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Can You Mix Levemir And Novolog In The Same Syringe

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  1. mkachar

    According to Gary Scheiner " Think Like a Pancreas " (2004 edition) Detimir ( Levemir ) can be mixed with a fast acting insulin. However most other sources state that you can not mix them. Has anyone tried mixing Levemir and Humalog with success ?

  2. DeusXM

    You can't mix them in the same syringe. What Scheiner means is you can take them at the same time - you just do two injections in different parts of your body.

  3. Subby

    I'd defer to the manufacturers with this, who state explicitly not to mix. AFAIK mixing won't make the world explode but studies suggest it may change the profile of one or both, an x factor you could do without.

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  1. k9diabetes

    I was reviewing a page on the U40/U100 conversion for posting to the main website and thought this was be a good time to go over the various terms used to describe insulin since the U40/U100 difference and the conversion to use U40 insulin in a U100 syringe has often been a subject of confusion. Eventually, this information will wind up on the main website.
    Type of Insulin
    Vetsulin = U40 = 40 international units of insulin in 1 mL of solution.
    Novolin/Humulin NPH = U100 = 100 international units of insulin in 1 mL of solution
    Filling a Syringe
    Syringes are matched to the type of insulin used.
    When you fill a U40 syringe with a U40 insulin, each mark on the syringe is 1 unit of insulin.
    Fill the U40 syringe to the "10" mark with Vetsulin and you are injecting 10 units of insulin contained in 0.25 mLs of "insulin solution", which is insulin plus a diluent.
    40u/mL divided by 4 = 10u/0.25mL
    When you fill a U100 syringe with a U100 insulin, each mark on the syringe is 1 unit of insulin.
    Fill the U100 syringe to the "10" mark with U100 NPH and you are injecting 10 units of insulin contained in 0.1 mLs of "insulin solution", which is insulin plus a diluent.
    U100 insulin has less diluent added to it than U40 insulin so the solution is more concentrated.
    Talking about Units versus Marks on a Syringe
    When you match the insulin type and syringe type (U40 to U40 or U100 to U100), "marks on the syringe" and "units of insulin" or "dose of insulin" are the same thing.
    10 marks on the syringe is 10 units of insulin.
    It doesn't matter which insulin you are using, only that the syringe type and the insulin type are matched.
    When you DO NOT match the insulin type to the syringe, "marks on the syringe" and "units of insulin" or "dose of insulin" ARE NOT THE SAME THING.
    This typically comes up because there are times when it is useful to put U40 insulin in a U100 syringe.
    When you do make the conversion, you...
    Multiply the units of U40 insulin or dose of U40 insulin x 2.5 and
    Fill the U100 syringe to mark on the syringe barrel that corresponds to the conversion.
    So, for example, if your dog gets 10 units of Vetsulin per injection and you want to give that 10 units of Vetsulin in a U100 syringe, you...
    Multiply 10 units x 2.5 = 25.
    Then you fill the U100 syringe to the 25 mark to deliver 10 units of insulin.
    Why It Matters
    It is extremely important for anyone doing this conversion to understand how many "units of insulin" you are giving.
    When you fill that U100 syringe to the 25 mark with Vetsulin, you are giving ONLY 10 UNITS of insulin.
    Say your dog is rushed to the emergency room or you go to a new vet and they ask you how many units of insulin you are giving?
    If you say 25 instead of 10, your dog is in serious jeopardy.
    The emergency or new vet may not find out that there is a conversion factor involved.
    So it's important to understand the difference between your dog's insulin dose (the number of units) and the strength of the solution of insulin and diluent your dog's insulin is.
    While you can't really compare one insulin to another as dogs react to them all differently, a unit of one insulin is equivalent in terms of physical measurements in molecules to a unit of another type of insulin.
    Natalie

  2. k9diabetes

    Here is a link to a conversion table: http://felinediabetes.com/insulin-conversions.htm

