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Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein. You will mix insulin from two bottles (vials). The order in which you mix the cloudy (long-acting) and clear (short or rapid-acting) insulin is important. Follow the order of the steps below. Roll the cloudy insulin bottle until all the white powder has dissolved. Rolling the bottle warms the insulin if you have been keeping the bottle in the refrigerator. Do not shake an insulin bottle. If you are using a bottle for the first time, remove the protective cover from the rubber lid. If the rubber lid of the insulin bottle is dirty, clean it with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry. Remove the plastic cap that covers the needle on your insulin syringe. Important: Do not touch the needle. Pull the plunger back on your insulin syringe and draw air into the syringe equal to the number of units of cloudy insulin to be given. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin. Remove the needle from the bottle. Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given. Push the needle of the syringe into the rubber lid of the clear insulin bottle. Note: You will draw the clear insulin into the syringe first, then the cloudy insulin (Step 8). It is important to follow this order. Push the plunger to force the air into the bottle. Leave the needle in place. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle. Pull back the plunger to fill the syringe with slightly more than the correct number of units of clear insulin to be given. Tap the barrel of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle. Important: Make sure that you have the correct number of units of insulin in your syringe. Remove the needle from the clear insulin bottle. Insert the needle into the rubber lid of the cloudy insulin bottle. Important: Do not push the plunger because this would force clear insulin into your cloudy insulin bottle. If clear insulin is mixed in the bottle of cloudy, it will alter the action of your other doses from that bottle. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle. Slowly pull back the plunger of the syringe to fill the syringe with the correct number of units of cloudy insulin to be given. This will prevent air bubbles entering the syringe. Remove the needle from the bottle. You should now have the total number of units for the clear and cloudy insulin in your syringe. For example, if you need 10 units of clear and 15 units of cloudy, you should have 25 units in your syringe. Now you are ready to give the shot. Current as of: April 30, 2024 Author: Ignite Healthwise, LLC Staff Clinical Review Board This information does not replace the advice of a doctor. Ignite Healthwise, LLC disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. To learn more about Ignite Healthwise, LLC, visit webmdignite.com. © 2024 Ignite Healthwise, LLC.How to prepare a mixed dose of insulin
Roll the cloudy insulin bottle gently between your hands.
Clean the lids of the bottles.
Draw air into the syringe for the cloudy insulin dose.
Force air into the cloudy insulin bottle.
Draw air into the syringe for the clear insulin dose.
Force air into the clear insulin bottle.
Draw clear insulin into the syringe.
Insert the needle into the cloudy insulin bottle.
Draw cloudy insulin into the syringe.
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
