Article

Insulin and Non-Insulin Injectable Diabetes Medications: Practical Information for Pharmacists

At some point in your career, you've probably encountered questions from patients or health care team members about diabetes medications' stability and how the products are supplied.

At some point in your career, you’ve probably encountered questions from patients or health care team members about diabetes medications’ stability and how the products are supplied.

The following tables are intended to serve as practical guides, providing information on the various insulin vials (Table 1), insulin pens (Table 2), and non-insulin injectables (Table 3) currently available on the market. Please read individual package inserts for more details and updates as they occur.

Table 1: Insulin Vials

Insulin Type

Drug Name

How Its Supplied

Unopened Stability

Opened Stability

Rapid-Acting

Apidra (glulisine)

10 mL

Refrigeration: expiration date

Room temp: 28 days

Refrigeration /room temp: 28 days

Humalog (lispro)

3 mL, 10 mL

Refrigeration: expiration date

Refrigeration /room temp: 28 days

Novolog (aspart)

10 mL

Refrigeration: expiration date

Refrigeration /room temp: 28 days

Short-Acting

Humulin R (regular)

3 mL, 10 mL

OTC

Refrigeration: expiration date

Refrigeration/room temp: 31 days

Humulin R (regular)

U-500

20 mL

Refrigeration: expiration date

Refrigeration/room temp: 40 days

Novolin R (regular)

10 mL

OTC

Refrigeration: expiration date

Room temp: 42 days

Room temp: 42d

Don’t refrigerate

Intermediate-Acting

Humulin N (NPH)

3 mL, 10 mL

OTC

Refrigeration: expiration date

Room temp: 31 days

Refrigeration/room temp: 31d

Novolin N (NPH)

10 mL

OTC

Refrigeration: expiration date

Room temp: 42d

Don’t refrigerate

Long-Acting

Lantus (glargine)

10 mL

Refrigeration: expiration date

Room temp: 28 days

Refrigeration/room temp: 28 days

Levemir (detemir)

10 mL

Refrigeration: expiration date

Room temp: 42 days

Refrigeration/room temp: 42 days

Premixed

Humalog 50/50

(lispro protamine/lispro)

10 mL

Refrigeration: expiration date

Room temp: 28 days

Refrigeration/room temp: 28 days

Humalog 75/25

(lispro protamine/lispro)

10 mL

Refrigeration: expiration date

Room temp: 28 days

Refrigeration/room temp: 28 days

Humulin 70/30 (NPH/R)

3 mL, 10 mL

Refrigeration: expiration date

Room temp: 31 days

Refrigeration/room temp: 31 days

Novolin 70/30 (NPH/R)

10 mL

Refrigeration: expiration date

Room temp: 42 days

Room temp: 42 days

Don’t refrigerate

Novolog 70/30

(aspart protamine/aspart)

10 mL

Refrigeration: expiration date

Refrigeration/room temp: 28 days

*Products U-100 (100 units/mL) unless otherwise noted.

Table 2: Insulin Pens

Insulin Type

Drug Name

How Its Supplied

Unopened Stability

Opened Stability

Maximum Units per Dose (allowed by device)

Rapid-Acting

Apidra SoloStar (glulisine)

3 mL

Package of 5

Refrigeration: expiration date

Room temp: 28 days

Room temp: 28 days

Don’t refrigerate

80

Humalog KwikPen (lispro)

U-100, U-200

3 mL

U-100: Package of 5

U-200: Package of 2

Refrigeration: expiration date

Room temp: 28 days

Don’t refrigerate

60

Novolog FlexTouch (aspart)

3 mL

Package of 5

Refrigeration: expiration date

Room temp: 28 days

Don’t refrigerate

80

Afrezza (human insulin) inhaled

3 cartridges/strip

5 strips/card

2 cards/foil pack

Foil pack: Refrigeration expiration date

Cards/strips: Refrigeration x30 days

All: room temp x10 days

Strips: room temp x3 days

If at room temp, don’t return to fridge

Available in 4, 8, 12 unit cartridges

Can combine

Short-Acting

Humulin R KwikPen (regular)

U-500

3 mL

Package of 2

Refrigeration: expiration date

Room temp: 28 days

Don’t refrigerate

300

Intermediate-Acting

Humulin N KwikPen (NPH)

3 mL

Package of 5

OTC

Refrigeration: expiration date

Room temp: 14d

Room temp: 14 days

Don’t refrigerate

60

Long-Acting

Lantus SoloStar (glargine)

3 mL

Package of 5

Refrigeration: expiration date

Room temp: 28 days

Room temp: 28 days

Don’t refrigerate

80

Levemir FlexTouch (detemir)

3 mL

Package of 5

Refrigeration: expiration date

Room temp: 42 days

Room temp: 42 days

Don’t refrigerate

80

Toujeo SoloStar (glargine)

U-300

1.5 mL

Packages of 3 or 5

Refrigeration: expiration date

Room temp: 42 days

Don’t refrigerate

80

Tresiba FlexTouch (degludec)

U-100, U-200

3 mL

U-100: Package of 5

U-200: Package of 3

Refrigeration: expiration date

Room temp: 56 days

Room temp: 56 days

Don’t refrigerate

U-100: 80

U-200: 160

Premixed

Humalog KwikPen 50/50

(lispro protamine/lispro)

3 mL

Package of 5

Refrigeration: expiration date

Room temp: 10 days

Room temp: 10 days

Don’t refrigerate

60

Humalog KwikPen 75/25

(lispro protamine/lispro)

3 mL

Package of 5

Refrigeration: expiration date

Room temp: 10 days

Room temp: 10 days

Don’t refrigerate

60

Humulin 70/30 KwikPen (NPH/R)

3mL

Package of 5

Refrigeration: expiration date

Room temp: 10 days

Room temp: 10 days

Don’t refrigerate

60

Novolog FlexPen 70/30

(aspart protamine/aspart)

3mL

Package of 5

Refrigeration: expiration date

Room temp: 14 days

Don’t refrigerate

60

Ryzodeg FlexTouch 70/30 (degludec/aspart)

3mL

Package of 5

Refrigeration: expiration date

Room temp: 28d

Room temp: 28 days

Don’t refrigerate

80

*Products U-100 (100 units/mL) unless otherwise noted.

Table 3: Non-Insulin Injectables

Product

How Its Supplied

Refrigeration Stability

Room Temp Stability

GLP-1 Agonists

Bydureon (exenatide ER)

2 mg

Syringe: package of 4

Pen: package of 4

Suspensions

needles included

Expiration date

28 days

Must be injected immediately following reconstitution

Byetta (exenatide)

5 mcg, 10 mcg

Pen: 60 doses

Expiration date

30 days

Tanzeum (albiglutide)

30 mg, 50 mg

Pen: package of 4

Suspension

needles included

Expiration date

28 days

Use within 8 hours of reconstitution

Trulicity (dulaglutide)

0.75 mg, 1.5 mg

Package of 4

Auto-injector

Expiration date

14 days

Victoza (liraglutide)

6 mg/mL

3 mL

Packages of 2 and 3

Expiration date

30 days

Amylin Analogue

Symlin (pramlintide)

1000 mcg/mL

60: 1.5 mL pen for 15, 30, 45, & 60mcg doses

120: 2.7 mL pen for 60 & 120 mcg doses

Package of 2

Expiration date

30 days if pen in use

30 days

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