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Definitions

Biosimilar - product that is similar to the reference product but requires permission from the prescriber to substitute
Duration of action - time period from first measurable effect until last measurable effect
Onset of action - time period from injection until first measurable effect
Interchangeable - product that may be substituted for the reference product without the prescriber's permission
Peak effect - time period from injection until greatest effect
IL - Interchangeable with Lantus

Admelog®
Insulin lispro

Dosage forms

SoloStar® Pen (100 units/ml)

3 ml pen
Comes in carton of 5 pens
Compatible with BD Ultra-Fine®, Ypsomed Clickfine®, and Owen Mumford Unifine® needles

Vial (100 units/ml)

Comes in 3 ml and 10 ml vials

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

3 - 5 hours

Peak effect

1/2 - 2 hours

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
Admelog® is a premeal (prandial) insulin. See insulin dosing for more.
Inject Admelog® within 15 minutes before a meal or immediately after a meal

Other

Admelog® should be clear and colorless
Admelog® is compatible with some insulin pumps

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials and pens are good for 28 days

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Vials may be refrigerated or kept at room temp
Vials and pens are good for 28 days

Afrezza®
Inhaled insulin

Dosage forms

Cartridge

4 unit cartridge of inhalation powder
8 unit cartridge of inhalation powder

Packaged as follows:

60 four unit cartridges
90 four unit cartridges
90 eight unit cartridges
60 four unit and 30 eight unit
30 four unit and 60 eight unit
90 four unit and 90 eight unit

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

∼ 2.6 hours

Peak effect

∼ 53 minutes

Dosing

Insulin-naïve patients

4 units with the start of each meal

Patients on injectable insulin

See conversion table

Other

See Inhaled insulin for a complete review of Afrezza®

Storage

Packaging

Afrezza® comes in a sealed foil package with 2 blister cards inside
Each blister card has 5 rows of 3 cartridges
3 cartridges are under one blister
Before use, cartridge and inhaler should be at room temperature for 10 minutes
Inhaler should be thrown away after 15 days

Refrigerated

Sealed foil package is good until expiration date

Room temperature

Sealed foil package - use within 10 days
Sealed blister cards + strips - use within 10 days
Opened blister - use within 3 days

Apidra®
Insulin glulisine

Dosage forms

Vial (100 units/ml)

10 ml vial

SoloStar® Pen (100 units/ml)

3 ml pen
Comes in package of 5 pens
Compatible with all BD® pen needles

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

3 - 5 hours

Peak effect

1/2 - 2 hours

Mixing

Mix with NPH only
Draw Apidra® first, then NPH
Inject immediately

Dosing

Dosage will vary by patient
Apidra® is a premeal (also called prandial) insulin. See insulin dosing for more.
Inject Apidra® within 15 minutes before a meal or within 20 minutes after starting a meal

Other

Apidra® should be clear and colorless
Apidra® is compatible with some insulin pumps

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials and pens are good for 28 days

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Vials may be refrigerated or kept at room temperature
Vials and pens are good for 28 days

Fiasp®
Insulin aspart

Dosage forms

Vial (100 units/ml)

10 ml vial

FlexTouch Pen® (100 units/ml)

3 ml pen
Comes in carton of 5 pens
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Pharmacokinetics

Onset of action

15 - 20 minutes

Duration of action

5 - 7 hours

Peak effect

90 - 133 minutes

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
Fiasp® is a premeal (prandial) insulin. See insulin dosing for more.
Inject Fiasp® at the start of a meal or within 20 minutes after starting a meal
Fiasp® is approved for use in some insulin pumps

Other

Fiasp® should be clear and colorless
Fiasp® is approved for use in some insulin pumps

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials and pens are good for 28 days

Punctured

Vials and pens may be refrigerated or kept at room temperature
Vials and pens are good for 28 days

Humalog®
Insulin lispro

Dosage forms

* For use in HumaPen® Luxura HD and HumaPen® Memoir

^‡Tempo pen connects to a phone app and relays dosing information

^✝Dose is dialed in 0.5 unit increments

**Can connect to a compatible trasmitter

Reference: Humalog PI
Humalog products
Name	Volume	Concentration	Max dose per injection	Package size
U-100 vial	3 ml and 10 ml	100 units/ml	N/A	1 vial
U-100 cartridge *	3 ml	100 units/ml	N/A	5 cartridges
U-100 KwikPen	3 ml	100 units/ml	60 units	5 pens
U-100 Tempo Pen ^‡	3 ml	100 units/ml	60 units	5 pens
U-100 Junior KwikPen ^✝	3 ml	100 units/ml	30 units	5 pens
U-200 KwikPen	3 ml	200 units/ml	60 units	2 pens
U-200 Tempo Pen**	3 ml	200 units/ml	60 units	2 pens

