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System Formulary Update
Insulin, Short-Acting, Rapid-Acting, and Oral Inhalation

Situation

The short-acting, rapid-acting, and oral inhalation insulin class review and formulary standardization was approved at the March 2022 System Pharmacy and Therapeutics Committee meeting.

Background

The following medications were reviewed: insulin regular, insulin lispro, insulin aspart, insulin glulisine, and insulin oral inhalation

**No changes to Humulin R – 500 units/mL practice at this time**

Assessment/Recommendation

Changes effective: Tuesday June 7, 2022

System P&T voted to include the following products on the UNC Health Medication Formulary:

• Insulin Regular
  • Humulin R – 100 units/mL (3 mL vial)
  • Myxredlin – 1 unit/mL (100 mL bag)
• Insulin Lispro
  • Humalog – 100 units/mL (3 mL vial)
• Patient Insulin Pump
  • 100 units/mL (3 mL)
  • 500 units/mL (3 mL)

Note: Stock of these formulary products may vary at individual entities

As a result, the following products will be removed from the UNC Health Medication Formulary

• Insulin regular
  • Humulin R 100 units/mL vial (10 mL)
  • Novolin R (all sizes)
  • Novolin R ReliOn (all sizes)
• Insulin lispro
  • Humalog vial (10 mL)
  • Humalog pen (all sizes)
  • Lyumjev vial AND pen (all sizes)
  • Admelog vial AND pen (all sizes)
• Insulin aspart
  • Novolog vial AND pen (all sizes)
  • Novolog ReliOn vial AND pen (all sizes)
  • Novolog PenFill cartridge (all sizes)
  • Fiasp vial AND pen (all sizes)
  • Fiasp PenFill cartridge (all sizes)
• Insulin glulisine
  • Apidra vial AND pen (all sizes)
• Insulin oral inhalation
  • Afrezza (all sizes)

Non-formulary orders will be converted according to the following therapeutic interchange:

Use a 1:1 unit conversion when interchanging branded products

Inhaled insulin can be converted to regular or rapid acting insulin using a 1:1 unit conversion