Drawing up 2 Types of Insulin

Two types of insulin can be mixed together in one syringe.  You may choose to do this if you need both clear and cloudy insulin.

 

oRegular oNovolog (aspart) oHumalog (lispro)

MIX WITH

o NPH o 70/30 o Other: _____________

 

• To avoid contaminating the two bottles of insulin, always draw up the clear insulin first.
• you should never mix glargine (Lantus®) with any other insulin in the same syringe.

 

Steps

 

1.   Wash hands well with soap and water.

 

2.   Gently roll the bottle of cloudy insulin between your hands to mix the insulin.

 

3.   Clean the rubber stoppers on the tops of both bottles with alcohol.  This lowers the chance for infection.

 

4.   Pull the plunger of the syringe out to the number of units needed for your NPH.  This fills the syring with air.  See picture below.

 

 

 

 

5.  Inject the air into the bottle of cloudy insulin. Do not let needle touch the insulin.  See picture below. 

 

 

 

6.    With the same syring, pull the plunger out to the number of units needed for your clear insulin dose.  this again fills the syringe with air.

 

 

7.   Inject the air into the bottle of clear insulin.

 

 

 

 

8.    Turn the bottle of clear insulin upside down.  Draw up your dose into the syringe.  See picture below.

 

 

 

 

9.   Check for air bubbles.  Injecting an air bubble will not hurt you, but it will prevent you from getting the right amount of insulin.

To Remove Air Bubbles

• Pull the plunger of the syringe out farther.
• Flick the side of the syringe sharply with your finger so air bubbles rise to the top of the syringe.
• Push the plunger of the syringe back to the correct number of units of insulin.  This should push the air back into the bottle.

 

Now it's time to draw up the cloudy insulin into the same syringe.

 

10.   With the same syringe, insert the needle into the cloudy insulin.  Do not push down on the plunger.  This would push clear insulin into the bottle of cloudy insulin.

 

11. Turn the bottle of cloudy insulin upside down.  Draw up your dose of cloudy insulin.

 

Hint: It might help to think about the total amount of insulin you need.  For example:  You have 6 units of clear insulin in the syringe.  You need 20 units of cloudy insulin.  So, you must pull the plunger out to the 26 unit mark.

 

12.   Remove the needle from the bottle. Make sure you have the correct total amount of insulin.
**If you draw too much cloudy insulin, discard the syringe and start again.

 

Mixing insulin ahead of time

 

• NPH and Regular can be pre-filled up to 21 days in advance before using.
• Keep these pre-filled syringes in the refrigerator with the needle tip pointed upward.  Rotate the syringe to mix before using.
• If Novolog or Humalog is mixed in the same syring with NPH, these doses should be given right after filling the syringe.

The Spanish version of the Health Facts for You is #6217.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 01/14/2008

Copyright © 10/23/2007 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #4308

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