Needles

KwikPen® is compatible with all BD® pen needles

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

3 - 5 hours

Peak effect

1/2 - 2 hours

Mixing

Mix with NPH only
Draw Humalog® first, then NPH
Inject immediately

Dosing

Dosage will vary by patient
Humalog® is a premeal (prandial) insulin. See insulin dosing for more.
Inject Humalog® within 15 minutes before a meal or immediately after a meal

Other

Humalog® should be clear and colorless
Humalog® is compatible with some insulin pumps
HumaPen® Luxura HD is a reusable pen that allows dosing in 0.5 unit increments
HumaPen® Memoir records the time, date, and dose of the last 16 injections

Storage

Unpunctured, refrigerated

Vials, pens, and cartridges are good until expiration date on product

Unpunctured, room temp

Vials, pens, and cartridges are good for 28 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens and cartridges should be kept at room temperature (do not refrigerate)
Vials, pens, and cartridges are good for 28 days

Lyumjev®
Insulin lispro-aabc

Dosage forms

* For use in HumaPen® Luxura HD

^✝Dose is dialed in 0.5 unit increments

^‡Tempo pen connects to a phone app and relays dosing information

Reference: Humalog PI
Lyumjev products
Name	Volume	Concentration	Max dose per injection	Package size
U-100 vial	10 ml	100 units/ml	N/A	1 vial
U-100 cartridge *	3 ml	100 units/ml	N/A	5 cartridges
U-100 KwikPen	3 ml	100 units/ml	60 units	5 pens
U-100 Junior KwikPen ^✝	3 ml	100 units/ml	30 units	5 pens
U-100 Tempo Pen ^‡	3 ml	100 units/ml	60 units	5 pens
U-200 KwikPen	3 ml	200 units/ml	60 units	2 pens

Pharmacokinetics

Onset of action

15 - 20 minutes

Duration of action

4 - 8 hours

Peak effect

2 - 3 hours

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
Lyumjev® is a premeal (prandial) insulin. See insulin dosing for more.
Inject Lyumjev® at the start of a meal or within 20 minutes after starting a meal

Other

Lyumjev® should be clear and colorless

Storage

Unpunctured, refrigerated

Vials, pens, and cartridges are good until expiration date on product

Unpunctured, room temp

Vials, pens, and cartridges are good for 28 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens and cartridges should be kept at room temperature (do not refrigerate)
Vials, pens, and cartridges are good for 28 days

Novolog®
Insulin aspart

Dosage forms

Vial (100 units/ml)

10 ml vial

FlexPen® (100 units/ml)

3 ml pen
Comes in package of 5
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

FlexTouch® Pen (100 units/ml)

3 ml pen
Comes in package of 5
FlexTouch® pen button maintains the same extension at all doses
Compatible with NovoFine® and NovoTwist® pen needles

Cartridge (100 units/ml)

3 ml cartridge
for use in NovoPen® reusable pens

Interchangeables

Kirsty (insulin aspart-xjhz): Pen (3 ml, 100 units/ml); Vial (10 ml, 100 units/ml)

Biosimilars

Merilog (insulin aspart-szjj): Pen (3 ml, 100 units/ml); Vial (10 ml, 100 units/ml)

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

3 - 5 hours

Peak effect

1 - 3 hours

Mixing

Mix with NPH only
Draw Novolog® first, then NPH
Inject immediately

Dosing

Dosage will vary by patient
Novolog® is a premeal (also called prandial) insulin. See insulin dosing for more.
Inject Novolog® within 5 - 10 minutes before a meal

Other

Novolog® should be clear and colorless
Novolog® is compatible with some insulin pumps

Storage

Unpunctured, refrigerated

Vials, pens, and cartridges are good until expiration date on product

Unpunctured, room temp

Vials, pens, and cartridges are good for 28 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens and cartridges should be kept at room temperature (do not refrigerate)
Vials, pens, and cartridges are good for 28 days

