This chart compares insulins in regard to duration, usual frequency, and cost. It also provides information on route of administration, stability of in-use products at room temperature, and place in therapy. Other resources pertaining to insulin and injectable diabetes meds include our algorithm, Initiation and Adjustment of Insulin Regimens for Type 2 Diabetes , and our charts, How to Switch Insulin Products , Insulin Analogs vs Human Insulin , and Comparison of GLP-1 Agonists .
--Information in this chart is from U.S. product information (see footnote “a”) unless otherwise specified.--
Insulin, Mfr
Duration
Usual Frequency
Formulations/Cost b,c
Stability, in-use, room temp
Rapid-acting: prandial human insulin analogs (rDNA origin). Onset 10 to 30 minutes (Fiasp, Lyumjev faster). 2,12 For type 1 diabetes, recommended at each meal (three or more injections daily) with one or two injections of basal insulin. 4 For type 2 diabetes, once daily at largest meal plus basal insulin, or basal-bolus regimen (i.e., two or three times daily with meals plus basal insulin). 3 All are given via subcutaneous injection. Humalog 100 unit/mL, Lyumjev, NovoLog, Apidra, and Admelog can be given subcutaneously via insulin pump. Fiasp, Humalog 100 unit/mL, Apidra, NovoLog, Admelog, and Lyumjev 100 unit/mL can be given by intravenous infusion. All are clear and colorless.
Admelog
(insulin lispro),
Sanofi-Aventis
One to three (or more) times daily. 3,4 Inject within 15 min before or immediately after a meal.
$130.76/10 mL vial
$39.23/3 mL vial
$50.49/3 mL SoloStar pen
$252.47/5 of 3 mL SoloStar pen
Vial, pen: 28 days
Pump reservoir: 7 days
IV infusion: 4 hours
(0.1 to 1 unit/mL in NS)
Humalog
(insulin lispro),
Eli Lilly
(authorized generic available for 10 mL vial, and 100 unit/mL pens)*
One to three (or more) times daily. 3,4 Inject within 15 min before or immediately after a meal.
$137.35*/10 mL vial
$82.41/3 mL vial
$510.45/5 of 3 mL cartridge ($102.09 each)
$265.20*/5 of 3 mL
100 unit/mL KwikPen or KwikPen Junior ($53.04* each)
$424.32/2 of 3 mL KwikPen
200 unit/mL
Vial, cartridge, pen: 28 days
Pump reservoir
(Humalog 100 unit/mL): 7 days
IV infusion: 48 hours
(0.1 to 1 unit/mL in NS)
NovoLog
(insulin aspart),
Novo Nordisk
One to three (or more) times daily. 3,4 Inject within 5 to 10 min before a meal.
$289.36/10 mL vial
$537.47/5 of 3 mL Penfill cartridge
$558.83/5 of 3 mL FlexPen
Vial, cartridge, pen: 28 days
Pump reservoir: 6 days
IV infusion: 24 hours
(0.05 to 1 unit/mL in NS, others).
Diluted 1:1 (U-50) or 1:9 (U-10) with Insulin Diluting Medium for NovoLog: 28 days
Apidra
(insulin glulisine),
Sanofi-Aventis
One to three (or more) times daily. 3,4 Inject within 15 min before a meal, or within 20 min after the start of the meal.
$283.95/10 mL vial
$548.52/5 of 3 mL SoloStar pen
Vial, pen: 28 days
Pump reservoir: 48 hours
IV infusion: 48 hours
(0.05 to 1 unit/mL in NS)
Fiasp
(insulin aspart),
Novo Nordisk
Formulated with niacinamide for faster absorption. 7
One to three (or more) times daily. 3,4 Inject at the start of the meal, or within 20 min after the start of the meal.
$289.36/10 mL vial
$558.83/5 of 3 mL FlexTouch pen
$537.47/5 of 3 mL PenFill cartridge
Vial, cartridge, pen: 28 days
IV infusion: 24 hours
(0.5 to 1 unit/mL in NS or D5W)
Lyumjev
(insulin lispro-aabc)
Eli Lilly
Formulated with treprostinil and citrate for faster absorption. 12
Up to ~5 hours 12
One to three (or more) times daily. 3,4 Inject within 20 minutes after the start of the meal.
$530.40/5 of 3 mL 100 unit/mL KwikPen ($106.08 each)
$424.32/2 of 3 mL KwikPen
200 unit/mL ($212.16 each)
Vial, pen: 28 days
Pump reservoir: 9 days
IV infusion: 12 hours
(1 unit/mL in NS or D5W)
Humulin R
100 units/mL,
Eli Lilly
About 8 hours (longer in obese patients)
One to three (or more) times daily. 3,4 Inject about 30 min before the meal.
$148.70/10 mL vial
$44.61/3 mL vial
Vial: 31 days
IV infusion: 48 hours
(0.1 to 1 unit/mL in NS)
Humulin R
500 units/mL,
Eli Lilly
Two or three times daily before a meal. Inject about 30 min before the meal.
$1,487/20 mL vial
$287.10/3 mL KwikPen
$574.20/2 of 3 mL KwikPen
Vial: 40 days
Pen: 28 days
Novolin R,
Novo Nordisk
One to three (or more) times daily. 3,4 Inject about 30 min before the meal.
$137.70/10 mL vial
$260.25/5 of 3 mL FlexPen
($52.05 each)
Vial: 42 days
Pen: 28 days
IV infusion: 24 hours
(0.05 to 1 unit/mL in NS, D5W, D10 with KCl 40 mEq/L)
Intermediate-acting (NPH): human insulin (rDNA origin) isophane suspension. Available OTC. For type 1 diabetes, may be used as the basal component of basal-prandial regimens (analogs preferred). 4 An initial insulin option in type 2 diabetes, often as an add-on to oral agents. 3 As type 2 diabetes progresses, may be used with mealtime rapid- or short-acting insulin with the largest meal. 3 Onset 90 min. 2 Administered via subcutaneous injection. Appears cloudy.
