Humulin R U-500 Dosage

Generic name: Insulin Regular (U-500) Prefilled Pens
Drug class: Insulin

Medically reviewed by  A Ras MD.

Recommended Adult Dosing

Dosage forms:  INJ (U-100 vial): 100 units per mL; INJ (U-500 vial): 500 units per mL; INJ (KwikPen U-500 pen): 500 units per mL

Diabetes mellitus

[SC route, U-100 strength]

Dose: individualize dose SC bid-qid; Info: usual total daily insulin requirement 0.5-1 units/kg/day (basal + prandial); give 30min before meals or per sliding scale; dose adjustment may be needed during pregnancy and/or immediate postpartum; onset 0.5-1h, peak 2-4h, duration 6-12h (short-acting insulin)

[SC route, U-500 strength]

Dose: individualize dose SC bid-qid; Info: for pts requiring >200 units/day; usual total daily insulin requirement 0.5-1 units/kg/day (basal + prandial); give 30min before meals or per sliding scale; dose adjustment may be needed during pregnancy and/or immediate postpartum; onset 0.5-1h, peak 2-4h, duration up to 24h (short to intermediate-acting insulin)

[*IV route, U-100 strength]

Dose: individualize dose IV infusion; Info: refer to institutional protocol; dose adjustment may be needed during pregnancy and/or immed. postpartum; onset 0.25h, peak 0.25-0.5h, duration 0.5-1h (short-acting insulin)

Diabetic ketoacidosis

[U-100 strength]

Dose: 0.1 units/kg/dose IV x1, then 0.1 units/kg/h IV; Alt: 0.14 units/kg/h IV; Info: if blood glucose decrease by <10% in 1st hour, give 0.14 units/kg/dose IV x1, then resume usual dose; when blood glucose 200 mg/dL, decrease dose to 0.02-0.05 units/kg/h IV; maintain blood glucose at 150-200 mg/dL until DKA resolves

*Hyperkalemia

[U-100 strength]

Dose: 10 units IV x1; Info: give w/ D50W

Renal dosing

renal impairment: consider decrease usual dose

HD/PD: consider decrease usual dose; no supplement

Hepatic dosing

[adjust dose amount]

hepatic impairment: decr. dose, amount not defined

Recommended Peds Dosing

Dosage forms:  INJ (U-100 vial): 100 units per mL; INJ (U-500 vial): 500 units per mL; INJ (KwikPen U-500 pen): 500 units per mL

Diabetes mellitus

[SC route, U-100 strength]

Dose: individualize dose SC bid-qid; Info: usual total insulin requirement 0.5-1 units/kg/day; adolescents may require higher doses; give 30min before meals or per sliding scale; onset 0.5-1h, peak 2-4h, duration 6-12h (short-acting insulin)

[SC route, U-500 strength]

Dose: individualize dose SC bid-qid; Info: for pts requiring >200 units/day; usual total insulin requirement 0.5-1 units/kg/day; adolescents may require higher doses; give 30min before meals or per sliding scale; onset 0.5-1h, peak 2-4h, duration up to 24h (short to intermediate-acting insulin)

[*IV route, U-100 strength]

Dose: individualize dose IV infusion; Info: refer to institutional protocol; onset 0.25h, peak 0.25-0.5h, duration 0.5-1h (short-acting insulin)

*Diabetic ketoacidosis

[U-100 strength]

Dose: 0.1 units/kg/h IV; Start: 1-2h after initial fluid tx; Info: give w/ IV potassium; for pts w/ marked insulin sensitivity, may decrease dose to <0.05 units/kg/h IV; add dextrose 5% when blood glucose 250-300 mg/dL or if blood glucose decrease at rate >90 mg/dL/h; maintain blood glucose at 200-250 mg/dL until DKA resolves; start insulin SC injection 1h before D/C insulin IV

Hyperkalemia

[U-100 strength, <1 mo]

Dose: 0.1-0.2 units/kg/h IV; Info: give w/ dextrose; refer to institution protocol

[U-100 strength, 1 mo and older]

Dose: 0.05-0.1 units/kg/h IV; Info: give w/ dextrose; refer to institution protocol

Renal dosing

renal impairment: consider decrease usual dose

HD/PD: consider decrease usual dose; no supplement

Hepatic dosing

[adjust dose amount]

hepatic impairment: decrease dose, amount not defined

SRC: NLM .