Humulin® R
Regular insulin

Dosage forms

Humulin® R U-100 Vial

Contains 100 units/ml
Comes in 3 ml and 10 ml vials

Humulin® R U-500 Vial

Contains 500 units/ml
20 ml vial
A special U-500 syringe must be prescribed with vial

Humulin® R U-500 KwikPen®

Contains 500 units/ml
3 ml pen
Comes in carton of 2 or 5 pens
BD® pen needles are recommended

Pharmacokinetics

Onset of action

30 - 60 minutes

Duration of action

6 - 8 hours

Peak effect

2 - 3 hours

Mixing

Mix with NPH only
Draw Humulin® R first, then NPH
Inject immediately

Dosing

Dosage will vary by patient
Humulin® R is a premeal (also called prandial) insulin. See insulin dosing for more.
Humulin® R should be followed by a meal within approximately 30 minutes of administration

Other

Humulin® R should be clear and colorless
Humulin® R U-500 should only be prescribed to patients who require > 200 units of insulin per day

Storage U-100

Unpunctured, refrigerated

Vials are good until expiration date on product

Unpunctured, room temp

Vials are good for 31 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Vials are good for 31 days

Storage U-500

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 40 days
Pens are good for 28 days

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Vials may be refrigerated or kept at room temperature
Pens are good for 28 days
Vials are good for 40 days

Novolin® R
Regular insulin

Dosage forms

Vial (100 units/ml)

10 ml vial

Flexpen (100 units/ml)

3 ml pen
Comes in carton of 5 pens
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Pharmacokinetics

Onset of action

30 - 60 minutes

Duration of action

6 - 8 hours

Peak effect

2 - 3 hours

Mixing

Mix with NPH only
Draw Novolin® R first, then NPH
Inject immediately

Dosing

Dosage will vary by patient
Novolin® R is a premeal (also called prandial) insulin. See insulin dosing for more.
Novolin® R should generally be injected approximately 30 minutes prior to the start of a meal

Other

Novolin® R should be clear and colorless

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 42 days
Pens are good for 28 days

Punctured (in use)

Vials and pens should be kept at room temperature (do not refrigerate)
Vials are good for 42 days
Pens are good for 28 days

Humulin® N
NPH, Human insulin isophane suspension

Dosage forms

Vial (100 units/ml)

Comes in 3 ml and 10 ml vials

KwikPen® (100 units/ml)

3 ml pen
Comes in package of 5
Compatible with BD® pen needles

Pharmacokinetics

Onset of action

2 - 4 hours

Duration of action

up to 20 hours

Peak effect

4 - 10 hours

Mixing

Humulin® N can be mixed with Regular, Apidra®, Humalog®, and Novolog®
Draw Humulin® N after other insulin
Inject immediately

Dosing

See NPH dosing for recommendations on dosing NPH insulin
See converting between insulin brands and types for information on changing insulins

Other

Humulin® N should be mixed before use (see instructions with product)
Humulin® N should appear uniformly cloudy with no particulate matter after mixing

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 31 days
Pens are good for 14 days

Punctured (in use)

Vials may be refrigerated or kept at room temp
Pens should be kept at room temperature (do not refrigerate)
Vials are good for 31 days
Pens are good for 14 days

Novolin® N
NPH, Isophane insulin human suspension

Dosage forms

Vial (100 units/ml)

10 ml vial

FlexPen (100 units/ml)

3 ml pen
Comes in carton with 5 pens
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Pharmacokinetics

Onset of action

2 - 4 hours

Duration of action

up to 20 hours

Peak effect

4 - 10 hours

Mixing

Novolin® N can be mixed with Regular, Apidra®, Humalog®, and Novolog®
Draw Novolin® N after other insulin
Inject immediately

Dosing

See NPH dosing for recommendations on dosing NPH insulin
See converting between insulin brands and types for information on changing insulins

Other

Novolin® N should be mixed before use (see instructions with product)
Novolin® N should appear uniformly cloudy with no particulate matter after mixing

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 42 days
Pens are good for 28 days

Punctured (in use)

Vial and pens should be stored at room temperature (do not refrigerate)
Vials are good for 42 days
Pens are good for 28 days

Basaglar®
Insulin glargine

Dosage forms

Kwikpen (100 units/ml)

3 ml pen
Comes in package of 5 pens
Compatible with BD® pen needles

Tempo Pen (100 units/ml)

3 ml pen
Comes in package of 5 pens
Compatible with BD® pen needles
Tempo pen connects to a phone app and relays dosing information