Novolin N,
Novo Nordisk
Up to 24 hours 2
Once or twice daily. 3
$137.70/10 mL vial
$260.25/5 of 3 mL FlexPen
($52.05 each)
Vial 42 days
Pen: 28 days
Humulin N,
Eli Lilly
Up to 24 hours 2
Once or twice daily. 3
$148.70/10 mL vial
$44.61/3 mL vial
$471.30/5 of 3 mL KwikPen ($94.26 each)
Vial: 31 days
Pen: 14 days
Long-acting: human insulin analogue (rDNA origin). For type 1 diabetes, preferred as the basal component of basal-prandial regimens. 4 An initial insulin option in type 2 diabetes, often as an add-on to oral agents. 3 As type 2 diabetes progresses, may be used with mealtime rapid- or short-acting insulin with the largest meal. 3 Administered via subcutaneous injection. Appears clear and colorless.
Basaglar
(insulin glargine),
Eli Lilly
Not a generic for Lantus.
Once daily at the same time each day.
Lantus
(insulin glargine),
Sanofi-Aventis
Median 24 hours (range 10.8 to >24 hours; sampling period 24 hours)
Once daily at the same time each day.
$283.56/10 mL vial
$425.31/5 of 3 mL SoloStar pen ($85.06 each)
Vial, pen: 28 days
Levemir
(insulin detemir),
Novo Nordisk
7.6 to >24 hours (sampling period 24 hours) (dose-dependent; binds to albumin)
Twice daily, or once daily with the evening meal or at bedtime.
$308.14/10 mL vial
$462.21/5 of 3 mL FlexTouch pen
Vial, pen: 42 days
Semglee
(insulin glargine-yfgn), d
Mylan Specialty
At least 24 hours
Once daily at the same time each day.
$98.65/10 mL vial
$147.98/5 of 3 mL pen ($29.60 each)
Vial, pen: 28 days
Toujeo
(insulin glargine),
Sanofi-Aventis
(300 units/mL)
Once daily at the same time each day. First injection may provide insufficient coverage; may take ≥5 days to see maximum effect.
$388.72/3 of 1.5 mL SoloStar pen ($129.57 each)
$647.87/5 of 1.5 mL SoloStar
$518.30/2 of 3 mL Max SoloStar pen ($259.15 each)
Ultra-Long-acting: human insulin analogue (rDNA origin). Administered via subcutaneous injection. Consider for patients with severe or nocturnal hypoglycemia on another basal analogue, or with hypoglycemia risk factors, 9-11 or adherence problems. Appears clear and colorless.
Tresiba
(insulin degludec),
Novo Nordisk
At least 42 hours
Once daily at any time of day.
$338.95 vial (100 units/mL)
$508.43/5 of 3 mL
100 units/mL FlexTouch pen
$610.11/3 of 3 mL 200 unit/mL FlexTouch pen
Vial, pen: 56 days
Insulin Mixes: human insulin analogue (rDNA origin) solution and protamine-crystallized human insulin analogue suspension (NovoLog Mix 70/30, Humalog Mix 75/25, Humalog Mix 50/50). Others are human insulin (rDNA origin) solution and human insulin isophane suspension. Humulin 70/30 and Novolin 70/30 available OTC. Generally, not appropriate for type 1 diabetes due to lack of dose flexibiltiy. 6 Typically started after failure of basal insulin plus non-insulin. 3 Usually started pre-breakfast and pre-supper. 3 Administered via subcutaneous injection. Cloudy.
NovoLog Mix 70/30 (70% insulin aspart protamine suspension/30% insulin aspart solution),
Novo Nordisk
Typically given pre-breakfast and pre-supper. 3 Give within 15 min before the meal, or after starting to eat (type 2 diabetes).
$300.12/10 mL vial
$558.83/5 of 3 mL FlexPen
Vial: 28 days
Pen: 14 days
Humalog Mix 75/25
(75% insulin lispro protamine suspension/25% insulin lispro solution), Eli Lilly
(authorized generic available for 100 unit/mL pens)*
Typically given pre-breakfast and pre-supper. 3 Give within 15 min before the meal.
$284.70/10 mL vial
$265.20*/5 of 3 mL KwikPen ($53.04* each)
Vial: 28 days
Pen: 10 days
Humalog Mix 50/50
(50% insulin lispro protamine suspension, 50% insulin lispro solution), Eli Lilly
Typically given pre-breakfast and pre-supper. 3 Give within 15 min before the meal.
$284.70/10 mL vial
$530.40/5 of 3 mL KwikPen ($106.08 each)
Vial: 28 days
Pen: 10 days
Humulin 70/30
(70% NPH/30% regular),
Eli Lilly
Mean about 23 hours (range: 18 to 24 hours)
Typically given pre-breakfast and pre-supper. 3 Give about 30 to 45 min before the meal.
$148.70/10 mL vial
$44.61/3 mL vial
$471.30/5 of 3 mL KwikPen
$94.26/3 mL KwikPen
Vial: 31 days
Pen: 10 days
Novolin 70/30
(70% NPH/ 30% regular),
Novo Nordisk
Typically given pre-breakfast and pre-supper. 3 Give about 30 min before the meal.
$137.70/10 mL vial
$260.25/5 of 3 mL FlexPen ($52.05 each)
Vial: 42 days
Pen: 28 days
References
Cite this document as follows: Clinical Resource, Comparison of Insulins (United States). Pharmacist’s Letter/Prescriber’s Letter. September 2021. [370901]
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