Can You Mix Levemir And Humulin R

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Proper Use

Drug information provided by: Micromedex Make sure you have the type (beef and pork, pork, or human) and the strength of insulin that your doctor ordered for you. You may find that keeping an insulin label with you is helpful when buying insulin supplies. The concentration (strength) of insulin is measured in USP Insulin Units and USP Insulin Human Units and is usually expressed in terms such as U-100 insulin. Insulin doses are measured and injected with specially marked insulin syringes. The appropriate syringe is chosen based on your insulin dose to make measuring the dose easy to read. This helps you measure your dose accurately. These syringes come in three sizes: 3/10 cubic centimeters (cc) measuring up to 30 USP Units of insulin, ½ cc measuring up to 50 USP Units of insulin, and 1 cc measuring up to 100 USP Units of insulin. It is important to follow any instructions from your doctor about the careful selection and rotation of injection sites on your body. There are several important steps that will help you successfully prepare your insulin injection. To draw the insulin up into the syringe correctly, you need to follow these steps: Wash your hands with soap and water. If y Continue reading >>

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Popular Questions

  1. TiedyedSunshine

    As of this year my insurance needs prior authorization for both types of insulin I'm prescribed: Humalog and Humulin N.
    I'm now 27 and have been on these two types of insulin since my diagnosis at age 9.
    Upon my attempt to re-fill my script for Humulin N, my pharmacy tried to contact my Dr's office for authorization but since my Dr's office is inept and does not accept faxes or phone calls from pharmacies (or anywhere else for that matter), I would need to make an appointment just to get my Dr. to send off authorization for this insulin. Having been on this insulin for about 18 years and having just seen my doc, I'd rather not go right back in and spend half a day at the Dr's office just for this. However, talking with the receptionist at the office, she said the doc would call me in one vial of Novolin N to hold me over until the appointment. But wait, Novolin N? That's not even what I take. And besides, I can get Novolin N at Wal-Mart without a prescription for less than my co-pay. So I told her nevermind.
    After doing some research I found that Humulin N and Novolin N appear to be similar enough to hopefully not cause much disruption in my routine/blood sugars. So, okay, I'll try that, it's what the doc was gonna call in for me anyway, no big deal.
    HOWEVER, when I discovered that Humalog would also need prior authorization I became concerned, as I don't know of a comparable type available for a reasonable price without a script. Novolin R is the only option I'm finding, which seems to have a longer onset, peak and duration than Humalog.
    So I'm debating whether I want to make the switch or suck it up and make an appointment just for a Humalog auth. Ugh.
    I still have a couple vials so the need is not immediate.. By the time I run out it may be time to see the doc anyway.
    But my questions are:
    Has anyone switched from Humalog to Novolin R? How was the transition?
    Does anyone use Novolin R? Do you use it in combination with another insulin and what type?
    Does anyone use Novolin R and Novolin N combo? How does it work for you?

    Any info/input/thoughts/etc. appreciated! :)

  2. Jen

    Humulin N and Novolin N are both NPH, just different brands. They are the same insulin, though, so should have the same onset, peak, and duration.
    R insulin has a longer onset and peak and duration than Humalog. When I was on R, I had to snack in the morning in order to offset the peak of the R. It also needs to be taken at least 30-60 minutes before a meal to give it time to kick in.
    When I was taking R and NPH together, I took two shots a day for years (R and NPH at breakfast and dinner). This required a very regimented schedule of meals and snacks which I could not disrupt at all without going extremely high or low. Later, my endocrinologist switched me to three shots a day (R and NPH at breakfast, R at dinner, and NPH at bedtime) which helped reduced overnight lows.

    Have you looked into MDI (multiple daily injections - four or more shots a day) at all? This regimen uses a flatter basal insulin like Lantus or Levemir, instead of NPH, and uses carbohydrate counting and an adjustable dose of Humalog at each meal. A lot of people take Lantus or Levemir before breakfast and before bed, and take Humalog or Novolog or Apidra before each meal and snack or whenever they need a correction. It's a more intensive insulin regimen, but it allows for much more flexibility and (usually) better control than using NPH. Although I see you have a pretty good A1c and a CGM, so maybe the NPH is working for you.

  3. Sam19

    I've never used R and NPH, but I keep quite a few vials in my fridge because they're cheap in case of emergency--- like if the whole supply chain got disrupted.
    If your insurance requires prior authorization for humalog, it is very likely that they have novolog (or maybe apidra) in their formulary not requiring pre auth. Same for N... Your insurance likely covers lantus or levemir instead.
    Jen is right N = N and R=R no difference between brands.
    I would call your insurance and ask what insulins are in their formulary or preferred then call your doctor or go sit in their waiting room until they change your rx... Their assistants usually take care of it, it shouldn't require an appointment unless they consider you "overdue" for one anyway. It sounds like just a matter of getting on the same page with your insurance though. They can refuse prior authorizations if you don't have documentation of trying, and failing, with their preferred brands.

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