate or long-acting insulin.
	NovoLog	Rx	SC CSII IV*	Within 5−10mins before a meal	SC: May mix with NPH insulin. Draw NovoLog into syringe first. Inject immediately after mixing. May dilute with Insulin Diluting Medium for NovoLog to 1:10 (U‑10) or 1:2 (U‑50) concentrations. CSII: Do not dilute or mix with other insulins IV: Do not mix with other insulins	CSII: Change inj site at least every 3 days and reservoir at least every 6 days.
insulin glulisine	Apidra	Rx	SC CSII IV	Within 15mins before a meal or 20mins after starting a meal	SC: May mix with NPH insulin. Draw Apidra into syringe first. Inject immediately after mixing. CSII: Do not dilute or mix with other insulins IV: Do not mix with other insulins	CSII: Change inj site at least every 48hrs and reservoir at least every 2 days.
insulin lispro	Admelog	Rx	SC IV*, CSII	Within 15mins before or immedi– ately after a meal	Do not dilute/mix with other insulins	CSII: Change inj site at least every 3 days and reservoir at least every 7 days.
insulin lispro	Humalog	Rx	SC IV*^†, CSII^†	Within 15mins before or immedi– ately after a meal	SC: May mix Humalog U-100 with NPH insulin. Draw Humalog into syringe first. Inject immediately after mixing. May dilute with STERILE DILUENT for Humalog to 1:10 (U‑10) or 1:2 (U‑50) concentrations. CSII: Do not dilute or mix with other insulins	CSII: Change inj site at least every 3 days and reservoir at least every 7 days.
SHORT-ACTING
insulin injection regular (R)	Humulin R U‑100	OTC	SC, IV*	Individ– ualize	SC: May mix with longer-acting human insulins. Draw clear insulin into syringe first.	Use syringes marked with U‑100.
	Humulin R U‑500	Rx	SC	Individ– ualize	See product label	Caution with dosage. Should look water-clear. Use with U-500 insulin syringes.
	Novolin R	OTC	SC, IV*	≥3 times daily within 30mins before a meal	SC: May mix with longer-acting human insulins. Draw clear insulin into syringe first.	Use syringes marked with U‑100.
INTERMEDIATE-ACTING
insulin isophane suspension (NPH)	Humulin N	OTC	SC	Individ– ualize	May mix with Humalog or Humulin R. Draw clear insulin into syringe first then Humulin N.	Rotate vial to mix. Should look uniformly cloudy. Use syringes marked with U‑100.
insulin isophane suspension (NPH)	Novolin N	OTC	SC	Individ– ualize	May mix with other insulins. Draw clear insulin into syringe first then Novolin N.	Rotate vial to mix. Should look uniformly cloudy. Use syringes marked with U‑100 or U‑40. Inject rapidly over 2−4secs to avoid clogging needle tip.
SHORT- AND INTERMEDIATE-ACTING MIXTURES
insulin aspart protamine/ insulin aspart	NovoLog Mix 70/30	Rx	SC	Twice daily within 15mins before a meal	Do not mix with other insulins	Roll vial, prefilled syringe 10 times until uniformly cloudy.
insulin isophane suspension (NPH)/ regular insulin (R)	Humulin 70/30	OTC	SC	Individ– ualize	See product label	Rotate vial to mix. Should look uniformly cloudy. Use syringes marked with U‑100.
insulin isophane suspension (NPH)/ regular insulin (R)	Novolin 70/30	OTC	SC	Individ– ualize	Do not change the ratio by adding NPH or Regular insulin to the vial. Use separate insulin formulations (Novolin N and Novolin R).	Rotate vial to mix. Should look uniformly cloudy. Use syringes marked with U‑100 or U‑40. Inject rapidly over 2−4secs to avoid clogging needle tip.
insulin lispro protamine/ insulin lispro	Humalog Mix 50/50	Rx	SC	Within 15mins before a meal	Do not mix with any other insulins	Rotate vial to mix. Should look uniformly cloudy.
insulin lispro protamine/ insulin lispro	Humalog Mix 75/25	Rx	SC	Within 15mins before a meal	Do not mix with any other insulins	Rotate vial to mix. Should look uniformly cloudy.
LONG-ACTING
insulin degludec	Tresiba	Rx	SC	Once daily at any time of day	Do not dilute or mix with other insulins	Should look clear, colorless.
insulin detemir	Levemir	Rx	SC	Once daily (PM) or twice daily (12hrs apart)	Do not dilute or mix with other insulins	Should look clear, colorless.
insulin glargine	Basaglar	Rx	SC	Once daily at the same time every day	Do not dilute or mix with other insulins	Should look clear, colorless.
	Lantus
	Toujeo
LONG-ACTING MIXTURES
insulin degludec/liraglutide	Xultophy 100/3.6	Rx	SC	Once daily at same time each day, with or without food	Do not dilute/mix with other insulins	Should look clear, colorless.
insulin glargine/lixisenatide	Soliqua 100/33	Rx	SC	Once daily within the hour prior to first meal	Do not dilute or mix with other insulins or solutions	Should look clear, colorless to almost colorless.
NOTES
Key: CSII = continuous subcutaneous insulin infusion * IV to be used in a clinical setting under proper medical supervision. ^†IV and CSII administration for Humalog U-100 only. Rate of insulin absorption, onset and duration of action may be affected by the injection site, blood supply, temperature, exercise, and other variables. Caution with changes in strength, manufacturer, preparation, species of insulin source. Not an inclusive list of medications and/or dosing instructions. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 10/2018)

This article originally appeared on MPR

Insulin Administration

Want to read more?

Want to read more?