Pharmacokinetics

Onset of action

1 - 3 hours

Duration of action

24+ hours

Peak effect

No peak

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
The recommended starting dose of Basaglar® in patients with type 2 diabetes who are not currently treated with insulin is 10 units (or 0.2 units/kg) once daily
Basaglar® may be administered at any time during the day
Basaglar® should be administered at the same time every day
Basaglar® is a basal insulin. See insulin dosing for more.
See converting between insulin brands and types for information on changing insulins

Other

Basaglar® should be clear and colorless

Storage

Unpunctured, refrigerated

Pens are good until expiration date on product

Unpunctured, room temp

Pens are good for 28 days

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Pens are good for 28 days

Lantus®
Insulin glargine

Dosage forms

Vial (100 units/ml)

10 ml vial

SoloStar® Pen (100 units/ml)

3 ml pen
Comes in package of 5 pens
Compatible with BD® pen needles

Pharmacokinetics

Onset of action

1 - 3 hours

Duration of action

24+ hours

Peak effect

No peak

Mixing

DO NOT MIX with other insulins

Dosing

Lantus is a basal insulin (see insulin dosing for more). The recommended starting dose in patients with type 2 diabetes who are not currently treated with insulin is 0.2 units/kg or up to 10 units once daily.
Lantus should be given once daily at any time of the day but at the same time every day
See converting between insulin brands and types for information on changing insulins

Other

Semglee and Rezvoglar are interchangeable with Lantus
Lantus should be clear and colorless

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials and pens are good for 28 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
Vials and pens are good for 28 days

Studies

Levemir®
Insulin detemir

To be discontinued

Levemir will be discontinued in the U.S. in 2024. See Novo Nordisk discontinuation notice.

Dosage forms

Vial (100 units/ml)

10 ml vial
Will be discontinued 12/31/2024

FlexTouch® Pen (100 units/ml)

3 ml pen
Comes in package of 5
FlexTouch® pen button maintains the same extension at all doses
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles
Will be discontinued 4/1/2024

Pharmacokinetics

Onset of action

1 - 3 hours

Duration of action

6 - 24 hours
Levemir's duration of action depends on the dose

Dose (units/kg)	Duration (hours)
0.1	6
0.2	12
0.4	20
≥0.8	22 - 24

Peak effect

Levemir does not have a pronounced peak effect like NPH, but at lower doses, its duration of action is shorter and its waning action can create a peak and valley effect.
At doses of 0.2 units/kg, it's maximum effect occurs 3 - 4 hours after dosing
At doses of ≥ 0.4 units/kg, it's maximum effect occurs 8 - 12 hours after dosing

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
Levemir® may be dosed once- or twice-daily
Once-daily doses should be administered with the evening meal or at bedtime
With twice-daily dosing, the evening dose can be administered with the evening meal, at bedtime, or 12 hours after the morning dose
The recommended starting dose of Levemir® in type 2 diabetics is 10 Units (or 0.1-0.2 Units/kg) given once daily in the evening or divided into a twice-daily regimen
Levemir® is a basal insulin. See insulin dosing for more.
See converting between insulin brands and types for information on changing insulins

Other

Levemir® should be clear and colorless

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials and pens are good for 42 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
VIals and pens are good for 42 days

Rezvoglar®
Insulin glargine-yfgn

Dosage forms

Pen (100 units/ml)

3 ml KwikPen
Comes in package of 5 pens
Recommended with BD® pen needles

Pharmacokinetics

Onset of action

1 - 3 hours

Duration of action

24+ hours

Peak effect

No peak

Mixing

DO NOT MIX with other insulins

Dosing

Rezvoglar is a basal insulin (see insulin dosing for more). The recommended starting dose in patients with type 2 diabetes who are not currently treated with insulin is 0.2 units/kg or up to 10 units once daily.
Rezvoglar should be given once daily at any time of the day but at the same time every day
See converting between insulin brands and types for information on changing insulins

Other

Rezvoglar is interchangeable with Lantus
Rezvoglar should be clear and colorless

Storage

Unpunctured, refrigerated

Pens are good until expiration date on product

Unpunctured, room temp

Pens are good for 28 days

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Pens are good for 28 days

Semglee®
Insulin glargine-yfgn

Dosage forms

Vial (100 units/ml)

10 ml vial

Pen (100 units/ml)

3 ml pen
Comes in package of 3 or 5 pens
Compatible with BD® Ultra-Fine pen needles

