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From a physician in Massachusetts, USA:

My 4 year old grandson has type 1 diabetes. Please advise which of these insulins may be mixed together in the same syringe for his injection, without adversely affecting each other: Humalog, NPH, Ultralente, Regular.


Officially approved by Eli Lilly:

  • You can mix Humalog with NPH or Ultralente in the same syringe.
  • You can mix Regular with NPH or Ultralente in the same syringe
Not "officially approved" but published in studies:
  • Mixing Regular and Humalog together in the same syringe
Officially not recommended
  • Mixing NPH with Ultralente in the same syringe. According to Eli Lilly the phosphate in the NPH theoretically could precipitate the zinc in the Ultralente. From what I have been told, this is a theoretical concern that has never actually been reported, Humalog by the way also has phosphate and has been extensively studied and approved to mix in the same syringe with Ultralente. I have never been able to get a clear explanation from Eli Lilly why mixing NPH and Ultralente should be a problem but not mixing Humalog and Ultralente.

Here is the mixing guidelines in chart form:

Insulin Mixing Guide
Insulin Humalog Regular NPH Lente UltraLente
Humalog   Yes* Yes Yes Yes
Regular Yes*   Yes Yes Yes
NPH Yes Yes   No No
Lente Yes Yes No   Yes
UltraLente Yes Yes No Yes  
* Not officially approved but published in studies.

I personally have many patients mixing Regular, Humalog, Lente, and Ultralente in the same syringe with no problem. I am aware of many physicians who have their patients mix NPH and Ultralente (with Regular or Humalog ) in the same syringe with no problem.

I suggest that patients or parents ask their own doctor what he or she recommends.


Original posting 29 Jun 1999
Posted to Insulin


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Last Updated: Tuesday April 06, 2010 15:09:06
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