Traditional insulin is available in a concentration of 100units/ml and is called U100 insulin. Anything greater then 100units/ml is considered “concentrated” insulin. Humulin R U500 insulin is 5 times more concentrated than U100 insulin. It is used in patients that are insulin resistant usually requiring greater than 200 units of insulin per day. Although Humulin R U500 has been available since 1994, until 2016 it was only available in a vial and needed to be administered with a syringe. It is now available in an insulin pen called the Kwikpen®. To read about uses of U500 insulin in the vial see http://diabetesdailypost.com/learning-about-insulin-from-concentrate-what-is-u-500-insulin/
The vial use was associated with some difficulties for patients and providers alike. There are no insulin syringes made specifically for U500 concentrated insulin. Therefore, a U100 insulin syringe was sometimes used and dosing calculations needed to be done. Alternatively, a tuberculin syringe could be used and the insulin dosed in volume (milliliters). Both options were complicated and there was a very high risk of dosing errors. The availability of a pen eliminates these potential critical errors.
To use the pen, you place a short pen needle on the end of the pen and dial the number of units needed. A needle as short as 4mm in length can be used. This Kwikpen can be injected into the stomach, buttocks, upper legs, and upper arms. It dials in 5unit increments. It can dial up to 300 units per injection. It holds 1500 units of insulin per pen. Be sure to rotate the injection site with each injection. The color of the pen was strategically planned to be aqua-colored in order for it to be easily differentiated from the other insulin pens. The Humulin R U-500 Kwikpen should be taken 30 minutes before eating and stored in a refrigerator until it is used. Once opened, it should be kept at room temperature and used within 28 days.
The KwikPen is a new delivery system for Humulin R U500 insulin that offers an easier and safer option for delivering this concentrated insulin. If you are currently injecting using a vial and syringe or are requiring over 200 units of U100 insulin per day, this may be an option for you. Speak to your healthcare provider if this is something you think may be beneficial for you.
This Article is Brought to you By Our Guest Staff Writers:
Rachelle St.Fleur , PharmD candidate 2017
Jacob Oleck, Pharm.D., Fellow, MCPHS University
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP Professor of Pharmacy Practice, MCPHS University, Boston, MA Clinical Pharmacist, Well Life, Peabody, MA