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How to Do Insulin Conversions

How to Do Insulin Conversions

How to Convert Insulin Products

There are many reasons why patients may need to switch between insulin products. However, this decision should always be made with the approval of the prescriber. The switch should be closely monitored, including close monitoring on the patient’s part of their blood glucose levels after the switch. In order to safely switch from one insulin product to another, patients need to understand how to do insulin conversions between brands.

NPH to Long-Acting

Long-acting insulins like Levemir and Lantus should not be mixed with other insulins.

NPH to Levemir (Insulin Detemir)

When switching from an NPH to an insulin detemir product like Levemir, conversions should be made unit-per-unit. However, it is possible that some patients on basal-bolus insulin may require more Levemir than NPH. The dose of Levemir should be administered once daily or divided twice daily for additional control.

NPH to Lantus (Insulin Glargine)

Patients receiving NPH once daily should convert unit-per-unit and continue once daily administration. Patients receiving NPH twice daily should switch to once daily administration when on Lantus and reduce the dose by 20 percent.

Long-Acting to NPH

For patients with type 2 diabetes, NPH should be taken at bedtime when combined with other oral antidiabetic medications. Otherwise, NPH should be taken twice daily, either divided 50/50 per administration, or 2/3 in the morning and 1/3 before dinner or at bedtime.

Levemir (Insulin Detemir) to NPH

Convert insulin detemir products like Levemir to NPH unit-per-unit.

Lantus (Insulin Glargine) to NPH

Convert insulin glargine products like Lantus to NPH unit-per-unit.

Long-Acting to Long-Acting

Long-acting insulins like Lantus and Levemir should not be mixed with other insulins. They should be given either once daily, or the dosage should be divided and administered twice daily for control.

Levemir (Insulin Detemir) to Lantus (Insulin Glargine)

Convert insulin detemir products like Levemir to insulin glargine products like Lantus unit-per-unit. A lower daily dose of Lantus may be needed.

Lantus (Insulin Glargine) to Levemir (Insulin Detemir)

Convert insulin glargine products like Lantus to insulin detemir products like Levemir unit-per-unit. A higher daily dose of Lantus may be needed.

Regular to Rapid-Acting

As the name indicates, rapid-acting insulin analog products have a quicker onset of action. However, they have a short duration of action compared to human regular insulin. Rapid-acting insulin products should be taken with a meal or approximately 10 minutes before a meal.

Humulin, Novolin (Regular Human Insulin) to Rapid-Acting Insulin Analog (Novolog [Insulin Aspart], Apidra [Insulin Glulisine], Humalog [Insulin Lispro])

Convert regular human insulin products like Humulin and Novolin to rapid-acting insulin analog products like Novolog, Apidra, and Humalog unit-per-unit.

Rapid-Acting to Regular

When switching from rapid-acting insulin analogs to human regular insulin, there should be more time between when the medication is given and mealtime. Give regular insulin approximately 30 minutes before meals.

Novolog (Insulin Aspart), Apidra (Insulin Glulisine), or Humalog (Insulin Lispro) to Humulin, Novolin (Regular Human Insulin)

Convert rapid-acting insulin analog products like Novolog, Apidra, and Humalog to regular human insulin products like Humulin and Novolin unit-per-unit.

Rapid-Acting to Rapid-Acting

Rapid-acting insulin analogs should be given with meals or approximately 10 minutes before meals.  

Novolog (Insulin Aspart), Apidra (Insulin Glulisine), or Humalog (Insulin Lispro) to Novolog (Insulin Aspart), Apidra (Insulin Glulisine), or Humalog (Insulin Lispro)

Convert rapid-acting analog products like Novolog, Apidra, or Humalog, to other rapid-acting analog products unit-per-unit.

Premixed to Premixed

Premixed insulin analog products have a faster onset of action but a similar duration of action as human premixed insulin products. As such, the time between taking the medication and having a meal differs when switching.

Humulin 70/30, Novolin 70/30 (Premixed NPH/Regular Insulin) to Premixed Protamine/Rapid-Acting Analog (Humalog Mix 75/25 [Insulin Lispro {by suppressing the production of glucose in the liver, Protamine/Insulin Lispro], Novolog Mix 70/30 [Insulin Aspart Protamine/Insulin Aspart])

Convert premixed NPH/regular insulin products like Humulin 70/30, Novolin 70/30 to premixed protamine/rapid-acting analog products like Humalog Mix 75/25 and Novolog Mix 70/30 unit-per-unit. Give premixed insulin analog products with meals or approximately 10 minutes before meals. 

Premixed Protamine/Rapid-Acting Analog (Humalog Mix 75/25 [Insulin Lispro Protamine/Insulin Lispro], Novolog Mix70/30 [Insulin Aspart Protamine/Insulin Aspart]) to Humulin 70/30, Novolin 70/30 (premixed NPH/Regular Insulin)

Convert premixed protamine/rapid-acting analog products like Humalog Mix 75/25 and Novolog Mix 70/30 to premixed NPH/regular insulin products like Humulin 70/30, Novolin 70/30 unit-per-unit. Give human premixed insulin products 30 minutes before meals.

Humulin 50/50 (Premixed NPH/Regular Insulin) to Humalog Mix 50/50 (Insulin Lispro/Insulin Lispro Protamine)

Convert premixed NPH/regular insulin products like Humulin 50/50 to insulin lispro/insulin lispro protamine products like Humalog Mix 50/50 unit-per-unit. Humalog 50/50 should be taken with meals or approximately 10 minutes before meals.


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Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.
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