Pharmacokinetics

Onset of action

1 - 3 hours

Duration of action

24+ hours

Peak effect

No peak

Mixing

DO NOT MIX with other insulins

Dosing

Semglee is a basal insulin (see insulin dosing for more). The recommended starting dose in patients with type 2 diabetes who are not currently treated with insulin is 0.2 units/kg or up to 10 units once daily.
Semglee should be given once daily at any time of the day but at the same time every day
See converting between insulin brands and types for information on changing insulins

Other

Semglee is interchangeable with Lantus
Semglee should be clear and colorless

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials and pens are good for 28 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
Vials and pens are good for 28 days

Toujeo®
Insulin glargine

Dosage forms

Toujeo SoloStar® Pen (300 units/ml)

1.5 ml pen
Comes in package of 3 pens
Max dose per injection is 80 units
Compatible with BD® Ultra-Fine pen needles

Toujeo Max® Pen (300 units/ml)

3 ml pen
Comes in package of 2 pens
Max dose per injection is 160 units
Compatible with BD® Ultra-Fine pen needles

Pharmacokinetics

Onset of action

6 hours

Duration of action

24+ hours
Steady state is reached at ≥ 5 days

Peak effect

No peak

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
The recommended starting dose of Toujeo® in patients with type 2 diabetes who are not currently treated with insulin is 0.2 units/kg once daily
Toujeo® may be administered at any time during the day
Toujeo® should be administered at the same time every day
Toujeo® is a basal insulin. See insulin dosing for more.
In a multidose study, the glucose-lowering effect of Toujeo® was about 27% lower than that of an equivalent dose of Lantus®
See converting between insulin brands and types for information on changing insulins

Other

Toujeo® should be clear and colorless

Storage

Unpunctured, refrigerated

Pens are good until expiration date on product

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Pens are good for 56 days

Tresiba®
Insulin degludec

Dosage forms

FlexTouch® Pen

Comes in 2 strengths:

U-100 - 100 units/ml
U-200 - 200 units/ml

Pens contain 3 mls
U-100 comes in package of 5 pens
U-200 comes in package of 3 pens
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Vial (100 units/ml)

10 ml vial

Pharmacokinetics

Onset of action

1 - 3 hours

Duration of action

24+ hours

Peak effect

No peak

Mixing

DO NOT MIX with other insulins

Dosing

Dosage will vary by patient
Tresiba is dosed once daily and may be given at any time during the day
The recommended starting dose of Tresiba in insulin-naïve type 2 diabetics is 10 units once daily
Tresiba is a basal insulin. See insulin dosing for more.
See converting between insulin brands and types for information on changing insulins
See Xultophy for information on Xultophy dosing

Other

Tresiba should be clear and colorless

Storage

Unpunctured, refrigerated

Pens and vials are good until expiration date on product

Unpunctured, room temp

Pens and vials are good for 56 days

Punctured (in use)

Pens and vials may be refrigerated or kept at room temperature
Pens and vials are good for 56 days

Studies

Awiqli®
Insulin icodec-abae

Dosage forms

FlexTouch® prefilled pen (U-700)

All pens come in 700 units/ml
3 ml pen (contains 2,100 units)
1.5 ml pen (contains 1,050 units)
1 ml pen (contains 700 units)

Pharmacokinetics

Onset of action

Max blood concentration reached at a median of 15 hours after injection

Duration of action

1 week

Peak effect

No peak (stable effect across dosing interval)

Mixing

DO NOT MIX with other insulins

Dosing

Insulin-naïve patients

70 units once weekly on the same day each week

Patients currently on daily basal insulin therapy

Administer the first dose of Awiqli on the day after the last dose of daily basal insulin
Week 1 dosage: The recommended one-time starting dosage of Awiqli FlexTouch is 1.5 times the total daily basal dosage multiplied by 7 rounded to the nearest 10 units (see Awiqli conversion examples for more)
Week 2 dosage: The recommended dosage is the previous total daily basal insulin dose multiplied by 7 and then rounded to the nearest 10 units (see Awiqli conversion examples for more)
Week 3 dosage and beyond: The recommended dosage of Awiqli can be titrated from the previous dosage based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal.

Missed doses

If a dose is missed, administer the missed dose as soon as possible within 4 days. Resume the once-weekly dosing schedule, one week from the day the missed dose was administered.
If more than 4 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day.
Increase blood glucose monitoring with missed doses.

