Insulin - Mixing
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- Gather all necessary supplies: insulin vials, syringe, and alcohol pads.
- Wash hands thoroughly with soap and water.
- Check the insulin vials to be sure they are the correct insulin and strength. Also, check with your personal healthcare provider to make sure it is okay for you to mix your insulins in the same syringe. Some insulins such as Levemir, should not be mixed.
- Clear insulin such as Regular, Novolog, Lispro, Lantus, and Apidra do not need to be agitated. All other types of insulin are cloudy and need to be agitated before a dose of insulin is drawn.
- To agitate insulin, roll the insulin vial between the palms of your hands. Do not shake the insulin vial.
- Inspect the insulin for any abnormalities in color, particulate matter, consistency, and thickness. If any abnormalities are seen, do not inject the insulin; throw it away and obtain a new vial.
- If the vial is new, pop the colored cap off.
- Clean the rubber stopper with an alcohol pad before each use.
- Verify that you know the correct dose of each insulin to be mixed in the syringe.
- You will be combing two types of insulin; clear which is short-acting, and cloudy which is longer-acting to make your total dosage.
- Pick up the syringe and remove the needle and plunger caps. Pull back on the syringe plunger to draw air into the syringe. Draw in an amount of air equal to your dose of cloudy insulin. To measure the amount correctly, pull back on the plunger to the point where the top of the black rubber portion of the plunger meets the measurement line on the syringe.
- Inject that air into the cloudy insulin vial. This is done to avoid creating a vacuum within the vial when you withdraw your insulin dose and will make it easier to withdraw the dose. DO NOT WITHDRAW THE INSULIN YET. Withdraw the empty syringe from the vial.
- Repeat this process with the clear insulin. Pull back on the syringe plunger to draw air into the syringe. Draw in an amount of air equal to your dose of clear insulin. Inject that air into the clear insulin vial.
- Invert the clear insulin vial and syringe and slowly withdraw the appropriate number of clear insulin units first. Remove any air bubbles in the syringe by gently tapping the syringe with your finger and carefully pushing any large air bubbles back into the vial.
- Double check that you withdrew the proper dose of clear insulin and that no large air bubbles are present; then withdraw the syringe form the vial.
- Insert the syringe needle into the rubber stopper of the cloudy insulin vial. Invert the vial and syringe and slowly and carefully withdraw the appropriate number of units of the cloudy insulin. Be sure to do this with accuracy since the insulin cannot be pushed back into the vial if too much is withdrawn or large air bubbles exist. Withdraw the syringe from the vial.
- Double check that you withdrew the appropriate dose. Carefully cover the needle with its cap or lay the syringe down so that the needle does not touch anything. The dose of insulin is now ready to be injected.
Additional Tips for Mixing Insulin Doses
- Always check your insulin vials to insure that you have the right type of insulin, that it is normal in appearance, and that it is not expired (expiration date is typically printed directly on the vial).
- Know your correct insulin doses (of your short-acting and longer-acting insulin) before you get ready to draw them into the syringe.
- Never change insulin brands, types, or concentrations (U-100 versus U-500) without first talking with your doctor.
- Keep extra vials of insulin in your refrigerator. Make sure you don't run out!
- Never let your insulins freeze.
- Keep the vials of insulin that you are currently using in the refrigerator when possible. However, most insulins can be stored at room temperature for up to 30 days.
- If insulin is not kept in the refrigerator, store it away from heat and light (below 860F).
- Do not shake your insulin hard and do not let it get tossed around. Longer-acting insulins (typically cloudy in appearance) should be rolled between the palms of the hands to agitate. If insulin is handled roughly, it may be more likely to clump.
- If you need to travel, protect insulin from getting too hot or cold. Do not leave it in a parked car, especially if it is very warm or very cold outside.
- When drawing insulins into the syringe remember: CLEAR BEFORE CLOUDY.
Last Updated: December 2006
This content was created by members of the DrugDigest team of experts and is solely under DrugDigest's editorial control.