Short answer: The Humulin R U-500 label is only for people who need more than 200 units of insulin a day. It is injected under the skin usually two or three times daily, about 30 minutes before meals, with the dose set individually. The KwikPen dials in 5-unit steps up to 300 units per injection and shows actual units, so no conversion is done. The label has no missed-dose rule.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Humulin R U-500 is approved for: Humulin R U-500 is a concentrated human insulin approved to improve blood sugar control in adults and children with diabetes who need more than 200 units of insulin per day (section 1). Its safety and effectiveness with other insulins or by insulin pump have not been determined (section 1.1).
Source
HUMULIN R U-500 (insulin human) injection, for subcutaneous use, prescribing information, Patient Information and Instructions for Use. Eli Lilly. DailyMed, version published September 2, 2026. DailyMed setid b60e8dd0-1d48-4dc9-87fd-e14675255e8c
Humulin R U-500 is injected under the skin of the thigh, upper arm, abdomen or buttocks, rotating sites within the same area. It is not given into a vein or by insulin pump, and not diluted or mixed with other insulins (sections 2.1 and 5.3).
It comes as a 3 mL KwikPen holding 1,500 units at 500 units/mL (section 3). The pen dials in 5-unit steps and delivers up to 300 units per injection (section 2.3).
Only clear, colorless solution is used, and the insulin label is checked before each injection (section 2.1).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Topic | What the label says |
|---|---|
| Who it is for | Only patients who require more than 200 units of insulin per day |
| How often | Usually two or three times daily |
| When | Approximately 30 minutes before meals |
| Dose | Individualized and titrated by metabolic needs, glucose results and glucose goal |
| KwikPen dose steps | 5 units; maximum 300 units per injection |
| Dose conversion | None; the dose window shows the units to inject |
| Pen | Unopened, room temperature up to 86 F | Unopened, refrigerated | Opened, room temperature up to 86 F | Opened, refrigerated |
|---|---|---|---|---|
| 3 mL KwikPen | 28 days | Until expiration date | 28 days | Do not refrigerate |
At room temperature, a KwikPen can be used for a total of 28 days, counting both unopened and opened time.
Dose changes may be needed with changes in activity, meals, kidney or liver function, other medicines or acute illness.
Any change in insulin regimen is made under close supervision with more frequent glucose checks; for type 2 diabetes, oral diabetes medicines may need adjusting.
Pens are protected from heat and light and not frozen; a pen that has been frozen is not used.
The Humulin R U-500 label gives no missed-dose rule. Neither the prescribing information nor the Patient Information says what to do if a dose is missed.
In Dose Track you set up Humulin R U-500 as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.