Other

Awiqli should be clear and colorless
The Awiqli FlexTouch pen dials in 10 unit increments and can deliver up to 700 units in a single injection

Storage

Unpunctured, refrigerated

Pens are good until expiration date on product

Unpunctured, room temp

Pens are good for 12 weeks

Punctured (in use)

Pens may be refrigerated or kept at room temperature
Pens are good for 12 weeks
Total time at room temperature cannot exceed 12 weeks (including in-use time)

Studies

Insulin icodec vs Insulin glargine in Type 2 Diabetes without Previous Insulin, NEJM (2023) [PubMed abstract]

Example for converting from daily basal insulin to Awiqli
Previous total daily dosage of basal insulin (units)	Week 1 dosage of Awiqli (units)	Week 2 dosage of Awiqli (units)
10	110	70
11	120	80
12	130	80
13	140	90
14	150	100
15	160	110
16	170	110
17	180	120
18	190	130
19	200	130
20	210	140
25	260	180
30	320	210
35	370	250
40	420	280

Humalog® Mix 75/25
75% insulin lispro protamine and 25% insulin lispro

Dosage forms

Vial (100 units/ml)

10 ml vial

KwikPen® (100 units/ml)

3 ml pen
Comes in package of 5
Compatible with BD® pen needles

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

up to 20 hours

Peak effect

1 - 4 hours

Mixing

DO NOT MIX with other insulins

Dosing

Insulin lispro is a rapid-acting insulin
Insulin lispro protamine is an intermediate-acting insulin that is formed by combining insulin lispro and protamine sulfate
Dosage will vary by patient
Dosage should be given within 15 minutes of a meal
See insulin dosing for more

Other

Humalog® Mix should be resuspended before use (see instructions with product)
Humalog® Mix should appear uniformly cloudy with no particulate matter after resuspending

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 28 days
Pens are good for 10 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
Vials are good for 28 days
Pens are good for 10 days

Humalog® Mix 50/50
50% insulin lispro and 50% insulin lispro protamine

Dosage forms

Vial (100 units/ml)

10 ml vial

KwikPen® (100 units/ml)

3 ml pen
Comes in package of 5
Compatible with BD® pen needles

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

up to 20 hours

Peak effect

1 - 4 hours

Mixing

DO NOT MIX with other insulins

Dosing

Insulin lispro is a rapid-acting insulin
Insulin lispro protamine is an intermediate-acting insulin that is formed by combining insulin lispro and protamine sulfate
Dosage will vary by patient
Dosage should be given within 15 minutes of a meal
See insulin dosing for more

Other

Humalog® Mix should be resuspended before use (see instructions with product)
Humalog® Mix should appear uniformly cloudy with no particulate matter after resuspending

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 28 days
Pens are good for 10 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
Vials are good for 28 days
Pens are good for 10 days

Humulin® 70/30
70% NPH and 30% regular insulin

Dosage forms

Vial (100 units/ml)

Comes in 3 ml and 10 ml vials

KwikPen® (100 units/ml)

3 ml pen
Comes in package of 5
Compatible with BD® pen needles

Pharmacokinetics

Onset of action

30 - 60 minutes

Duration of action

up to 20 hours

Peak effect

3 - 12 hours

Mixing

DO NOT MIX with other insulins

Dosing

Regular insulin is a short-acting insulin
NPH is a intermediate-acting insulin
Doses should be given 30 - 45 minutes before a meal
See dosing 70/30 insulin and NPH dosing for more

Other

Humulin® 70/30 should be resuspended before use (see instructions with product)
Humulin® 70/30 should appear uniformly cloudy with no particulate matter after resuspending

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 31 days
Pens are good for 10 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
Vials are good for 31 days
Pens are good for 10 days

Novolin® 70/30
70% NPH and 30% regular insulin

Dosage forms

Vial (100 units/ml)

10 ml vial

FlexPen (100 units/ml)

3 ml pen
Comes in carton with 5 pens
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Pharmacokinetics

Onset of action

30 - 60 minutes

Duration of action

up to 20 hours

Peak effect

3 - 12 hours

Mixing

DO NOT MIX with other insulins

Dosing

Regular insulin is a short-acting insulin
NPH is a intermediate-acting insulin
Doses should be given 30 - 45 minutes before a meal
See dosing 70/30 insulin and NPH dosing for more

Other

Novolin® 70/30 should be resuspended before use (see instructions with product)
Novolin® 70/30 should appear uniformly cloudy with no particulate matter after resuspending