  3. We Hope

    Just going to add here that some other insulins are also U 100:
    Humulin R/Novolin R= U 100 = 100 international units of insulin in 1 mL of solution
    Humulin 70/30/Novolin 70/30= U 100 = 100 international units of insulin in 1 mL of solution
    Levemir= U 100= 100 international units of insulin in 1 mL of solution.
    Lantus= U 100 = 100 international units of insulin in 1 mL of solution
    Humalog/Novolog/Apidra= U 100 = 100 international units of insulin in 1 mL of solution
    There's also another U 40 commonly used, but mainly for cats:
    PZIVet= U 40 = 40 international units of insulin in 1 mL of solution.
    BTW--PZI Vet will be discontinued. Notice was made April 8, 2008:
    http://www.idexx.com/animalhealth/ph...ivet/index.jsp
    IDEXX notice
    http://web.archive.org/web/200702110...ivet/index.jsp
    Link from IDEXX PZIVet pages February 2007--via Internet Archives. This page has now been replaced with the April 8, 2008 "Dear Doctor" letter; the old one can be read by using the link above.
    "Proven stability for 3 years from date of manufacture"
    http://www.vetsulin.com/PDF/Vetsulin...tor_Letter.pdf
    Vetsulin is now FDA-approved for cats.
    There are also some insulin strengths which can be obtained through a compounding pharmacy. The most common is U 40, but there is a U 50 strength available in beef insulin through a Texas compounding pharmacy, BCP:
    http://www.bcpvetpharm.com/products_bovine.htm
    "BCP PZI® insulin is available in 100u/ml 5ml or 10ml, 50u/ml 10ml & 40u/ml 10ml."
    The compounding pharmacies are able to produce vials of just about any strength insulin required. This compounding pharmacy works with compounding human insulin for pets, but most compounded insulin is beef:
    http://members.tripod.com/diabetics_world/pets.htm
    Congaree Veterinary Pharmacy
    1309-B State Street
    Cayce, SC 29033
    Toll free: 1-877-939-1335
    Fax: 803-939-0073 803-939-1335
    http://www.congareevetrx.com/
    "PZI r-DNA human insulin. Their general order is for U100 strength in 5ml vials. Pharmacist Terry Fiffick says he has made strengths ranging from U2, U40, U50 and U100."
    If you're using one of the not so common strengths of insulin, you'll need to ask your vet the type of syringe to be used with this special prescription.

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Novo Nordisk Receives U.s. Fda Approval For Novolog Flextouch And Levemir Flextouch

Novo Nordisk Receives U.S. FDA approval for NovoLog FlexTouch and Levemir FlexTouch Novo Nordisk Receives U.S. FDA approval for NovoLog FlexTouch and Levemir FlexTouch Plainsboro, N.J. (November 1, 2013) /PRNewswire/ Novo Nordisk, a world leader in diabetes care, today announced that the U.S. Food and Drug Administration (FDA) has approved the prefilled insulin pens NovoLog (insulin aspart [rDNA origin] injection) FlexTouch and Levemir (insulin detemir [rDNA origin] injection) FlexTouch. FlexTouch is a new prefilled insulin delivery system from Novo Nordisk. When a dose is dialed with traditional prefilled pens, the push button extends, and at larger doses this can present challenges for the patient. The unique dosing mechanism of FlexTouch ensures the push-button does not extend at any dose and allows insulin to be administered by pressing the low dose force button. "Novo Nordisk is committed to continuously introducing new solutions that can improve the lives of people with diabetes," said Mads Krogsgaard Thomsen, executive vice president and chief scientific officer of Novo Nordisk. "This approval marks another advancement in insulin delivery and an important milestone for Novo Continue reading >>

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Popular Questions

  1. jessiern

    Other insulins inactivate the lantus. I can't give you a big chemical reason for that, although we did learn the overall why in organic chem years ago.

  2. Antikigirl

    Not mixing lantus with things is in the paperwork (long microscopic words)that comes with the vial in the box from the manufacturer. But I have an easier solution for it...
    Just don't mix lantus at all...memorize it and just go with it as second nature. I do...it is as second nature to me as 'date/time/sign'...LOL! I like simple, and not mixing it is simple...
    I have had patients at home mix it...and it doesn't do anything! Their sugars are out of whack..and they are just "well...I can only take one shot"...and I typically reply "and that is why you are hear getting more shots than you imagined huh? Please don't mix it, it becomes inactive and thus...you are here and feeling horrible! I don't want you to feel horrible! You have a condition that is inside your body, and sadly the solution must too go inside your body, and this particular solution is fragile itself, so it has to go more direct than mouth to be damaged by the stomach. Please try to help yourself by not mixing the solution and having to come here...I don't like to see you feeling cruddy!".

  3. ann945n

    It would be interesting to know how it is inactivated

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