Insulin Administration


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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, CSII, IV* Individualize. SC: at start of meal or within 20mins after starting 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* Individualize. SC: 15mins before meal or within 20mins after starting 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
SC: use with intermediate or long-acting insulin.
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 immediately 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.
Humalog Rx SC, IV*, CSII Within 15mins before or immediately 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: ~30mins before a meal
SC: May mix with NPH insulin only. Draw Humulin R (clear) into syringe first then NPH. Inject immediately. Use syringes marked with U‑100.
Humulin
R U‑500
Rx SC Individ
ualize. ~30mins before a meal
Do not dilute/mix with other insulins Caution with dosage. Should look clear, colorless. Use with U-500 insulin syringes.
Novolin R OTC SC, IV* Individualize. SC: ~30mins before a meal SC: May mix with NPH insulin only. Draw Novolin R (clear) into syringe first then NPH. Inject immediately. 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. Inject immediately. Rotate vial or pen until uniformly white and cloudy. Use syringes marked with U‑100.
Novolin N OTC SC Individ
ualize
May mix with regular insulin only. Draw regular insulin (clear) into syringe first then Novolin N. Inject immediately. Roll vial in horizontal position 10 times or move pen up and down 20 times until uniformly white and cloudy. Inject immediately.
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 Individualize. ~30–45mins before a meal Do not mix with other insulins Rotate vial or pen until uniformly white and cloudy. Use syringes marked with U‑100.
Novolin 70/30 OTC SC Individualize. Twice daily ~30mins before a meal Do not mix with other insulins Roll vial in horizontal position 10 times or move pen up and down 20 times until uniformly white and cloudy. Inject immediately.
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 or pen 10 times until uniformly white and cloudy.
Humalog 
Mix 75/25
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 with PM meal or at bedtime or twice daily (AM and PM) 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. 6/2020)

This article originally appeared on MPR