Storage

Unpunctured, refrigerated

Vial and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 42 days
Pens are good for 28 days

Punctured (in use)

Vials and pens should be kept at room temperature (do not refrigerate)
Vials are good for 42 days
Pens are good for 28 days

Novolog® Mix 70/30
70% insulin aspart protamine and 30% insulin aspart

Dosage forms

Vial (100 units/ml)

10 ml vial

FlexPen® (100 units/ml)

3 ml pen
Comes in package of 5
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

up to 20 hours

Peak effect

1 - 4 hours

Mixing

DO NOT MIX with other insulins

Dosing

Insulin aspart is a rapid-acting insulin
Insulin aspart protamine is an intermediate-acting insulin that is formed by combining insulin aspart and protamine sulfate
Dosage will vary by patient
Doses should be given within 15 minutes of a meal
See insulin dosing for more

Other

Novolog® Mix should be resuspended before use (see instructions with product)
Novolog® Mix should appear uniformly cloudy with no particulate matter after resuspending

Storage

Unpunctured, refrigerated

Vials and pens are good until expiration date on product

Unpunctured, room temp

Vials are good for 28 days
Pens are good for 14 days

Punctured (in use)

Vials may be refrigerated or kept at room temperature
Pens should be kept at room temperature (do not refrigerate)
Vials are good for 28 days
Pens are good for 14 days

Ryzodeg® 70/30
70% insulin degludec and 30% insulin aspart

Dosage forms

FlexTouch® Pen (100 units/ml)

Pens contain 3 ml
Comes in package of 5 pens
Compatible with NovoFine, Novofine Plus, NovoTwist, and BD pen needles

Pharmacokinetics

Onset of action

10 - 30 minutes

Duration of action

24+ hours

Peak effect

1/2 - 2 hours

Mixing

DO NOT MIX with other insulins

Dosing

Insulin aspart is a rapid-acting insulin
Insulin degludec is a long-acting insulin
Dosage will vary by patient
May be given once or twice daily with any main meal
A rapid- or short-acting insulin may be given at other meals if needed
Doses should be given within 15 minutes of a meal
See insulin dosing for more

Other

Ryzodeg should be clear and colorless

Storage

Unpunctured, refrigerated

Pens are good until expiration date on product

Unpunctured, room temp

Pens are good for 28 days

Punctured (in use)

Pens should be kept at room temperature (do not refrigerate)
Pens are good for 28 days

INSULIN COST AND ASSISTANCE

Federal poverty income levels
Insulin	Reduced cost programs	Free programs
Basaglar, Humalog, Humulin N, Humulin R, Humalog Mix 50/50, Humalog Mix 75/25	Lilly Insulin Value Program Insurance: with and without Cost: $35 for a month supply Eligibility requirements: none	Lilly Cares program Income < 400% of federal poverty level U.S. legal resident No insurance
Lantus, Toujeo, Admelog, Apidra	Sanofi Insulin Value Savings Program Insurance: without Cost: $35/month for up to 10 packs of pens and/or vials Eligibility requirements: none	Sanofi Patient Connection Income < 400% of federal poverty level U.S. legal resident No insurance
Levemir, Tresiba, Novolog, Fiasp Novolin N, Novolin R, Novolin 70/30, Novolog Mix 70/30	MyInsulinRx Program Insurance: with and without Cost: $35/month for up to 3 vials or 2 packs of pens Eligibility requirements: none Walmart (Novolin N, Novolin R, Novolin 70/30, Novolog) Insurance: with and without Cost: Novolin N - $25/vial and $43 for 5 pens Novolin R - $25/vial and $43 for 5 pens Novolin 70/30 - $25/vial and $43 for 5 pens Novolog - $72.88/vial and $85.88 for 5 pens	NovoCare Patient Assistance Program Income < 400% of federal poverty level U.S. legal resident No insurance

OVER-THE-COUNTER INSULIN

In many U.S. states, insulin can be bought over-the-counter (without a prescription) at pharmacies
Over-the-counter insulin is typically limited to Regular, NPH, and the 70/30 mixes of NPH and regular
The availability of over-the-counter insulin is intended to help diabetics in a bind or emergency
A simple way to find out if a state allows over-the-counter insulin is to call a pharmacy in that state

BIBLIOGRAPHY

Manufacturer's package insert

INSULIN CHART

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Storage U-500

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